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Once consigned to an extraordinary divine intervention, the term "miracle" is often used today for anything out of the ordinary. But even if the usage has become a little worn, there are things that, though not of supernatural origin, may still deserve the description. In that regard, today's surgical techniques to correct lip or palate clefts and the impact they can have on lives is well-nigh miraculous.

Before the 1950s, though, there was little that could be done to correct these kinds of birth defects. That all changed, though, with a "bolt from the blue" discovery by a military doctor over a half century ago. During Cleft & Craniofacial Awareness & Prevention Month this July, we recognize that doctor's breakthrough insight and the vast progress since then in cleft reconstruction surgery.

Affecting more than 4,000 babies each year, clefts develop during early pregnancy as portions of the face, typically the lips or extending into the palate, don't completely unite with each other. As a result, gaps (clefts) occur where the tissues should be uniform, forming on one side of the face or both.

Clefts can have a harmful effect on a baby's ability to feed or even breathe, and they can interfere with speech development as the child gets older. But what may cause the most emotional pain is the alteration of a person's normal appearance, which may inhibit their ability to socially interact with others.

But a child today with a lip or palate cleft can reclaim a more normal appearance through a series of surgical repairs. The genesis for this began when a U.S. Naval surgeon named Ralph Millard stationed in Korea in 1950 noticed something when studying photographs of his cleft patients. He realized there was no missing tissue with a cleft—all the "parts" were still there and only needed to be "rearranged" surgically.

Today's surgeons do just that, having built modern cleft correction on Dr. Millard's original procedures. And although it involves multiple procedures and often a team of surgeons, dentists and orthodontists, the end result is life-changing.

As amazing as these results may be, cleft correction is a process that can take years, taxing the stamina of both patients and their families. But with ample support, a child with a cleft now has a chance to enter adulthood with a normal smile and appearance. If anything deserves the title "miracle," surely cleft reconstruction surgery does.

If you would like more information about cleft treatment and reconstruction, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”

By Dr. JoAnne Bernard, DDS., PA
January 05, 2016
Category: Dental Procedures
Tags: cleft lip   cleft palate   oral surgery  
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One of the most common and anguish-filled birth defects is a cleft lip or palate (roof of the mouth). Not only do clefts disrupt the normality of a child’s facial appearance, they can also lead to problems with chewing, speech and the long-term health of teeth and gums.

A cleft is a tissue gap that occurs during fetal development, usually in the first trimester, in which parts of the baby’s face fail to unite. Why this occurs is not fully understood, but vitamin imbalances in the mother, exposure to radiation or other toxic environments, or infections are all believed to play a role.

Facial clefts are classified as either incomplete, in which there is some but not full tissue fusion, or complete, with no fusion at all. A cleft can be unilateral, affecting only one side of the face, or bi-lateral, affecting both sides. During infancy a cleft can adversely affect a child’s ability to nurse, and it sometimes disrupts breathing. As the child grows, speech patterns may be severely disrupted and their teeth and bite may not develop properly.

Fortunately, there have been dramatic advances in cleft repair over the past sixty years. It’s actually a process that can span a child’s entire developmental years and involve the expertise of a number of surgical and dental specialists. For a cleft lip, the initial surgical repair to realign and join the separated tissues usually occurs around three to six months of age; repair of a cleft palate (where the gap extends into the roof of the mouth) between 6 and 12 months.

Subsequent procedures may be needed in later years to refine earlier results and to accommodate the mouth’s continuing growth. At some point the treatment focus shifts to cosmetic enhancement (which can include implants, crown or bridgework) and periodontal health, to ensure gum tissues that support teeth and gums aren’t compromised by the effects of the cleft or its treatment.

At the end of this long process, something of a miracle may seem to occur: a young person’s once disfigured mouth transforms into a beautiful smile. It’s a chance for them to gain a normal life — and a new lease on physical, emotional and oral health.

If you would like more information on cleft reconstructive surgery, please contact us or schedule an appointment for a consultation.



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