Cleft Lip & Palate

Cleft means split or separation of parts.  During early pregnancy separate areas of the face develop individually and then join together.  If some parts do not join properly the result is a cleft.  The type and severity of clefts vary from child to child.

A completely formed lip is important not only for a normal facial appearance, but also for sucking and to form certain sounds made during speech.  A cleft lip is a condition that creates an opening in the upper lip between the mouth and nose.  It looks as though there is a split in the lip.  It can range from a slight notch in the colored portion of the lip to complete separation in one or both sides of the lip extending up and into the nose.  A cleft on one side is called a unilateral cleft. If a cleft occurs on both sides, it is called a bilateral cleft.  A cleft in the gum may occur in association with a cleft lip.  This may range from a small notch in the gum to a complete division of the gum into separate parts.

What is a Cleft Palate?

The palate is the roof of your mouth. It is made of bone and muscle and is covered by a thin, wet skin that forms the red covering inside the mouth.  You can feel your own palate by running your tongue over the top of your mouth.  Its purpose is to separate your nose from your mouth.  The palate has an extremely important role during speech because when you talk, it prevents air from blowing out of your nose instead of your mouth.  The palate is also very important when eating.  It prevents food and liquids from going up into the nose.

As in cleft lip, a cleft palate occurs in early pregnancy when separate areas of the face have developed individually do not join together properly. A cleft palate occurs when there is an opening in the roof of the mouth.  The back of the palate is called the soft palate and the front is known as the hard palate.  A cleft palate can range from just an opening at the back of the soft palate to a nearly complete separation of the roof of the mouth (soft and hard palate).  Sometimes a baby with a cleft palate may have a small chin and a few babies with this combination may have difficulties with breathing easily.  This condition may be called Pierre Robin sequence.

Drs. Drs. Zajkowski, MacCarthy, Jacobsen or Lawler , Zajkowski , MacCarthy , and Jacobsen are all on the Cleft Palate Team at Maine Medical Center.  The team meets monthly, and is composed of plastic surgeons, speech therapists, social workers, geneticists, orthodontists, prosthodontists, pediatric dentists, and oral and maxillofacial surgeons.  As oral surgeons we care for the child with clefts multiple times as they grow.   We will close the hole from the mouth to the nose around age 8.  We then can later perform jaw surgery in the late teenage years.  Lastly, when the patient has finished growing we can place dental implants to help replace missing teeth.