Cleft Lip and Palate Repair

During early pregnancy the upper lip or palate may fail to fuse together resulting in either a cleft lip/palate or both.

Dr. John Caccamese works with an entire pediatric cleft lip and palate team comprised of specialized dentists/orthodontists, pediatricians, pediatric ENT physicians, speech and language pathologists to provide comprehensive care for your child.

Cleft lip surgery is usually performed when the child is about 10 weeks old. The goal of surgery is to close the separation, restore muscle function, and provide a normal shape to the mouth. The nostril deformity may be improved as a result of the procedure, or may require a subsequent surgery.

A cleft palate is initially treated with surgery safely when the child is between 7 to 18 months old. This depends upon the individual child and his/her own situation. For example, if the child has other associated health problems, it is likely that the surgery will be delayed.

The major goals of surgery are to:

  • Close the gap or hole between the roof of the mouth and the nose
  • Reconnect the muscles that make the palate work
  • Make the repaired palate long enough so that it can perform its function properly
  • There are many different techniques that surgeons will use to accomplish these goals. The choice of techniques may vary between surgeons and should be discussed between the parents and the surgeon prior to surgery.
  • The cleft hard palate is generally repaired between the ages of 8 and 12, when the cuspid teeth begin to develop. The procedure involves placement of bone from the hip into the bony defect, and closure of the communication from the nose to the gum tissue in three layers. It may also be performed in teenagers and adults as an individual procedure, or combined with corrective jaw surgery.

Pediatric Jaw Tumors and Pathology

Pediatric jaw tumors are an uncommon occurrence that requires a comprehensive team approach to achieve the long-term goals for your child including:.

  • Tumor surveillance
  • Maintaining normal facial skeletal and dental growth which may not cease until 18-21 years of age
  • Normal speech and swallowing function
  • Replacement of the missing dentition (teeth)

Majority of pediatric jaw tumors are benign and can often be managed with more conservative surgical approaches preserving the structure of the jaws and face.

Dr. John Caccamese along with members of the UMOMSA oncology/reconstructive surgery team, maxillofacial prosthodontics, and various departments within the University of Maryland School of Dentistry (pediatric dentistry and orthodontic departments) will assess the needs of your child/adolescent and provide comprehensive, compassionate integrated care.