CLEFT PALATE

Cleft Palate is a facial deformity, so rare that most people have never heard of it, occurring 1 in 1,000 births.  Some babies are born only cleft lip and others  more severe that include the palate.

Treating cleft palate involves more than just a plastic surgeon to repair the cosmetic aspects. Since cleft palate often involves the ear, an otolaryngologist (ear nose and throat doctor), audiologist and speech pathologist are on the team. Also involved is an orthodontist, oral and maxillofacial surgeon, general dentist, prosthodontist, neurosurgeon, pediatrician, psychologist, and social worker.

Dr. Feldman explains what happen s with cleft palate. "The lip and palate, the hard bony plate in the roof of the mouth fail to differentiate at critical points in the time of the developing child. Consequently, if differentiation of the tissues that make up these structures is incomplete or abnormal, the union of the lip and palate can be lacking in varying degrees. The resulting defects may be incomplete in which only the lip and/or palate is partially involved, or complete in which both the lip and palate are totally involved. The cleft can be unilateral, that is, occurring on both sides. Clefts occur more often in boys and normally more on the left than the right side."

"The whole idea behind early orthodontic/orthopedic intervention is to move bone", states Dr. Feldman. "Infants' bones are more pliable and are easy to move. Usually bone must be moved before any surgery can take place. Therefore, many cleft palate children are fitted with orthodontic/orthopedic appliances in the hospital before they are taken home"

 A Latham Appliance named after the Doctor who  invented it, is used to align the premaxilla back in place. 

In order to fabricate the Latham appliance, an impression of the childs face ( Milange), and the palate with  an alginate material, which is the same material used in taking dental impressions.  De. Feldman then uses this impression  to fabricate the  appliance that will be inserted onto the palate , in order to move the upper segments  together.