Expert Multidisciplinary Team Treats Cleft Lip and Palate Throughout Childhood

Most people don’t know that cleft lip and cleft palate patients – who have openings in the lip or roof of the mouth – are optimally seen from infanthood until they are 18 years old, according to Wellington Davis III, MD, Chief, Pediatric Plastic Surgery, Lehigh Valley Reilly Children’s Hospital.

“Cleft patients won’t get the care they need if they just have a surgeon who does a couple surgeries and sends them off, which happens. Multidisciplinary management is a critical portion of cleft care,” Dr. Davis says.

Dr. Davis works with Marsha Gordon, DDS, pediatric dentist; Philip Tighe, DMD, orthodontist; and Tara Huggard, MS, CCC-SLP, speech and swallow therapist, to help treat speech and dental difficulties that result from oral birth defects. At the Dental Clinic at Lehigh Valley Hospital–17th Street, the collaborative team regularly consults with children and their families.

“We all see the patients together, come up with a plan for the patients together and discuss our plans with the families,” says Dr. Davis, who provides his cellphone number to families. “We are very family-oriented and super accessible.”

The Cleft Lip and Cleft Palate Surgery Program at Lehigh Valley Reilly Children’s Hospital, which has grown by 15 to 20 patients annually since it began, treats a wide range of individuals. Most are born with either a cleft lip or cleft palate, or both, which may impact speech, eating, breathing and dental development. The opening may present as a small groove or notch, or may split the lip and/or palate in two. In cases where the cleft is wide, people may require presurgical intervention to narrow the opening.

The team also treats individuals with velopharyngeal insufficiency, which presents as nasal air regurgitation or hypernasal speech, and those with Pierre Robin sequence, a congenital condition characterized by an underdeveloped jaw, backward displacement of the tongue and upper airway obstruction.

As children grow, they may require speech support, bone grafting, orthodontic care and minor “touch-ups” of cleft surgeries, including improving the appearance of nasal deformities.

“The optimal outcome is good speech, good facial aesthetics, and good dental health and function,” says Dr. Davis, who notes that the program is not limited to babies and young children.

Adults, teens or children who have had cleft lip or cleft palate surgery in the past – but did not receive adequate follow-up – are welcome to consult with Dr. Davis about their appearance, speech or any other concern.