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Craniofacial Orthodontics

Craniofacial Orthodontics – Cleft Lip and Palate

What is Craniofacial Orthodontics?

Craniofacial orthodontics is a sub-specialty of orthodontics that focuses on the treatment of patients with congeital abnormalities such as cleft lip and palate. Dr. Whatleey will work with a team comprised of speech pathologists, oral surgeons, and craniofacial plastic surgeons and other specialists in planning treatment.  As a member of a craniofacial team, Dr. Whatleey evaluates tooth and jaw development and growth. He takes care of the non-surgical treatment of the position of the jaws, and is also responsible for the pre- and post-operative treatment of jaw surgery, monitoring growth by means of X-rays and models.

What is a Cleft Lip and Palate?

Cleft lip and cleft palate are facial malformations in which the parts of the face that form the upper lip and mouth remain split, instead of sealing together before birth. Similar splits can occur in the roof of the mouth, or palate. Clefting results when there is not enough tissue in the mouth or lip area, and the tissue that is available does not join together properly. While the defect occurs in early fetal development, in most cases, the cause is unknown.

While there are certainly aesthetic considerations associated with cleft lip and palate, having this abnormality can affect people in many more serious ways.

  • Difficulty Eating – When there is a separation or opening in the palate, food and liquids can pass from the mouth back through the nose. While waiting for surgery, patients can use specially designed prosthetics to help keep fluids flowing downward towards the stomach, ensuring that they receive adequate nutrition.
  • Speech Difficulties – Because the upper lip and palate are not properly formed, it may be difficult for children to speak clearly, and when they do, it may produce a nasal sound. As speech may be hard to understand, a speech pathologist may be used to resolve these issues.
  • Ear Infections – Cleft lip and palate can lead to a buildup of fluid in the middle ear, leaving children at a higher risk for ear infections, and if not properly treated, even deafness. To prevent infections, small tubes may be placed in the eardrums to facilitate fluid drainage.
  • Dental Problems – Children who suffer from cleft lip and palate also often have missing, malformed, or displaced teeth, leading to a higher number of cavities and other dental and orthodontic issues.

Treatment

The treatment for cleft lip and palate occurs at intermittent stages throughout the growth process of the child.  When a baby is born with a Cleft Palate, our team coordinator typically goes to the birthing center to assist parents with feeding concerns.  At that time it will be assessed if the child is a candidate for an oral appliance to assist in bringing the cleft segments together prior to repairing the palate and lip.  Bringing the segments together can reduce the need for large grafting and improve long-term success of the repair.  After the initial repairs, the child is followed periodically by the team to assess speech and hearing development.  Orthodontics and surgical revisions are based upon growth and recommendations are made by the team as they are necessary.

Please do not hesitate to contact us to schedule an evaluation to discuss your individual concerns. 

 

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