The development of the jaws and oral and facial soft structures takes place as early as intrauterine life.
Any defects that occur during this period can lead to changes that affect both the physiognomy and the functionality of oral structures.
Most of the time, developmental defects are visible from birth and treatment will be carried out when the child is old enough for the intervention to take place.
Cleft lip, cleft palate or both, also popularly known as rabbit lip or wolf’s mouth, are malformations that are present at birth but can be detected in the womb.
They are characterized by disruption of continuity in the structures they affect and may occur in the following sites:
Upper lip– may be only superficially affected and then the cleft has more of a fissure character or may affect both the red lip and muscle structures and the lip is completely split.
In the latter situation, the mouth is no longer sealed and the oral gum structures can be seen.
Alveolar process– the bone where the buds of the temporary and permanent teeth develop is affected, so dental abnormalities are possible as a result.
These take the form of destruction of the buds with lack of eruption in the arches, dental inclusions or gaps.
Hard palate and soft palate– also known as the roof of the mouth, if these structures are affected there may be communication with the nasal cavity and food may leak from the nose.
Most of the time, if the clefts deeply affect the oral structures, the child will have problems feeding. This is because the baby feeds from the mother’s breast, sucking mainly through the lips. If this sucking is not done, milk is no longer expressed through the mother’s breast and the baby will not feed properly.
Also, if the cleft palate is cleft, it is possible that the milk will reach the nasal passages. In either case, the baby will be deprived of nutrients.
Determinants
Factors that can lead to clefts include:
Infectious agents – viruses such as rubella can trigger clefts.
Ionizing radiation and medicines – it is therefore advisable that during pregnancy the mother is exposed to as little radiation as possible and takes medicines only under the strict supervision of a doctor, to ensure the proper development of the fetus during intrauterine life.
Drugs and steroid hormones
Deficiencies – lack of certain vitamins and other essential developmental constituents can lead to clefts.
The diagnosis of cleft lip or palate can also be established prenatally when ultrasound examinations are carried out.
If the diagnosis is positive, the surgeon should be contacted in order to work together to ensure that the child develops and grows as normally as possible.
Interventions are carried out in childhood and the child’s progress will be monitored by the surgeon until the age of 14.
