This helps in directing the type of intervention which is the most appropriate. When necessary, recommendations for speech therapy are made based on the child's specific needs. In these operations, some of the tissue from the palate and the back of the throat are repositioned to help close off the escape of air through the nose. A cleft defect can involve the teeth and gums. A child with a cleft palate may need surgery after the initial cleft palate repair to replace missing bone in the front of the mouth and the roof to the mouth.
Bone is taken from the bones of the hip or skull, and placed in the area of the cleft in the gum.
This enables the teeth which may not have erupted a stable support to erupt through. There is also added support and improved contour if a bridge is needed to fill in missing teeth. Children who have had cleft lip and palate and subsequent repair may have a resulting facial imbalance, and their teeth may not fit together properly. This surgery is generally delayed until the child is a teenager. The nose may appear flattened, or there may be asymmetry of the nose.