What is Cleft Lip/Cleft Palate?

Cleft lip and cleft palate are collectively known as orofacial clefts. These birth defects cause the child’s mouth and/or oral cavity to form improperly, leaving a visibly conspicuous gap between the mouth and the nose (cleft lip) and/or a gap in the roof of the mouth (cleft palate). In many cases, both conditions are present, effectively creating a continuous gap through the child’s face and into his or her palate.

Cause, Risks

Orofacial clefts don’t discriminate—they can afflict children of any race, ethnicity or socioeconomic status. While their cause is uncertain, some maternal health conditions, such as diabetes, can increase risk. Poverty and environment may also play a role. This may be why children in Latin America are roughly two times as likely to be born with orofacial clefts as children in the U.S.

But one thing is certain—no child anywhere deserves to live with the physical and social hardships associated with an un-repaired orofacial cleft.

Health and Developmental Impacts — Children with an orofacial cleft often face one or more of these health and developmental problems: feeding problems, speech and language development problems, breathing difficulties, hearing problems, dental problems and frequent ear infections.

Psychological and Emotional Impacts

Heartbreaking and cruel as it may seem, children with orofacial cleft often experience direct, unhidden ridicule and discrimination due to their deformed appearance. No wonder so many of them experience terrible insecurity and social anxiety.

Still to this day, parents seeking to protect their children from the very real risk of discrimination may instead raise them as virtual shut-ins, even into adulthood. They can suffer from extreme social underdevelopment and isolation as a result.

Simply put, serious physical problems aside, the long-term psycho-social impacts associated with unrepaired orofacial clefts can be extremely debilitating in and of themselves.

The Case for Treatment Outreach

Here at Austin Smiles, most of our medical volunteers specialize in pediatric care. Many spend their working lives with kids born with orofacial clefts in Central Texas, helping to make them whole. We’ve seen firsthand the incredible difference medical interventions make in the lives of these children and their families.

But some children born with orofacial clefts are denied these chances at normal, happy productive lives simply because of where they were born. That’s why so many of our medical volunteers devote their time off from work to continue working, to seek out these children in need where they live and help as many of them as we possibly can.


Everyone who experiences these incredibly positive transformations—the families and friends of children whose clefts were successfully repaired, as well as many of the children themselves once they become adults—is compelled to donate their time, money and/or resources to the cause of treatment outreach. Once people understand the miracles treatment provides for children born with orofacial cleft, they feel compelled to help. It’s simply a no-brainer.

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In a series of operations that ideally start at three months old and often stretch into young adulthood, surgeons close the cleft lip and cleft palate and work to shape the face and skull to leave the child with a “normal” appearance. Early surgeries focus on mitigating or eliminating the associated fundamental eating, breathing and speech problems. As the child ages and his/her growth slows, surgeons can then turn their focus to crafting a normal facial appearance for him/her. In fact, you might live, work or study alongside someone who was born with an orofacial cleft that has been repaired and never suspect they were born with a serious birth defect.

Speech, Hearing Therapy, Orthodontia

Children who are undergoing treatment to repair orofacial cleft often need help learning to speak and communicate, so intensive speech therapy is often essential. Hearing problems are often associated and require corrective procedures and/or therapy. Because the teeth of children with orofacial cleft often come in terribly misaligned, they may need to be under the care of an orthodontist for extended periods of their childhood and adolescence. Almost all children with cleft palate need a procedure called Myringotomy with tubes. This allows for drainage of the middle ear. Without the tube placement, children tend to hear the world as if they were under water.

Psychosocial Care and Family Support

Even with comprehensive, interdisciplinary medical care from a cleft team, the journey for these children and their families is a long and difficult one. Care must be provided for the “whole child,” and his or her family. This can include counseling that helps the child overcome the real and psychological scars associated with orofacial cleft and the ongoing treatment to repair it, and that helps him or her understand and accept the remaining physical and mental challenges ahead.

Parents and family members also benefit from counseling and practical skill development that help them provide the emotional and functional support these children need. Families we serve on our overseas mission may also need financial assistance for travel, shelter and living expense while away from home.

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