July is National Cleft and Craniofacial Awareness and Prevention Month and Pi Dental Center is educating the public about these birth defects.
Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy.
The lips form between the fourth and seventh weeks of pregnancy. Body tissue and special cells from each side of the head grow toward the center of the face and join together to make the face, as the baby develops during pregnancy, forming the facial features. If the tissue that makes up the lip does not join completely before birth, a cleft lip occurs, resulting in an opening in the upper lip. This opening can be a small slit or a large opening that goes through the lip into the nose. A cleft lip can be on one or both sides of the lip, or in rare cases, the middle of the lip. Children with a cleft lip also can have a cleft palate.
Between the sixth and ninth weeks of pregnancy, the roof of the mouth is formed. A cleft palate occurs if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. In some babies, both the front and back parts of the palate are open. For others, only part of the palate is open.
Cleft lips and palates can cause problems with feeding and speaking clearly. Dental problems, frequent ear infections, and hearing problems are also common.
The fourth most common birth defect in the U.S., cleft lips affect one in 700 babies annually. Clefts occur more often in children of Asian, Latino, or Native American descent. Twice as many boys than girls have a cleft lip. But, twice as many girls have cleft palate without a cleft lip.
While most scientists believe clefts are due to a combination of genetic and environmental factors, the actual cause of orofacial clefts is unknown. The CDC recently reported findings from research studies about factors that increase the chance of having a baby with these birth defects. They include women who smoke during pregnancy, women who have been diagnosed with diabetes prior to pregnancy, and women who used certain medicines to treat epilepsy during the first three months of pregnancy, such as topiramate or valproic acid. Other medications that can increase risk include anti-seizure/anticonvulsant drugs, acne drugs containing Accutane, and methotrexate, a drug commonly used for treating cancer, arthritis, and psoriasis.
The prosthodontists at Pi Dental Center recommend a coordinated approach to care for patients with orofacial clefts by a team that consists of experienced dental professionals, qualified physicians and health care providers from several different specialties.
Here are some of the specialists that the team includes:
- a plastic surgeon
- a prosthodontist
- an oral-maxillofacial surgeon
- a craniofacial surgeon
- a neurosurgeon
- a pediatric dentist
- an orthodontist
- a speech-language pathologist
- an audiologist
- a geneticist
- a pediatrician
- a psychologist, social worker or other mental health specialist
- an ophthalmologist
Prosthodontists are part of the team that helps cleft palate patients. Prosthodontics is a dental specialty recognized by the American Dental Association. A prosthodontist is a dentist who specializes in the esthetic restoration and replacement of teeth and has completed dental school plus three additional years of advanced training and education in an ADA-accredited prosthodontic graduate program. A prosthodontist is the best specialist to choose to make a dental prosthesis.
Both of Pi Dental Center’s Board Certified Prosthodontists, Dr. Thomas Balshi and Dr. Glenn Wolfinger treat cleft defect patients. Dr. Balshi states, “We cater to adolescents and adults who have had the cleft surgically repaired. If they have not had it repaired, we can refer them to a number of good plastic surgeons who work with us.”
“Once the soft tissue is closed surgically and the lip heals, we can take care of the dental component using various forms of prosthodontics. Orthodontic treatment may also be needed, since most cleft palates are missing a tooth in the area of the cleft, and the palate collapses inward reducing the diameter of the arch form.”
A maxillary obturator is one type of prostheses produced at Pi Dental Center that is commonly used for patients with cleft defects. At Pi Dental Center, doctors also replace congenitally missing teeth with dental implants, design prostheses and provide ongoing complex treatment as patients grow into adulthood.
Three of the leading organizations that raise awareness for cleft lip and cleft palate conditions include The American Cleft Palate Craniofacial Association (ACPA), the Cleft Palate Foundation and Smile Train.
ACPA is an international non-profit medical society of health care professionals who treat patients and perform research on oral cleft and craniofacial conditions in children and adults with cleft lip, cleft palate, and craniofacial anomalies. Read More: http://www.acpa-cpf.org/
The Cleft Palate Foundation (CPF) serves individuals and families affected by cleft lip, cleft palate and other craniofacial conditions by team coordination, education, and patient support. CPF, founded in 1973, benefits millions of children in developing countries who live with untreated clefts. Cleft repair surgery is simple and the transformation is immediate. Their sustainable model provides training, funding and resources to empower local doctors in over 85 developing countries to provide free cleft repair surgery and comprehensive cleft care in their own community’s public service arm of the American Cleft Palate-Craniofacial Association. http://www.cleftline.org/
Smile Train is an international children’s charity that helps millions of children in developing countries who have untreated clefts by providing training, funding and resources empowering local doctors in more than eighty-five developing countries to provide free cleft repair surgery and comprehensive cleft treatment. http://smiltrain.org
If you know someone who is struggling with the dilemma of choosing specialists to treat cleft defects, feel free to contact Pi Dental Center.
Palatal Obturator – A palatal obturator is a prosthesis that can be used to close defects such as an opening in the roof of the mouth. They are similar to dental retainers. Openings in the hard and soft palate may affect speech or cause nasal regurgitation during feeding. A palatal obturator can improve speech, proper air flow, eating, reduce regurgitation. People who use palatal obturators must be monitored regularly by their prosthodontist to insure continued effectiveness and comfort of the prosthesis.
Palate - The roof of the mouth
For More Information About Cleft Lip and Cleft Palate and Cleft and Craniofacial Awareness Month:
CDC – Cleft Palate Information: http://www.cdc.gov/ncbddd/birthdefects/cleftlip.html
Web MD –Information: http://www.webmd.com/oral-health/guide/cleft-lip-cleft-palate
Resources by Location: http://www.cleftline.org/parents-individuals/team-care/state-listings-p/
Information about Choosing a Cleft Palate or Craniofacial Team: http://www.cleftline.org/docs/PDF_Factsheets/Choosing_Team.pdf
Cleidocranial Dysplasia And Dental Health: http://dentalimplants-usa.com/cleidocranial-dysplasia-and-dental-health/
Pi Dental Center Stories:
Monique’s Story: https://www.youtube.com/watch?v=EMg0RTmpsAA
Patient photos of Monique who was born with a cleft lip and palate: