Cleft Lip and Palate

Dental and orthodontic treatment for cleft

Children born with a cleft lip and/or palate may develop dental problems and require regular appointments with an orthodontist (a dentist who specialises in the correction of teeth irregularities). Orthodontists work within cleft services in the U.K. Children born with a cleft are more likely to have fewer teeth (hypodontia) or extra teeth (supernumerary) than children without a cleft. They are also more likely to have a narrow top jaw, perhaps because of previous surgery, and the teeth that do grow may become crowded and crooked. Crooked teeth can be hard to clean properly and so a child born with a cleft may be more likely to get tooth decay. Children born with a cleft lip and/or palate will receive orthodontic care within the ‘Cleft treatment pathway’ until they reach 21 years of age. When all of the adult teeth have come through or erupted (usually in the early teenage years), braces may be fitted in order to ensure that the teeth are straight. People born with a cleft lip and/or palate who didn’t have orthodontic treatment when they were young can still benefit from having orthodontic treatment as an adult: this treatment is provided by the regional cleft services in the U.K. (see ‘Adult cleft services’).
Sometimes children born with a cleft lip will have a notch on their front gum (alveolar) and may require alveolar bone graft bone graft surgery (see ‘Cleft treatment pathway’). This surgery will involve the skills of orthodontists and cleft surgeons.
As children grow older their faces continue to grow and develop. Some children born with a cleft may require jaw alignment surgery (orthognathic surgery) to help their teeth bite together properly. Orthodontists work closely with other members of the cleft team such as surgeons, speech and language therapists and clinical psychologists and attend the MDT meetings to ensure that families are well prepared for the surgery and children receive the best pre and post-operative care to get the maximum benefit from the surgery.

Last reviewed June 2017.

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