Lagos: Maxillofacial surgeons say many challenges faced by patients with cleft lip and palate can be reduced through early intervention, proper care, and risk reduction strategies. They emphasised that fixing a cleft lip or palate is not just about surgery, but giving people their confidence back, helping them communicate, and ensuring they could thrive and fit in socially.
According to News Agency of Nigeria, the surgeons from the Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, highlighted these points in a World Oral Health Day message. The message was penned by Dr. Fatima Kyari, Dr. Adekunle Adegbayi, Dr. Adamson Olatunbosun, Ayelomi Oluwanifemi, Prof. James Olutayo, Prof. Wasiu Adeyemo, and Prof. Mobolanle Ogunlewe.
World Oral Health Day, celebrated annually on March 20, seeks to unite and help reduce the burden of oral diseases affecting individuals, health systems, and economies. The experts spoke on the ‘Challenges and Management of Children with Cleft Lip and Palate’. Cleft lip and palate (CLP) are congenital birth defects occurring when facial tissues fail to fully join in the womb, resulting in openings in the upper lip or roof of the mouth.
Data from the World Health Organisation (WHO) indicates that globally, one in every 700 children is born with the condition. The health agency added that no fewer than 19,000 cleft children were born yearly in Africa, out of which 12,000 were in West Africa and 6,000 in Nigeria. WHO in 2008 included CLP in the list of global burden of disease initiatives.
The surgeons noted that children with cleft lip and palate presented with numerous challenges including speech defects, psychosocial challenges, and abnormal size, shape, and position of teeth. More concerning for parents of children with CLP are feeding difficulties that result in malnutrition due to the anatomical defect in the palate, which prevents the development of necessary seal and intraoral pressure for suckling, leading to frequent aspirations and subsequent recurrent respiratory tract infections. These factors contribute to failure to thrive and poor nutrition, with feeding time significantly longer and causing fatigue for both baby and mother, ultimately affecting the child’s overall nutrition.
They noted that preventing cleft lip and palate entirely is not possible because they result from a mix of genetic and environmental factors. According to them, early diagnosis, timely surgical intervention, and continuous support from dedicated cleft care teams can effectively minimize the challenges of cleft lip and palate among patients. They stressed that taking folic acid before and during pregnancy, avoiding alcohol and unprescribed medications or herbal concussions, treating maternal illnesses, and getting genetic tests can lower cleft lip risk.
They emphasized that a multidisciplinary team-based approach has been the standard of care for treating patients with orofacial cleft and craniofacial anomalies since 1938, when the first such team was established. These specialists should include the disciplines of audiology, radiology, genetic counselling, neurology and neurosurgery, nursing, nutritionist, plastic and reconstructive surgery, oral and maxillofacial surgery, orthodontics, otorhinolaryngology, pediatric medicine, among others. Successful long-term outcomes depend on individualised, fully integrated treatments provided in an effective and coordinated manner.
They disclosed that comprehensive cleft care in collaboration with Smiletrain is being provided for free at the cleft clinic of LUTH, urging the public to take advantage of it.