By: Sonya Chitra Subash
What is a cleft lip and palate? Most commonly signified by a ‘harelip’, or slight gaping holes in the roof of the mouth, cleft lip and palate is a benign genetic birth defect affecting approximately one in every seven hundred children born in accordance to the Cleft Lip and Palate Association. Asians are the most affected, while African- Americans are least affected. Research being conducted by the Cleft Lip and Palate Association is still in progress to understand the main underlying reasons. For the births occurring in developed countries, a simple set of procedures is enough to fix this nonfatal defect. However, in developing countries, a child born with such a minor disfigurement is subjected to life as an outcast without proper treatment. They are shunned from the community, subjected to taunting, rejected for job opportunities, abandoned by family members, subjected to witchcraft rituals, and sometimes attacked and killed.
How does this defect occur? Sometimes during embryonic development, the upper lip and the roof of the mouth do not fuse properly. This typically happens during the first six to ten weeks of gestation. The physical severity of this birth defect can range from a minuscule to notch in the upper lip to a large groove. The severity of the physical deformity can also lead to complications with the ears, nose, and mouth. Ear infections will occur more often (due to the inability of the muscles of the palate to open the Eustachian tubes that allow for the middle air to drain, causing a rapid collection of fluid), and speech pathologists are often needed to help the child with speech development.
What is the treatment? The treatment to cure and better the quality of life is simple. Surgery to close the lip and palate together is not life threatening, and oral maxillofacial surgeons provide surgeries to fix this.
One surgical technique used is ‘bone grafting’. A small portion of bone is extracted from the patient’s hip, ribs, leg, or head and is placed in the cleft area (the bone protected by the upper lip) to introduce great support for un-erupted teeth that will grow as the child’s mouth develops after the surgery. This is usually most effective if the patient is five to six years old during the treatment. The added bone will make the gum appear more natural, and help increase the strength of the pre-maxilla (the front part of the roof of the mouth).
Older people affected have a lesser chance of having a perfectly symmetrical gum, but dentists can perform procedures using prosthetic teeth. Metallic dental bone implants are also used-the proper treatment will vary per patient. However, the cost of these procedures can be expensive, especially for those afflicted in developing countries where resources are scarce.
How can I help? There are many specialists in the US available for help with cleft palate reconstruction, and many organizations that travel to developing countries are available to aid. One organization, Operation Smile does humanitarian work with volunteers and dental specialists every year. Mission trips continually leave from the US, and anyone can help in some way. Smile Train, another organization, is in constant need of donations to keep funding its mission trips as well. We often underestimate, or don’t necessarily think about, the value of a smile. In developing countries it is worth more than it is here in the US, and volunteers are always needed to help aid these missions.
Information regarding sources and organizations in this article can be found at the following websites:
Cleft Lip and Palate Association: http://www.clapa.com/
Operation Smile: http://www.operationsmile.org/
Smile Train: http://www.smiletrain.org/