PROBLEMS IN CLEFT LIP AND PALATE (CLP)

 Congenital anomalies  Feeding  Hearing  Speech  Disruption of facial growth  Disruption of dental development  Dental anomalies  Psychosocial

 Disturbances in dental and skeletal development caused by the clefting process itself depend upon the site an severity of the cleft Lip only  there’s lil effect in this type, although notching of the alveolus adjacent to the cleft lip may sometimes be seen. Lip and alveolus  Unilateral cleft lip and alveolus unsually associated with segmental displacement.  Bilateral casese the premaxilla may be rotated forwards.  Lat inc on the affected side may exhibit i. Congenital absence ii. An abnormality of tooth size and/or shape iii. Enamel defect iv. Two conical teeth, one on each side of the cleft

Lip and Palate  In unilateral cleft rotation and collapse of both segments inwards anteriorly is usually seen( on the affected side)  In bilateral clefts both lateral segments are often collapsed behind a prominent premaxilla Palate only  A widening of the arch post[usually]  Cleft pt has more concave profile & a degree of this is d/t a restriction of growth.  Pt tends to have more retrognathic maxilla & mand & reduced upper face height

 Babies with cleft palates can swallow once the material being fed reaches hypopharynx  Have extreme difficulty producing negative pressure in their mouth to allow sucking.  Overcome by use of specially designed large syringes with rubber extension tubes connected to them or use of obturator.

 Individuals with unoperated clefts  they do not experience significant restriction of facial growth, although there is a lack of development in the region of the cleft itself, possibly because of hypoplasia.  Individuals who have undergone surgical repair to CLP  exhibit marked restriction of mid-face growth anteroposteriorly (maxillary retrusion) and transversely.  This is attributed to the restraining effects of the scar tissue, which result from surgical intervention.

 Cleft affecting the alveolus result in non- eruption or displacement of lateral incisors or canines.  Bilateral cleft premaxilla (prolabium) is displaced along with the incisors.

 Delayed eruption (delays increases with severity of cleft)  Hypodontia  General reduction in tooth size.eg;microdontia  Abnormalities of tooth size and shape.  Enamel defects.eg;hypomineralized  Impacted teeth (maxillary canines)  Missing teeth  Supernumerary tooth

 Space maintenance and control is instituted during childhood.  Appliances to maintain or increase the width of dental arch are frequently used.  This treatment is usually begin with eruption of the first maxillary permanent molars.  Comprehensive orthodontic care is deferred until later, when most of permanent teeth erupted.  Consideration of orthognathic surgical intervention for skeletal discrepancies and malocclusion.

 Poor self image  Lack of self confience