Cleft lip and palate are among the most common congenital (birth) defects worldwide, affecting approximately 1 in 700 births. While the diagnosis can be unexpected and emotional for families, surgical correction and comprehensive care have advanced dramatically — and most children achieve excellent functional and aesthetic outcomes.
What Is a Cleft?
A cleft is a gap or split in the upper lip, the roof of the mouth (palate), or both. It occurs during fetal development when the facial structures fail to fuse completely. Cleft lip and cleft palate can occur together or separately, and the extent varies significantly from a small notch to a complete separation that extends through the lip and into the nose.
The Impact on Function
Clefts affect feeding, speech development, hearing (due to associated Eustachian tube dysfunction and recurrent middle ear infections), dental development (teeth may be missing, displaced, or malformed in the cleft area), and facial growth. Early and coordinated treatment addresses all of these dimensions.
The Surgical Timeline
Cleft lip repair is typically performed at 3–6 months of age. Cleft palate repair follows at 9–12 months, before the most critical period of speech development. Bone grafting of the alveolar cleft (the gap in the gum ridge) is performed around age 8–9, timed with the eruption of the permanent canine tooth. Orthognathic (jaw) surgery may be needed in adolescence or adulthood to address jaw growth discrepancies that develop over time.
The Team Approach
Comprehensive cleft care requires a coordinated team: oral and maxillofacial surgeon, plastic surgeon, orthodontist, speech-language pathologist, audiologist, pediatric dentist, and psychologist. Cleft teams at major medical centers provide this interdisciplinary expertise in a coordinated manner.
If your child has been diagnosed with a cleft, connecting with a specialized cleft and craniofacial team early ensures access to the most current protocols and the best possible outcomes.