Cleft lip, also called cleft lip, is a characteristic with which some children are born due to various factors. Both the cleft lip and the cleft palate, or the combination of both, occur during gestation: they are congenital, but that does not mean that they are always hereditary. It seems that the intake of folic acid supplements during pregnancy can help prevent this type malformations.
What are the causes of cleft lip?
The specialty of dentistry and stomatology works with this type of congenital malformations.The baby is born with cleft or cleft lip, these pathologies do not develop after birth. From weeks 5 and 17 of gestation is when alterations in the development of the facial form and the palate can occur.
Despite being born with it, the cleft lip is a multifactorial feature, which is not always hereditary. Its casuistry is very diverse.They may be of hereditary origin, with the alteration of a gene or several genes. It can also be a consequence of a chromosomal alteration, in which case it would be part of a syndrome, such as Crouzon Syndrome or Pierre Robin.
However it can be caused by environmental factors during the gestation period of the mother. Certain medications, such as some anti-epileptics, can cause these alterations inside the uterus, as well as may be due to a maternal tumor that presses the embryo. In the same way, a small relation between a greater age of the mother and a slight increase in the incidence of this pathology has been observed. It seems that the intake of folic acid supplements during pregnancy helps prevent such malformations. In any case, further studies are needed.
Features of the cleft lip
There are different types of cleft lip or cleft palate depending on the degree of involvement:They may be unilateral, affecting only one side of the face, or bilateral affecting both. Among the unilateral, the left are more frequent.They can be complete or incomplete, according to the degree of affectation of the tissues. There are babies born with a cleft that only affects the lip and part of the nasal wing, what we call cleft lip; and others that present a more complex pathology that also affects the palate. It can even reach the uvula or bell, the so-called cleft lip and cleft. There are fissures only of the palate; and even those that only affect the uvula.
We can also find a type of submucosal cleft palate, where the palate is apparently normal, but it is below the superficial tissues where the cleft is located.It is important to emphasize, for the sake of parents, that the child with a variety of lip-palate clefts may suffer from several alterations in different areas of health, but not all of them necessarily manifest themselves in all cases. . . Various health professionals should be coordinated: pediatric, maxillofacial, plastic surgeons or micro-surgeons. In addition to a team of orthodontists , odontopediatricians, prosthodontists, physiotherapists, osteopaths, speech therapists, otorrinos or geneticists. The work of psychologists or psychiatrists is also important, since there may be a negative impact on psycho-social development and the patient's self-esteem.. Orthodontic follow-up should be performed from infants until they reach adulthood, always within the multidisciplinary field. The orthodontist deals with:
- The motivation in the dental hygiene of the patient, since newborns although there is no erupted tooth; as well as guiding the eruption of teeth, often altered.
- Perform maxillofacial orthopedics, at very early ages, such as 5 years, if the child collaborates and the deformity requires it. There are even protocols of hospital equipment where orthopedics are performed on babies for a better outcome of certain surgeries.
- Assist the surgeon, speech therapist, physiotherapist, osteopath in their work.
- Get a healthy masticatory function, and of course a better aesthetic of the smile.
- During the treatments it is the responsibility of the health professionals to communicate to the patient and his / her family the real expectations, personalized in each case, and always with the illusion of visualizing the end of the tunnel.
- The patient and his / her relatives are the center of this team. We must pay attention to their needs in an individualized way, the same way they should be advised by health professionals.