Your child's orthodontist at Children's will perform different types of treatment as your child grows older.
A baby with a cleft lip and palate may have trouble feeding. If the palate is split, food may escape through the nose. Also, an opening in the roof of the mouth can weaken a baby’s ability to suck.
To correct such problems, your pediatric dentist or orthodontist can insert an obturator in your child’s mouth. This is a plastic device that fits over the roof of the mouth and acts as a palate. It helps babies create suction for feeding and prevents most food from escaping through the nose. A special dental paste is sometimes used to hold it in place.
After an obturator is placed, your pediatric dentist or orthodontist will check it often and adjust it as needed. An obturator is worn until the cleft palate is surgically closed at about 6 to 9 months old.
Your child’s upper lip may need to be "molded" to reduce stress on it. This is often done by stretching a piece of foam tape over the lip. Other devices may also be used for this. Your Craniofacial team will decide which type of molding is best for your child.
Your dental team at Children’s will watch your child’s teeth develop for several years until it is time for the bone graft.
- This is surgery to insert bone into the area of the cleft.
- To prepare for the bone graft, the Craniofacial team will study X-rays, photographs and models of your child's mouth.
- From these studies, the craniofacial team will make a treatment plan that is best for your child's needs.
Quite often, a child's upper jaw must be expanded before a bone graft may be done. There are a number of devices for this. The pediatric dental team will explain the device that is best for your child.
- An expansion device is usually worn for several months before the bone graft is done.
- After the bone graft, the device is left in place as a "retainer" for several more months.
- Your child may need to wear a retainer until the final phase of treatment is done during his mid-teens.
Other treatments may also be needed at this time to correct your child's teeth and jaws. This phase of treatment can take up to a year and a half.
The final phase of treatment is usually begun after all adult teeth appear. The orthodontist will study X-rays, photographs and models of your child’s mouth. From these studies, the orthodontist will make a treatment plan that is best for your child’s needs.
During this phase of treatment, your child will likely be fitted with braces. More expansion of the upper jaw may also be needed.
If your child needs pediatric dental surgery, it will occur about one to one and a half years after braces are fitted. Braces will remain in place after surgery.
If your child is missing teeth, the problem may be corrected with some type of implant. It depends on how many and which teeth are missing. Your pediatric dental team will discuss types of implants with you as needed.
This phase of treatment often takes two to three years.
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