Lip and Palate

Lip and Palate - What it is

A 'cleft' is a gap, which can occur in the lip or palate (roof of the mouth) or both. The cleft lip may be as minor as a notch in the upper lip or as extensive as a wide fissure extending through the lip and gum (alveolar ridge) into the nose. The cleft may occur on one side of the lip (unilateral cleft lip) or on both sides of the lip (bilateral cleft lip). A cleft palate may occur in combination with a unilateral or bilateral cleft of the lip or it may occur with a completely normal lip.

Lip and Palate - Causes and Risk Factors

Clefts arise when the lip and mouth do not fuse properly in the second and third months of pregnancy. While many possible causes of clefts are being investigated, no single cause has been identified. The majority of clefts may be due to a combination of inherited factors (genes) interacting with certain environmental factors. Clefts run in families to some extent. If one parent or child in a family has a cleft, the chances of a subsequent child being born with a cleft increases from the usual 1 in 500 to approximately 1 in 20. Parents in such situations should meet with a geneticist to find out the approximate risk of having another baby with a cleft.

Children with cleft lip and palate have special concerns related to their teeth and jaws. Most have special dental problems. A cleft may involve the alveolar ridge (bone with teeth growing inside). Since the area of the cleft has no bone, there may be one or more teeth missing, the teeth may be defective in their shape or surface (enamel), or they may erupt into an abnormal position (rotated, tilted etc.) There may even be extra teeth. The teeth most commonly affected are the upper incisors and canines on the side of the cleft.

Lip and Palate - Treatments

Treatment goals are to improve the child's ability to eat, speak and hear normally and to achieve a normal facial appearance.

Treatment of these associated dental and jaw conditions are best carried out by a team of specialists. In NDCS, we have a cleft clinic and the specialists include:

Pedodontists (who specialize in the care of children's teeth)
Orthodontists (who specialize in braces for tooth movement and the orthopedic movement of the jaws)
Oral Maxillofacial Surgeons (who perform surgery in the mouth and jaws)
Prosthodontists (who make artificial teeth or mask short or poorly formed teeth).

We will also work closely with specialists from Singapore General Hospital (SGH) and KK Women’s and Children’s Hospital (KKH)