A cleft may involve the lip, palate, or both and it may be complete or incomplete.  Cleft may occur on one side (unilateral) or both sides (bilateral).  There are also mid-facial clefts and more subtle clefts that affect the nose or cause lip thinness, dental irregularities, submucous cleft, or bifid uvula (uvula split in two).  Some clefts, such as the Pierre-Robin anomaly (cleft soft palate, superior tongue placement, and small recessed jaw), cause physical obstruction that may lead to airway and feeding problems.

Cleft lips can be repaired as early as 48 hours after a healthy birth.  Cleft palates are usually repaired between six and nine months of age when the mouth is large enough, but before speech develops. Some clefts require additional palate surgeries between age 4 and 5 to help with hyper-nasal speech.  Clefts that affect the dental ridge (alveolar cleft) are repaired at about 6 years of age by using a bone graft (performed by an oral surgeon).  Speech therapy and braces are frequently required with cleft palate.  Finally, rhinoplasty (nose surgery) may be helpful at the age of 16 or 17, once full growth has been attained. 

Central Florida has a cleft team that brings together oral surgeons, plastic surgeons, otolaryngologists (ear, nose, and throat surgeons), speech and hearing therapists, geneticists, pediatric dentists, orthodontists, and others.  Evaluation by this team is recommended by 18 months of age to ensure comprehensive care.  To contact the Children’s Medical Services Cleft Clinic, please call 407-856-6525 ext. 147.  You can also click here to visit our CMS Cleft Clinic page.

The causes of cleft are not completely understood, although genetic and environmental components are probably involved.  About one-third of all clefts have some family history.  General statistics indicate that a cleft occurs in one of every five hundred births.