Cleft lip and palate is purely a developmental defect seen in new born kids, when the different parts of the face which join together to form the lips & the jaws, do not fuse completely.
The care & treatment of such kids involves the expertise of many specialists, for a long period of time. The one who is at the centre of all the action & plays a key role in coordinating the treatment needed at a particular stage of life, is the Orthodontist.
The orthodontist, along with the paediatrician is one of the first to be notified when a cleft child is born. The orthodontist does not treat all the problems faced by the cleft children, but he/she is trained to recognise all the problems with cleft children and refer them to the respective departments they are to be treated in.
The treatment involved depends on the stage of dental and jaw development at a particular age.
Immediately after birth till 3-4 months
Detailed counselling of the parents regarding the care of the cleft child, is done
Fabrication of the FEEDING PLATE for easy intake of milk and preventing further widening of the cleft of the palate.
Infant orthopedic device helps mold the upper jaw to suitably position it in preparation of the lip surgery .Monitoring the development of the cleft jaw margins for the improvement of the alignment of the nose , lip and palate is vital for a better lip surgery at 3-4 months of age.
From the First year till the Sixth year
Preventing the Dental Decay with oral care regimes supplemented with fluorides and oral care therapeutics. Cleft children always shows different kinds of problems once they start growing and must be brought to the treatment stream as soon as possible.
Cleft care at Six to Eight years of age
At around 6 years of age, braces are put on the child’s teeth and orthodontic treatment is carried out for aligning the arches. As the arches are aligned, the cleft area is seen to increase in size. The gap thus created in the upper arch is later bridged using natural or artificial bone (Alveolar Bone Graft) during a surgical procedure done after the dental arches have been suitably expanded, around the 6-8 years of life. The purpose is to facilitate a stable bone graft in the cleft alveolus.
prepared for graft surgery
after graft surgery
The bone grating serves a threefold purpose.
It ensures the proper descent of the maxillary lateral incisors and the canines in the cleft segments.
It gives bulk to the cleft region of the face
It provides support to the nose and upper lip on the cleft side of the upper jaw.
Cleft care at 12 to 14 yrs of age
Orthodontic alignment of the upper and lower arches in this age group is essential for the proper growth stimulation of the cleft maxilla, and coordianting the upper and lower dentition for a prper occlusion and pleasant esthetics
Around 15-16 years of age, the orthodontist will again prepare the patient for doing corrective surgery of the jaws to give a near normal appearance. This requires careful planning by the orthodontist and the surgeon.
The orthodontist should be in constant touch with the patients or parents to give best treatment possible in order to improve the quality of life of the patient.
Cleft care in Adults
Orthodontist can help the adult cleft patients, who desire better esthetics and proper bite with the realignment of the teeth and the jaw positions for,
Preparation of the arches for a residual lip and nose corrective surgeries.
Preparation of the Implant sites in cases of missing lateral incisors and canines.
Orthodontic preparation of the jaws for the planning to correct the jaws with the option of Surgical orthodontics, which is planned with the Maxillo- Facial Surgeons.