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Oral-Facial Clefts

(Cleft Lip; Cleft Palate)

Definition

An oral-facial cleft is a birth defect. The lip or the roof of the mouth does not form the usual way. The defect may be a cleft lip, a cleft palate, or both. A cleft lip is a gap in the upper lip, often just below the nose. A cleft palate is a gap in the roof of the mouth or in the soft tissue at the back of the mouth. In most people, a cleft lip and cleft palate happen together.

Baby With Cleft Lip
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Causes

Early in pregnancy, all babies have an opening in the lip and palate. As the baby grows, these openings should slowly grow together. By birth, they should be closed. For some reason, these openings do not close in some children. It may be due to a mix of genes and the environment.

Risk Factors

This problem is more common in females. A cleft lip with or without a cleft palate is more common in males.

Other things that may raise the risk are:

  • Other birth defects
  • A sibling, parent, or other close family member born with an oral-facial cleft

Things in the mother during pregnancy that may raise the risk are:

  • Taking certain medicines, such as antiseizure drugs, thalidomide, or retinoic acid
  • Smoking
  • Drinking alcohol
  • Having diabetes
  • Being around toxins, such as heavy metals

Symptoms

The main symptom is an opening in the lip or palate.

Problems that can happen from this are:

  • Feeding problems, especially with cleft palate
  • Problems speaking
  • Hearing problems
  • Weight loss

Diagnosis

Your doctor may be able to see a cleft lip before birth. It may be seen during a prenatal ultrasound. A cleft lip can be seen as early as 18 weeks into pregnancy. Cleft palate may be harder to see before birth because it is inside the mouth.

Cleft lip or cleft palate can be diagnosed by looking at the newborn baby. A newborn with an oral-facial cleft may be referred to a team of specialists soon after birth. Rarely, a mild cleft palate may go undiagnosed for several months or even years.

Treatment

A dental plate may be given. It is placed in the roof of the mouth. It can make it easier to eat and drink until surgery is done.

The goal of treatment is to close the gap in the lip and palate. This is done with surgery. Other surgeries may also be done to correct related problems.

Prevention

Women may be able to lower the risk of this problem in their babies by taking a multivitamin before and during pregnancy.

RESOURCES:

Children's Craniofacial Association
https://ccakids.org

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Women's Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

Cleft lip and palate. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cleft-lip-and-palate. Accessed December 4, 2020.

Cleft palate with cleft lip. Kid's Health—Nemours Foundation website. Available at: https://kidshealth.org/en/parents/cleft-palate-cleft-lip.html?ref=search. Accessed December 4, 2020.

Dixon MJ, Marazita ML, et al. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet. 2011 Mar;12(3):167-178.

Facts about cleft lip and cleft palate. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/birthdefects/CleftLip.html. Accessed December 4, 2020.

Last reviewed December 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC  Last Updated: 6/2/2021