The jaws may also be of major concern. The nasal deformity in a cleft patient is often related to the extent of the underlying bone deformity, and the width of the cleft is a major factor in subsequent tooth development. It is not unusual for tooth development to be delayed in the child who is being treated for cleft lip and palate. By examining such a child during mixed dentition stage, one might erroneously conclude that these teeth are congenitally missing. These children must therefore be examined periodically and treatment plans may have to be modified and often compromised, depending on the severity of the cleft, the growth of the jaws and the status of the developing deciduous and permanent teeth.
Dental anomalies occur frequently in persons with clefts.
A common example, while not necessarily occurring in all cases, is the congenital absence of teeth, particularly those at the site of the cleft. Since those teeth develop away from the site of the cleft, their absence, having been found to occur in greater frequency among the cleft population, becomes even more mystifying. One or all four bicuspids of some cases, may be absent. In addition, the second bicuspids of some cleft children may show an abnormal pattern of calcification and development. These are sometimes seen in the non-cleft population, but not nearly as often.