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Home ⁄ Cleft Lip/ Palate ⁄ Treatment Schedule

Treatment Schedule in Dallas, TX

Age
Treatment
Rationale

Newborn
Orthopedic Appliance
  • Minimizes facial distortion
  • Controls palate segments while awaiting palate closure
  • Prevents abnormal tongue placement habit

Naso-Alveolar Molding Device
  • Encourages more normal feeding patterns
  • Reduces air swallowing during feeding
  • Allows nasal breathing
  • Decreases lip and nose malformation
  • Involves family: direct contribution to baby’s daily care

3 months
Ear and Nasal Repair
  • Best if greater than 10lbs, 10 weeks, and/or 10mg/dl hemoglobin
  • Natural-looking closure is top priority
  • Muscle reconstruction is essential
  • Nose catilage reshaping stabilizes lip/nose during growlh
  • Thorough pre-consideration of scar tissue’s natural pull

Ear Tube(s)
  • Provides ear ventilation, prevents chronic fluid build-up, infection

9 – 12 months
Palate Repair
  • Repair timed to ensure functional palate by time of speech
  • Early closure critical to promote best speech development
  • Prepare for healing process contraction to pull upper jaw back
  • Single stage closure of hard and soft palate

Preschool to 5 – 7 years
Palatal Expander
  • Palatal expander gently shapes/widens upper jaw arch
  • Creates space for 6-year molars
  • Setup for bone grafting

Speech Exercises
  • Articulation, speech, breathing, and tongue habits learned

Hearing Evaluations
  • Must correct any hearing loss to ensure normal speech/learning progress

Bone Graft(s) at Cleft Site(s)
  • Fills in the cleft area of dental ridge so incoming incisors anchor well; also creates normal maxillary arch shape and width
  • Serves as “mortar” between palatal segments
  • Ensures proper alignment of incoming permanent teeth within arch
  • Closes any remaining holes in the palatal lining or in the nasal floor
  • Improves oral/nasal hygiene

May Extract Malformed/Extra Teeth May Bracket/Move Rotated Teeth

7 – 12 years
Orthodontic Treatment
  • Rapid growth period: intervention can ellectively influence and assist normal development

12 years to Final Growth
Lip, Nose, Scar Surgery (if needed)
  • Facial shape may have changed significantly throughout childhood; refinement creates pleasing appearance and improves function (breathing, speaking, eating)

Continue/Complete Orthodontics, Jaw Surgery (required 20%-30% of the time)
  • When body growth stops, jaw reaches full growth; surgery holds