Cleft Palate or Cleft Lip

Cleft lip and cleft palate are birth defects that affect the upper lip and roof of the mouth. They happen when the tissue that forms the roof of the mouth and upper lip don’t join before birth. The problem can range from a small notch in the lip to a groove that runs into the roof of the mouth and nose. This can affect the way the child’s face looks. It can also lead to problems with eating, talking and ear infections.

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How common are oral-facial clefts?
About 6,800 babies in the United States are born with oral-facial clefts each year (1). This number refers to isolated oral-facial clefts, meaning clefts that are not accompanied by other birth defects. Isolated oral-facial clefts are among the most common birth defects in this country (1). About 70 percent of babies with oral-facial clefts have isolated clefts (2).About 4,200 babies are born each year with cleft lip/palate (1). This birth defect occurs more often among people of Asian ancestry and certain groups of Native Americans than among Caucasians. It occurs least frequently among African Americans (2).Isolated cleft palate occurs less often, appearing in about 2,600 babies each year (1). Unlike cleft lip/palate, the risk appears to be similar across all racial groups.

There also are about 400 syndromes in which babies have some form of oral-facial cleft along with a wide variety of other birth defects (2). The diverse problems of these babies are not described here. All babies with oral-facial clefts should be thoroughly examined by a doctor soon after birth to diagnose or rule out other birth defects.

When do oral-facial clefts develop?
These birth defects occur very early in fetal development. The tissue that will become the lip usually joins in the middle and fuses by about 5 to 6 weeks after conception. The palate forms in a similar manner at about 7 weeks. A cleft occurs when these structures don’t close completely.

What causes oral-facial clefts?
The causes of these birth defects are not well understood. Studies suggest that a number of genes, as well as environmental factors, such as drugs (including several different anti-seizure drugs) and maternal smoking, may contribute (3). Other environmental factors that are suspected of playing a role include infections, maternal alcohol use and deficiency of the B vitamin folic acid (3, 4).


Treatment usually is surgery to close the lip and palate. Doctors often do this surgery in several stages. Usually the first surgery is during the baby’s first year. With treatment, most children with cleft lip or palate do well.
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