Cleft Lip and Palate – Latest News from Jammu and Kashmir | Tourism

Dr Aishwaraya Gupta
The lip forms between the fourth and seventh week of pregnancy. As the baby grows during pregnancy, the tissues on either side grow towards the center of the face and come together to form the face. This junction of tissues forms facial features, such as the lips and mouth. If these tissues do not join, a gap appears where the tissues should have joined. A cleft lip occurs if the tissue that makes up the lip does not fully join before birth. This results in an opening in the upper lip. It is due to the failure of the fusion of the maxillary prominence and the medial nasal processes. The cleft lip appears as a small notch or indentation in the lip (partial or incomplete cleft), or it continues into the nose (full cleft). A cleft lip can be on one (unilateral) or both sides (bilateral) of the lip or in the middle of the lip, which happens very rarely. Children with a cleft lip may also have a cleft palate.
What is cleft palate?
The roof of the mouth (palate) forms between the sixth and ninth week of pregnancy. A cleft palate occurs if the tissues that make up the roof of the mouth do not come together completely during pregnancy. For some babies, the front (hard palate) and back (soft palate) of the palate do not fuse together. For other babies, only part of the palate is involved.
Causes and risk factors?
The causes of orofacial clefts in most infants are unknown. Researchers believe that most cases of cleft lip and palate are caused by an interaction of genetic and environmental factors.
Either the mother or father can pass on genes that cause cleft, either alone or as part of a genetic syndrome that includes cleft lip or cleft palate as one of its manifestations. In some cases, babies inherit a gene that makes them more likely to develop a cleft, and then an environmental trigger actually causes the cleft.
According to the Centers for Disease Control, factors that could increase a baby’s risk of developing cleft lip or cleft palate include:
* Family history. Parents with a family history of cleft lip or palate have a higher risk of having a baby with a cleft.
* Exposure to certain substances during pregnancy. Cleft lip and cleft palate may be more likely to occur in pregnant women who smoke cigarettes, drink alcohol, or take certain medications during pregnancy, such as anti-epileptic drugs.
* Have diabetes. There is evidence that women diagnosed with diabetes before pregnancy may have an increased risk of having a baby with cleft lip with or without cleft palate.
* Being obese during pregnancy. There is some evidence that babies born to obese mothers may have an increased risk of cleft lip and palate.
* Not getting enough nutrients, like folic acid, before and during pregnancy
* Consanguineous marriages, marriages between consanguineous.
Complications
Children with cleft lip with or without cleft palate face various challenges, depending on the type and severity of the cleft.
* Difficulty eating. Feeding is one of the most immediate concerns after birth. Due to a lack of suction, an infant with a cleft may have difficulty feeding. While most babies with an isolated cleft lip can breastfeed, a cleft palate makes sucking difficult. Usually a long bottle, Haberman feeder, shutter or feeding plate, etc. are advised.
* Ear infections and hearing loss. Babies with a cleft palate are particularly at risk of developing middle ear infections and hearing loss.
* Dental problems. If the cleft extends through the upper gum line, tooth development may be affected. Other problems may include fused teeth, missing teeth and extra teeth, hypomineralized teeth, etc. Additionally, abnormal positioning of individual teeth can affect occlusion, which can create an open bite or crossbite. This can then affect the patient’s speech.
* Speech difficulties. Because the palate is used in sound formation, normal speech development can be affected by a cleft palate. Also, due to an open connection between the mouth and the inside of the nose, air leaks into the nasal cavity, resulting in hypernasal vocal resonance and nasal emissions during conversation.
* Challenges of coping with a medical condition. Children with clefts may face social, emotional, and behavioral problems due to differences in appearance and the stress of intensive medical care.
* Psychosocial problems. There is social anxiety in parents and children, low self-esteem and low self-confidence in children.
Diagnostic
Orofacial clefts, particularly cleft lip with or without cleft palate, can be diagnosed during pregnancy by routine ultrasound. Usually, a cleft lip or palate is immediately identifiable at birth. However, sometimes certain types of cleft palate (eg, submucosal cleft palate and bifid uvula) may not be diagnosed until later in life.
Prevention
After the birth of a baby with a cleft, parents are understandably concerned about the possibility of having another child with the same condition. Although many cases of cleft lip and palate cannot be avoided, consider these steps to reduce the risk:
* Consider genetic counseling. If you have a family history of cleft lip and palate, talk to your doctor before becoming pregnant. Your doctor can refer you to a genetic counselor who can help you determine your risk of having children with cleft lip and cleft palate.
* Do not use tobacco or alcohol. Using alcohol or tobacco during pregnancy increases the risk of having a baby with a birth defect.
* Take prenatal vitamins.
Who treats children with cleft lip and/or palate?
Due to the number of oral health and medical issues associated with a cleft lip or palate, a team of doctors and other specialists are usually involved in the care of these children. Members of a cleft lip and palate team typically include a pediatrician, pediatric dentist, plastic surgeon, otolaryngologist, oral surgeon, orthodontist, prosthodontist, speech therapist, speech therapist, audiologist, psychologist, geneticist, etc. The healthcare team works together to develop a care plan tailored to each patient’s individual needs.
(The author is a postgraduate student from the Department of Pedodontics and Preventive Dentistry Indira Gandhi Government Dental College, Jammu.)

Christine E. Phillips