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Oral cleft birth defects are one of the most common birth defects, affecting approximately one in 500 children in the United States. Although cleft defects can vary greatly in their severity they are always scary for the parents of a newborn and will always require at least one, and sometimes many, corrective surgeries. In addition, oral cleft defects can interfere with feeding and have consequences for speech and hearing development. So what exactly are the different types of oral cleft birth defects and what causes them?

An oral cleft defect occurs relatively early in a pregnancy, between weeks 6 through 10, and is essentially when the bones and tissue of the baby’s upper jaw, nose and mouth do not fuse together properly to form the roof of the mouth (the palate) and the upper lip. Depending on how severe the defect is, the baby may be born with a cleft palate, a cleft lip, or both. And of course, each of these also has its own scale of severity.

For example, cleft palate birth defect can itself affect different parts of the palate or the entire palate. The palate is divided into two parts—a hard part which runs up against the teeth, and a soft part, which is towards the back of the mouth. If a child is born with a cleft palate, there is an opening in the palate between the roof of the mouth and the nose that could be in either the hard or soft part, or both. A complete cleft palate occurs when the right and left sides of the palate do not fuse together. A cleft lip birth defect also has varying degrees of severity. Cleft lip is simply a gap or opening in the upper lip, which can be present on just one side of the lip (unilateral) or on both sides (bilateral), and can extend all the way into the nose. A double cleft is the most severe of all the cleft deformities and runs from the back of the mouth, or the soft part of the palate, all the way through to the nose.

Despite the fact that oral cleft birth defects are among the most common craniofacial differences, there a number of different causes of them. Some studies indicate that there may be a genetic component. In addition, smoking cigarettes and the use of alcohol and drugs during pregnancy also increases the risk. Tragically, a number of recent studies have shown clear links between certain types of medications taken during pregnancy and oral cleft defects. For example, Topamax, an anti-seizure medication commonly used to treat epilepsy increases the risk of oral cleft birth defects if taken during pregnancy, a link that has resulted in a number of lawsuits against the makers of Topamax.

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