Last updated September 26, 2023
In this issue, dentists will discuss cleft lip and palate, how to treat it cleanly, and frequently asked questions.
Written by dentist/issy
After graduating from the National School of Dentistry, he trained at the Tokyo Medical and Dental University Dental Hospital, and is currently working in general and orthodontic dentistry.
Member of the Japanese Society of Oral Implantology
What is cleft lip and palate? Basic knowledge of causes, types, incidence, etc.
What is cleft lip and palate?
A cleft lip and palate is a cleft lip or cleft maxilla. In some cases, the cleft may extend to the face, and both occur as congenital abnormalities.
Although it is believed to be caused by genetic abnormalities and external stresses in early pregnancy,Most of the causes are unknown.It is. In Japan, it is estimated to occur in one out of every 500 people.
Cleft lip and palate as one symptom of a syndrome or as an isolated symptom outside of a syndromeThere is aThe latter is more than a majority as a percentageThe following is a list of the most common problems with the
Cleft lip and palate is a relatively common congenital disorder.
What is the problem with a cleft lip and palate?
(1) Insufficient growth of the jawbone
Cleft lip and palate inhibits the normal growth of the jawbone. The stunted growth results in a smaller jawbone.
(2) Teeth will not be aligned properly.
With cleft lip and palate, congenital defects and abnormal tooth morphology occur more frequently than normal. This can result in misaligned teeth.
(iii) Language and eating disorders
With cleft lip and palate, air leaks from the cleft, often resulting in speech difficulties. For the same reason, feeding and swallowing difficulties may also occur.
(4) Easy to catch a cold
A cleft lip and palate can cause dryness of the oral cavity, making the child more susceptible to catching colds. A cleft palate is also susceptible to sinusitis and otitis media because of its traffic with the nasal cavity.
Cleft lip and palate treatment and timing of surgery
Cleft lip treatment and timing of surgery
Initial cleft lip surgery is generallyAround 3 months of age, when the child weighs about 6 kg.This is done in the Since cleft lip is a disease of the visible area from the outside, the appearance of the cleft lip is first improved by performing the procedure early. In newborns, the wound healing ability is very high and the cartilage is soft, making it easy to modify the nasal cartilage.
Cleft Palate Treatment and Surgery Timing
The initial surgery for cleft palate should not interfere with the development of language function and various other oral functions.About 1 to 1.5 years oldThis is often done in
Taking into account the growth of the maxilla, the soft palate is first closed at about 1 to 1.5 years of age, and the second surgery is performed after that to close the hard palate.The two-time method is often used.It is. The presence of a cleft in the palate results in a variety of dysfunctions, so as it growsA device called a HOTZ floor, which covers the cleft palate, is used from relatively early on.The HOTZ floor will be used until the cleft palate surgery is completed.
How to follow and care for cleft lip and palate after surgery
How to care for scars and prevent infection after surgery
(1) After cleft lip surgery
After cleft lip surgery,Tube feeding for a few daysThe baby will then be fed with a cleft palate bottle if a cleft palate is present. The baby is then fed with a cleft palate bottle if a cleft palate is present, or with a normal bottle if no cleft palate is present. The scar, like other surgeries, will show inflammatory findings such as redness and swelling due to infection,In most cases, infants settle quickly because of their high wound-healing capacity.
If the inflammatory findings are strong, antibiotics are used. The cleft lip surgery wound is visible on the surface,The probability of making the wound less noticeable is increased by not touching it unnecessarily and by applying tape or cream to help the wound heal.
(2) After cleft palate surgery
After cleft palate surgery, a device is placed on the jaw to protect the palate.The device will be used for about a week, during which time the patient will be tube-fed.This is often the case. After the device is removed, the patient begins to eat foods that do not require biting, such as porridge.After about a month, eating is possible as usualto be. Because cleft palate surgery also affects the soft palate, what is ingested through the mouth may, on rare occasions, come out through the nose, but this settles down as the patient gets used to it.
Rehabilitation methods for eating, pronunciation, etc.
In cleft lip and palate, functional problems include feeding and speech disorders. These are especially problematic due to nasopharyngeal obstruction. Nasopharyngeal closure is the function of the soft palate to prevent air and food from going toward the nasal cavity by covering it. In cleft lip and palate, this function is impaired, but is most often restored by surgery.
Cleft Palate.Once the surgery is completed, about a month later, training with a speech therapist in a playful manner to acquire nasopharyngeal closure function.If there is no improvement in nasopharyngeal closure function after 4 years of age,Use of an assistive device called a speech aidThe patients are trained to eat as much as they can. The patient will be trained to eat as much as possible, and will gradually be trained to eat regular meals in cooperation with a dietician.
orthodontic treatment
Cleft lip and palate often results in dental malposition due to undergrowth of the jawbone, insufficient number of teeth, and abnormal morphology. If dental malposition occurs,Orthodontic treatment from about 6 to 7 years of age, and if abnormalities in jawbone growth are observed, orthodontic treatment until about the end of puberty.is often followed by Surgical orthodontic treatment or jawbone grafting may be used in conjunction with orthodontic treatment if necessary.
Frequently asked questions and answers about cleft lip and palate
Is cleft lip and palate inherited?
There was a time when cleft lip and palate was thought to be a hereditary disease,Currently, there is no evidence to indicate that the disease is hereditary, and it is believed to be caused by various environmental factors.
4-2. can cleft lip and palate be prevented?
Unfortunately, there is no way to prevent cleft lip and palate 100%. If pressed, it is important to have a healthy pregnancy, including diet.
4-3. is cleft lip and palate covered by insurance?
Cleft lip and palate is basically everything, including orthodontic treatment.Health insurance will be applied........ However, because it is only applicable at designated medical facilities for cleft lip and palate,It is also important to remember that not all medical facilities are covered by health insurance.
4-4. What if I am concerned about the scar from cleft lip and palate surgery?
The treatment of cleft lip and palate is a disease that inevitably requires surgery. Although medical advances have made the wounds less noticeable, they are not completely invisible.If you are really concerned about the scar, we recommend that you consult a plastic surgeon.
Summary and advice from dentists
Cleft lip and palate is a relatively frequent congenital condition. If your child has a cleft lip and palate, there is no need to be pessimistic, as there is now a well-coordinated, multidisciplinary treatment system in place, and most cases are cured successfully. First, make sure to visit a hospital with a well-developed treatment system.
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