Related Treatments

After the PalateRepair, will the Child Need Any Further Treatment for the Teeth?
Nearly all children with cleft palate require orthodontic therapybecause the teeth closest to the cleft site tend to come in at incorrectangles. This therapy may begin as early as age four when the childcan sit and cooperate in a dental chair. While most of the orthodontictherapy can be performed by your local orthodontist, we recommendthat the treatment be overseen by an expert in the field of cleftorthodontics. In some patients a procedure called a "bone grafting"is needed at approximately eight years of age to allow the adultteeth to erupt (come in) properly. Should this procedure be necessary,small fragments of bone are taken from the hip or the outer surfaceof the skull and placed in the gap between the bone edges wherethey adhere into solid bone. Whether or not this procedure is necessarywill be determined by the orthodontist and the surgeon. We are hopingthat with the use of the new presurgical orthopedic procedures thisbone grafting procedure may not be necessary.

Fig 3: Before Surgery	After Sugery

Will Further SurgeryBe Needed on the Nose?
Usually the surgical correction ofthe nose which is performed at the time of the first lip operationresults in adequate correction of the nasal shape until the patientbecomes a teenager. During the teenage years, when children becomemore interested in their appearance, a final touch-up proceduremay be needed. Figure 3 shows the results of such a procedure onan older patient with severe nasal deformity. This patient did nothave nasal reconstruction at the time of the first lip repair. Inaddition, most children with a unilateral cleft lip and palate havea deviated, or crooked septum which causes difficulty with nasalbreathing. This can also be corrected in the adolescent period atthe same time as the surgical modification of nasal shape.

What HappensIf the Palate Restricts Growth of the Upper Jaw?
As previouslymentioned, surgical repair of the palate may restrict growth ofthe upper jaw. This is usually correctable with orthodontic therapy.Occasionally, however, if the upper jaw growth has been severelyrestricted, such that the lower jaw is actually in front of theupper jaw, it is necessary to bring the upper jaw forward by a surgicalprocedure (maxillary advancement).

Do You Have Any More Questions?
It is natural for you to have other questions.During the process of evaluation and treatment we encourage youto speak with members of our team and to become a well informedparent or patient. You may have questions or feelings that are bestshared by other patients and family members of patients. The selfhelp group, Forward Face, was established to provide you with familyand patient support.