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Cleft Lip and Palate
Alternate Names : Cleft Lip, Cleft Palate, Oral Cleft
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Cleft lip is a birth defect that involves a split in the upper lip. Cleft palate involves a split down the palate. The palate is the center of the roof of the mouth. When these defects occur separately, they are known as isolated cleft lip or isolated cleft palate. They may also occur together. This is called cleft lip with cleft palate.
What is going on in the body?
Cleft lip and cleft palate both develop while a baby is in the womb. Cleft lip occurs when grooves that are normally present in the face of a developing fetus don't smooth out as it grows. The baby is then born with a split or opening where the grooves were, called a cleft lip.
The roof of the mouth, on the other hand, develops from tissue on each side of the mouth. This tissue usually grows together and fuses at the middle of the roof of the mouth. If the tissue does not fuse normally, the baby is born with a split extending from front to back along the roof of the mouth. This is called a cleft palate.
What are the causes and risks of the condition?
Cleft lip and palate are caused by environmental factors and genetics. For instance, people who have a cleft lip alone or cleft lip with cleft palate are more likely to have children with cleft lip. The actual risk depends on the severity of the split and family history. While people with cleft palate may also have affected children, the risk is not as high as it is for cleft lip. Despite the genetic risk, most cases of cleft lip and palate occur randomly. Taken together, cleft lip or palate occurs in about 1 in 700 live births, with cleft lip being more common. Cleft lip is more common in boys than in girls.
Certain factors during a woman's pregnancy are associated with an increased risk of cleft lip and palate in the fetus. While more research is needed to establish a cause and effect relationship for many of these factors, the list currently includes the following:
alcohol dependency
certain over-the-counter medications, such as dextromethorphan, a common cough suppressant
certain prescription medications, such as those used to control seizures, as well as isotretinoin, a medication used to treat acne
chorionic villi sampling, which is a diagnostic test that takes cell samples from the pregnant woman's uterus, when it is done before the 8th week of pregnancy
drug abuse
excess intake of vitamin A
herbal remedies
inadequate intake of folic acid
pesticide exposure
smoking
The March of Dimes recently issued an advisory that pregnant women should avoid all herbal remedies, over-the-counter medications, and prescription medications unless recommended by the healthcare provider.
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Author: Ronald J. Jorgenson, DDS, PhD, FACMG Reviewer: Eileen McLaughlin, RN, BSN Date Reviewed: 08/06/01
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