How a Cleft Palate May Affect Your Child’s Teeth - Tips to Help

How a Cleft Palate May Affect Your Child’s Teeth - Tips to Help
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Table of Contents

  1. What is a Cleft Palate?
  2. Causes
  3. Complications for Teeth & Mouth
  4. Oral Hygiene Tips for Your Child
  5. Benefits of Good Oral Hygiene on Treatment Outcomes
  6. References

Children with a cleft palate often face many challenges, especially when eating and speaking, but they also must face the reality of what the birth defect can do to their dental hygiene and oral health.

The large gap in the lip or mouth that signifies a cleft lip or cleft palate makes for a lengthy, challenging journey of recovery that includes surgical correction.

What is a Cleft Palate?

The cleft palate, often confused with cleft lip, is an oral and facial malformation that occurs early in pregnancy as a baby develops. Clefting happens when there isn’t enough tissue in the mouth and the available tissue fails to join properly.

A cleft palate split, or opening, affects the roof of the mouth and can involve both the soft palate (the soft back portion of the mouth’s roof) and hard palate (the bony portion of the roof of your child’s mouth.)

The condition usually forms on one side of the mouth, but in some situations, it can form on both sides. Because the palate and lip develop separately, a child can be born with one of three specific conditions:

  • A cleft palate without a cleft lip
  • A cleft lip without a cleft palate
  • Or both a cleft lip and a cleft palate

Causes of Cleft Palate

Cleft palate occurs in one of every 1000 children born annually in the United States, making it the fourth common birth defect affecting children. The defect predominantly affects kids of Asian descent, and twice as many girls as boys. Regardless, medical experts say the condition has an unknown etiology and cannot be prevented.

Because of a cleft’s unknown cause, researchers think it is stems from a combination of genetic and environmental factors. Newborns are more likely to be born with cleft issue if a parent, sibling or relative has (or had) the problem, a strong genetic signal.

Another working theory is that a cleft palate is linked to medication therapies taken by mothers during their pregnancy. Drugs thought to cause this condition include anticonvulsants, anti-arthritis medications, drugs that contain Methotrexate or Accutane, which are prescribed used to treat acne, and drugs used to treat cancer and psoriasis.

Other potential factors that can contribute to the development of a cleft issue include:

  • Vitamin deficiency, especially folic acid
  • Smoking during pregnancy
  • Drug and substance abuse
  • Maternal diet
  • Maternal diabetes
  • Excessive exposure to air pollutants

Complications for Teeth and Mouth

Dealing with a cleft means much more than worrying about appearance. Among the complications of a cleft lip or palate are how it affects the size, shape, positioning and number of teeth. Because of open gap in the mouth and lip, consistent exposure to air dries up saliva, allowing bacteria to flourish in the mouth.

Studies from the University of Washington found that children with facial differences have abnormal salivary glands, hindering their oral health. This explains why children who grow with this condition have a high average rate of tooth decay.

The most common complications with a cleft palate involve teeth and gum issues, trouble speaking, and difficulties eating and swallowing.
Dental Problems

Cavities, malformed teeth, displaced teeth and extra teeth represent the bulk of dental problems experienced by someone with a cleft issue. All of these require frequent dental treatment.

Children also develop alveolar ridge defects. The alveolar ridge is the bony gum that holds upper teeth. Defects in the alveolar can displace, rotate or tip teeth. It can also prevent the appearance of teeth permanently. Fortunately, these complications can be treated with oral surgery.

Speech Complications
Children with cleft palates often have difficulty speaking clearly. Their voices tend not to carry well, and they often speak with a nasal tone, making them hard to understand. However, not all affected children have speech problems, and surgical procedures can fix for some. For those who are severely affected, a speech pathologist can help resolve these complications.
Eating Problems

The opening in the palate allows foods and liquids to pass abnormally from the mouth to the nose, which causes breathing and safety problems. During the first few months of life, specifically designed feeding bottles can prevent this occurrence.

Children may have to wear a man-made palate to improve their ability to eat safely. This ensures they receive adequate nutrition until doctors can surgically repair the cleft.

Oral Hygiene Tips for Your Child

Children with cleft palate also have challenges that come with missing, mal-positioned and malformed teeth. While general preventive and restorative dental hygiene care of children with cleft palate are the same as those of other children, they need close monitoring. Some oral hygiene tips include brushing regularly, using fluoride toothpaste, flossing consistently and visiting the dentist regularly.

Brush Teeth Regularly but Not Aggressively
This ensures that you brush your child’s teeth twice a day to remove bacteria and plaque and keep their teeth clean. Note that this will be effective if you use the right technique. The American Dental Association recommends that you should brush in a circular motion from the front, back, then stop for 2 to 3 minutes using a toothbrush with soft bristles.
Use Fluoride
Brushing with toothpaste containing fluoride helps prevent tooth decay and cavities.
Floss Regularly
Doctors would like to see once-a-day flossing, which helps remove bacteria and plaque from the teeth, especially in areas where a toothbrush cannot reach. Removing debris also prevents bad breath that often occurs when food is trapped between dental ridges.
Regular Dental Checkups
Children coping with a cleft lip or palate should see the dentist as soon after birth as feasible. Early evaluation by professional personnel is important as it helps determine appropriate treatment options for your child. Treatment often depends on the severity of the condition.

Benefits of Good Oral Hygiene on Treatment Outcomes

There are many reasons why kids with cleft palate should observe good oral hygiene. Among them include:

  • Good hygiene prevents the development of cavities and gum diseases
  • It prevents the development of more serious dental diseases
  • It stops bad breath
  • It lowers general healthcare costs


Cleft Lip and Cleft Palate in Children: Care Instructions. (February 2021). MyHealthAlberta.

Cleft Lip and Palate. (December 2018). Cleveland Clinic.

Cleft Lip and Cleft Palate. (July 2021). WebMD

How Does Your Child’s Cleft Palate Affect Their Oral Health? Colgate.

Faces about Cleft Lip and Cleft Palatev. (December 2020). Centers for Disease Control and Prevention.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.