How to care for your child’s cleft

Clefts aren’t just an issue for infants. When clefts aren’t handled carefully, dental structure and speech can be affected all the way into adulthood. But with attentive care and treatment, your child can overcome the condition and thrive.  

What is a cleft?

Clefts occur when the lips or roof of the mouth (the palate) don’t join during development in the womb. A birth defect that affects more than 4,400 babies in the United States each year, according to the Centers for Disease Control and Prevention, clefts leave an opening in the lip or palate that can lead to speech and dental issues. While cleft palate is less noticeable than cleft lip, it can cause more serious dental problems because it affects the positioning, shape and number of teeth a child develops.

How do clefts affect your child’s development?

Since clefts alter the shape of a baby’s mouth, your child’s development may prove more difficult than in babies without clefts. In particular, clefts often lead to issues with:

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  • Breastfeeding. If the palate or lip opening is especially large, babies may have problems latching.

  • Cavities. Children with cleft palates are more likely to have narrow dental arches, which means teeth have less space to grow and are often crowded together. This can make it difficult to reach all tooth surfaces when brushing. Plus, babies with clefts could be more prone to excess cavity-causing bacteria, according to recent evidence that suggests a connection between clefts and salivary gland issues.

  • Dental development. Your child may require oral surgery or orthodontic treatments if the cleft affects the size, shape, positioning or number of teeth.

  • Speech. Children with clefts commonly experience language or speech delays due to the shape of their oral cavities.  

How are clefts treated?

Successful treatment of cleft lip and cleft palate does more than modify your child’s facial appearance. It also improves speech and language development, the ability to eat and speak and the structure of the oral cavity and teeth. When treated successfully, children can go on to live healthy lives.

Surgery to close and repair clefts is typically performed before a child’s first birthday, with follow-up surgeries to improve speech and overall appearance performed after age two and through adolescence. Treatment may require a team of experts, including surgeons; dentists; ear, nose and throat doctors; speech therapists and other medical professionals.

The extent of your child’s treatment typically depends on the severity and size of the cleft and if any complications arise during initial surgery. As your child develops, additional treatments, including the following, may be necessary:

• Speech therapy improves communication and sound techniques.

• Crowns and bridges restore missing or misshapen teeth.

• Braces and other orthodontic care realign teeth.

• Orthopedic appliances correct jaw growth.

• Oral prosthesis reconstructs the oral cavity.

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What’s the best way to clean and care for clefts?

Like other children, kids born with clefts require proper dental hygiene. But when a child has a cleft, it may be more difficult. As soon as your child’s teeth appear, use a small, soft-bristled toothbrush and water to clean the teeth. But if the shape of your child’s mouth or teeth is more challenging to clean, try a toothette, which is a soft sponge with mouthwash used to gently swab teeth.

Also, be sure to visit a dentist by your child’s first birthday. If possible, try finding a professional familiar with missing, misaligned or ill-formed teeth due to clefts. Ask if your family dentist has experience with clefts, or try reaching out to organizations like the American Cleft-Palate Craniofacial Association to find an experienced dental professional.

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