Cleft Lip and Cleft Palate - Causes | Symptoms | Diagnosis | Treatments
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Cleft Lip and Cleft Palate - Causes, Symptoms, Diagnosis, and Treatments

Published on Feb 27, 2020 and last reviewed on Mar 13, 2023   -  5 min read


Cleft lip and palate is a condition affecting children right from birth and is becoming more common nowadays. Read this article to know the causes, symptoms, diagnosis, and treatment options.

Cleft Lip and Cleft Palate - Causes, Symptoms, Diagnosis, and Treatments

What Is Cleft Lip and Cleft Palate?

Cleft lip is an abnormal opening in the lips and roof of the mouth. It is a common birth defect in children. It can occur on one or both sides depending on the severity. Orofacial clefts include both cleft lip and cleft palate. This condition is often accompanied with other disorders. Recent advances have made both cleft lip and palate completely treatable.


Unilateral complete , Unilateral incomplete , Bilateral complete

  1. Unilateral complete - The slit or the gap extends from the lips to the nose only on one side.

  2. Unilateral incomplete - The slit or the gap extends only upto the lip region only on one side.

  3. Bilateral complete - The slit or gap extends from lip upto to nose on both sides.

What Are the Causes of Cleft Lip and Palate?

What Are the Risk Factors?

  1. Consanguineous marriage.

  2. Risk increases if one of the family members is diagnosed with this condition.

  3. Women who conceive in the later years tend to have more risk.

  4. Exposure to radiation.

  5. It is common in Asian and American children.

  6. Mongoloids have high reported cases of this condition.

  7. Boys are more frequently affected than girls.

How Does It Look Like?

child is born with cleft

Every two minutes, a child is born with cleft somewhere in the world.

What Are the Problems Faced by the Baby?

  1. Swallowing problems.

  2. Breathing problems.

  3. Difficulty in speech.

  4. Difficulty in hearing.

  5. Ear infections.

  6. Dental problems.

    1. Gum and bones surrounding the teeth may be affected.

    2. Higher risk of tooth decay.

    3. Missing or displaced tooth which might require orthodontic treatment (braces).

  7. Imbalance in social and emotional states.

  8. Malnutrition (deficient nutrient supply).

  9. Memory problems.

  10. Attention deficit.

How Is It Diagnosed?

Before birth, it can be identified using ultrasound imaging. It is a very helpful non-invasive diagnostic tool.

After birth, it can be identified using physical examination of the mouth, nose, and palate. It is usually done within 72 hours of birth.

What Is the Treatment?

The treatment for cleft lip and palate requires a multidisciplinary approach.

1) Surgical Treatment:

With proper surgical techniques, the lip, nose, and facial structures can be restored. This will thereby promote normal functioning. The repair of cleft lip is done by a surgical procedure called cheiloplasty.

A rule of 10 has to be followed for the surgery to be more successful. The child who is undergoing surgery:

  • should be at least 10 weeks of age.

  • should be at least 10 pounds of weight.

  • should have a hemoglobin (Hb) value of about 10 gm/dL.

2) Non-Surgical Treatment:

For patients who have high risk involved in surgery and those who are not willing for surgery, dental obturator is the treatment of choice. It can be used in the sites of deficient tissues. The main advantage of an obturator is high degree of closure. One of its notable disadvantages is the irritation of oral mucosa.


  1. Hearing - Most of the children with cleft lip and palate suffer from hearing disabilities. Children can be given appropriate hearing aids. An audiologist will help to assess and monitor hearing. Otolaryngologists also play a vital role.

  2. Speaking - Children will need help from speech-language pathologists and occupational therapists to conduct speech therapies. It is highly effective and will help the children to speak normally.

  3. Eating - Feeding and growth of the child will be a primary concern for the parents. Infants will not be able to breastfeed like others. Feeding tubes and specialized bottles will be required to feed the infant. Draining of oral fluids in the nasal cavity should be done to enable better feeding.

  4. Nasality - Velopharyngeal insufficiency is the inability of the soft palate to close while speaking. It can cause hypernasality (increased nasal resonance), hyponasality (reduced nasal resonance), or both, which is known as mixed nasal resonance.

  5. Psychological factors - Having a kid with this condition is a great psychological disturbance for the parents. As these parents are generally under constant stress, they are given psychological counseling. In case the child is suffering from inferiority complex, it is advisable for the child to undergo psychotherapy.

  6. Dental problems - This might require the help of pediatric dentist, prosthodontist, and orthodontist.

a. Prosthodontic care - Prosthodontists help in designing a feeding obturator. It is also known as a speech bulb. This prosthesis will help the patient to close the separation between oral and nasal cavity. It helps in proper development of jaws. It helps to reduce nasal regurgitation (food and liquids coming out through the nose). It reduces choking. In case of a missing tooth, it can be replaced with fixed partial dentures, complete dentures or dental implants in the later stages. The prosthodontist formulates the treatment plan with plastic surgeons.

b. Orthodontic care - Orthodontists help to regulate the growth of facial structures and monitors the jaw development.

How Can You Prevent It?

There is no exact way to prevent cleft lip and palate. But, intake of Folic acid by the mother during pregnancy might help. Carrying mothers should strictly avoid cigarettes and alcohol. Vitamin supplements should be taken by the mother.


If the treatment is a well-planned teamwork by general dentists, plastic surgeons, oral and maxillofacial surgeons, orthodontists, psychologists, occupational therapists, geneticist, etc., then the rate of prognosis is definitely high. Ideal surgical methods can help in restoring all the vital functions along with minimal scarring. Children who are over 8 years of age might require bone grafting.

The treatment of cleft lip and palate would require highly skilled professionals. For more information, consult a doctor online.

Frequently Asked Questions


How Is Cleft Palate Treated?

Palate repair surgery is the treatment for cleft palate. This surgery is done when the baby is six to twelve months old. The gap between the roof of the mouth is closed and rearranged using dissolvable stitches.


What Medicines Can Lead to Cleft Palate?

The use of certain medicines during pregnancy can also lead to cleft palate. Medicines like Topiramate or Valproic acid during the first trimester (first three months) have a higher chance of causing cleft palate in children.


When Can the Cleft Lip Be Diagnosed?

A cleft lip can be diagnosed by doing an ultrasound scan. The ultrasound scan between 18 and 21 weeks of pregnancy can help detect the cleft. However, it is very difficult to identify the cleft in these scans, but after birth, it can be easily identified on clinical examination.


What Is the Most Common Problem With Cleft Lip and Palate?

One of the most common problems with children with cleft palate and cleft lip is feeding problems. They cannot breastfeed, which can lead to other growth-related issues. Moreover, there can be problems with hearing, ear infections, and speaking.


What Bones Lead to the Cleft Palate?

The cleft palate occurs due to the incomplete union of multiple bones of the face, which may include hard and soft palate. During the development, the opening between the palatine processes of the right and left maxillary bones and sometimes the nasal septum can lead to a cleft palate.


What Is the Treatment for Cleft Lip?

The treatment for cleft lip is the same as that of cleft palate, with surgery only. The surgery can be performed as early as three to six months of age. However, other treatments, such as speech therapy and dental care, may also be needed along with surgery.


How Are Cleft Lips Fixed?

The cleft lip is corrected by the surgeon using a rotation advancement repair. In this surgery, an incision is made on each side of the cleft from the lip to the nostril, and both sides are sutured together.


What Vitamin Deficiency Can Lead to a Cleft Palate?

A deficiency of vitamin B and folic acid is considered one of the causes of cleft lip and palate. Females who do not take these vitamins during their maternal stage are at a higher risk that their children will get affected with cleft lip and palate. The risk may be higher in parents who are older than usual at the time of birth of their baby.


What Is the Name of Cleft Palate Surgery?

Cleft palate surgery is called palatoplasty. This is performed when the child is 10 to 12 months old. This surgery aims to close the gap between the nose and mouth.


How to Feed a Baby With a Cleft Lip?

Most babies born with cleft lips and without cleft palate can be fed well without special equipment. The child with cleft lip can be breastfed or use a regular bottle-feeding system. However, the only thing that might be needed might be positioning the nipple in the mouth of the baby to form a seal.

Article Resources

Last reviewed at:
13 Mar 2023  -  5 min read




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