Dental News: The Genetic Link Between Orofacial Clefting and Dental Anomalies
2015 by DentalSpots

From previously published literature, it is clear that cleft palate and orofacial clefting can be genetically transferred from one generation to another. However, such birth defects have a prevalence of 1–2/1000 live births. There are two types of such defects that exists such as the cleft lip with or without cleft palate (CL/P); and cleft palate only (CPO). However, in humans mostly nonsyndromic cleft lip (CL/P) has been studied as it was more prevalent whereas the CPO has mostly been studied and researched in animals. There are several reasons that dental abnormalities can occur such as, prolonged issues to the internal mouth setting as a result of weaknesses in mesenchymal tissue, blood supply, or perturbations in molecular level connections between the dental lamina and surrounding tissue. These can be influenced by genes or by physical effects of the cleft and its severity, or surgical repair procedures of the oral cavity in general. Moreover, if the cleft severity persists, then there is an increased chance of living with dental anomalies or abnormalities.

How Does Cleft Palate Develop?

Cleft palate and cleft lip occur early on in the pregnancy while the fetus is still developing inside the womb. This anomaly occurs when there is not sufficient tissue in the mouth or lip area, and the tissues there do not bind together in alignment or remain open in the form of a slit. To a normal healthy individual it would look like a physical split or parting of the two margins of the upper lip and/or seems like a narrow gap in the skin of the upper lip. In severe cases, however, this slit or opening can involve the upper jaw and other neighboring bones making it difficult to breathe or swallow food. Since this occurs early on in life, if detected on time the dental surgeons and orthopedic doctors can fix this anomaly, and the child can lead a normal healthy life without any complications.

Furthermore, this anomaly has a tendency to occur in children of Asian, Latino, or Native American descent. When comparing prevalence of this anomaly in gender, twice as many boys have a cleft lip, as compared to girls both with and without a cleft palate. However, twice as many girls have cleft palate without a cleft lip.

There are several issues that are affiliated with this anomaly. If left untreated it can lead to problems such as;

Who Can Treat Children With Cleft Palate

Apparently, it looks like a dental surgeon, or a cosmetic surgeon can fix this anomaly. However, one would wonder as to how much effort and teamwork is needed to fix this complex issue. Some of the highly trained team members of a cleft lip and palate team typically consist of:

  • Plastic surgeons
  • An otolaryngologist (An ear, nose, and throat doctor)
  • An oral surgeon
  • An orthodontist
  • A dentist (to implement routine dental care)
  • A prosthodontist (who create artificial teeth)
  • A speech pathologist
  • A speech therapist
  • An audiologist
  • A nurse coordinator (for ongoing support )
  • A social worker/psychologist (for family support)
  • A geneticist (for genetic counseling).

How to Raise Awareness of Cleft Palate

Even though cleft palate is a thing of the past in the U.S., it still prevails in other parts of the world where there is lack of education, cousin marriages is the norm leading to less and less genetic diversity. Moreover, it is still important to educate and know about this anomaly even if you live in the U.S., since there are a few cases emerging here and there that can generate a lot of attention as people do not hear about it too often. Additionally, if someone in the family or friends or acquaintances know about someone having this anomaly or issue at hand, they should be referred to a dentist as soon as possible as the jaw of a child and teeth are still in the developmental phase when they are young and such anomalies can be fixed with surgery and cosmetic procedures so that such patients can lead normal lives and can intake regular food. Otherwise, the surgical procedures in itself can result in complications and difficulty in leading normal lives since the bones are fused tightly as children grow older and there is little wiggle room in the jaw area in general, once they reach adulthood.

Taken as a whole, the current research suggest that most affected families do not have a higher genetic risk for dental anomalies than the general population. However, some families may carry susceptibility to both overt clefts and dental abnormalities, suggesting rare mutations in such cases. Furthermore, research findings points to the fact that the higher prevalence of such anomalies in certain cases is primarily a physical consequence of the cleft and surgical interventions. Moreover, once this defect in the mouth is detected and fixed a child can lead a normal and healthy life.

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