CLEFT PALATE (cheiloschisis) is a condition in which thetwo palates of the skull that form the hard palate are notcompletely joined. The soft palate in these cases are cleftas well.
• Between the 6th and 12th weeks of fetal gestation,the left and rightsides of the face and facial skeleton fuse in the midddle. When they dofail to do so, the result is a craniofacial cleft.• Cleft palate without cleft lip occurs more in females (57%) than males(43%).• It is possible that facial clefts are caused by a disorder in themigration of neural crest cells.• Another theory is that facial clefts are caused by failure of the fusionprocess and failure of inwards growth of the mesoderm.
INCOMPLETE CLEFT PALATE• May occur as a hole in the roof of the mouth.• Usually, it only includes the SOFT PALATEUNILATERAL / BILATERAL COMPLETE CLEFT PALATE• Extends through both the hard and soft palates, into the nasalcavity• Includes a gap in the jaw
MAY APPEAR AS: PROBLEMS ASSOCIATED WITH• A split in the roof of the OROFACIAL CLEFT:palate that can affect both • Failure to gain weightsided of the face • Feeding problems• A split in the roof of the face • Flow of milk through nasal passagethat doesn’t affect the during feedingappearance of the face. • Poor growth • Speech difficulties Difficulty in swallowing Nasal Speaking voice Recurring ear infections Change in Nose shape Poorly aligned teeth
CLEFT PALATE is classified under MULTIFACTORIAL BIRTH DEFECT.MULTIFACTORIAL BIRTH DEFECT = Genetic Factor + EnvironmentalFactor GENETIC FACTORS ENVIRONMENTAL FACTORS •IRF6 Gene on chromosome 1 • Maternal smoking • MAFB gene on chromosome 20 • Maternal alcohol abuse • ABCA4 on chromosome 1 • Maternal diet and vitamin intake • a region on chromosome 8 • Medications take during pregnancy • Exposure to viruses in chemicals of Common Examples of Multi factorial Birth Defects are: fetus • Cleft lip/and palate • Women with diabetes diagnosed • Club foot before pregnancy • Congenital Heart Defects • Neural Tube Defects (Spina Bifida)
• Dental Procedures on patient with cleft palate usually has nodifference with those patient with normal conditions.• Proper and adequate care should be observed by the dentists.• A team approach is required during difficult dental procedures suchas SURGERY. A Partial List of Oral Problems in Children with Cleft Lip & Palate•Feeding Problems•Missing teeth- 50%•Supernumerary Teeth- 20%•Dystrophic (hypoplastic) teeth- 30%•Disturbances of tooth eruption•Ectopic tooth eruption•Malocclusion- 100%•Dental caries and gingivitis