Topic: Management of Cleft Lip and Palate

Cleft lip and palate (CLP) are the most common facial deformity and the second most common body deformity. They may involve lip only, lip and palate, or palate only. The etiology of CLP may be either environmental (smoking, alcohol, nutrition) or genetic (30% familial occurrence). A large number of specialists are involved in the treatment of CLP: cleft surgeons, speech pathologists, orthodontists, dentists, ENT surgeons, psychologists, and many other specialists.

An ideal protocol, both surgical or orthodontic, has not been identified as of now. However, many randomized clinical trials and long-term retrospective studies have been carried out to improve results while reducing the burden of care.

Treatment starts at birth with psychological support. It is followed sometimes by pre-surgical infant orthopedics. Then surgery (in one, two, or three steps) is carried out. Speech treatment is executed only if needed. Orthodontic treatment is started as late as possible and is guided by functional (ENT, breathing, speech) or occlusal (dental trauma, space required) indications.

The global objective is always to achieve the best possible function and esthetics while trying to keep the burden of care low.

30 May 2022