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Cleft lip and cleft palate are conditions which usually occur when tissues that form the lip or the roof of the mouth fail to grow together, creating a gap in the lip or a hole in the roof of the mouth. The reasons for this are not entirely known, but the condition is among the most common problems noted at birth - it occurs once in every 1000 live births (the same frequency as club foot). A recent study  indicates that smoking during pregnancy may double the risk that the child will be born with a cleft lip or palate. Since it frequently this occurs, almost everyone knows someone who has a cleft lip or cleft palate.

The repaired cleft lip may be noticed in the adult as an uneven upper lip and a scar which runs from the nose down through the upper lip. Persons with a repaired cleft palate may have a nasal quality to their speech. This can occur because there is a shortage of tissue in the roof of the mouth after the repair in some cases and sounds can accidentally leak out the nose when certain words are spoken. In most cases following reconstructive surgery the patient can expect to live a normal life and hopefully the cleft condition should not stand in the way of any dreams or aspirations.

Treatment of Cleft Lip and Palate
The cleft lip is usually repaired at about age 3 months. The cleft palate is usually fixed at about one year of age, though this may vary based on the size of the cleft itself. Usually the patients remain in the hospital for one or two nights and sutures in the lip are taken out in about 5 days. Sutures in the palate do not need to be taken out because they are made of a material which will dissolve.

Most patients will need long term care by an organized followup cleft team so the full range of dental and speech therapy services can be provided as the child grows. Children with cleft palate which have been repaired will need to have their speech followed very closely and they will frequently need to work on special drills to improve their speech. Almost all children with cleft lip or cleft palate will need the services of several dentists as they grow up. A pediatric dentist, an orthodontist, and a prosthedontist all may be necessary to allow the patient to have a complete set of teeth which are positioned properly for the patient’s life.

This brief overview of the care and treatment of cleft lip and palate reflects the current philosophy of the craniofacial team at the University of Iowa. Many of the feelings about how this condition should be treated are controversial - however, almost everyone would agree that the best long-term results are consistently seen in patients who are treated by an organized, accredited team specializing in cleft care. The team at the University of Iowa is accredited by the American Cleft Palate and Craniofacial Association to provide the full range of care necessary to handle problems which may arise in patients who are born with clefts.