Discoveries and Data: Specific Conditions

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title_bd_clefts-8588089

pic_bd_cleftlip-3108927 Oral clefts occur in 1 in 790 California births: 0.9 per 1000 have cleft lip (with/without cleft palate) and 0.4 per 1000 have cleft palate alone.

DEVELOPMENT, DETECTION AND TREATMENT

Oral clefts result when tissues of the developing mouth fail to meet and fuse 5-9 weeks after conception. The cause of oral clefts is not yet well understood, but evidence points to interactions between genetic and environmental factors. Inheritance patterns and other factors suggest that cleft lip (with or without an accompanying cleft palate) and cleft palate alone are actually distinct entities.

Although occasionally diagnosed with prenatal ultrasound, there is no systematic screening for oral clefts.

Surgery to close clefts is done in infancy, but most individuals require additional operations during childhood and adolescence—often 4 surgeries before age 2. Babies with oral clefts may have feeding problems; older children often have ear infections, speech difficulties and require orthodontic treatment. The lifetime cost for medical treatment, educational services and lost productivity averages more than $101,000. About 15% of all babies with oral clefts die before age 1, usually because of associated birth defects.

OCCURRENCE PATTERNS

bullet-8344302 About 1/4 of those with cleft lip (with/without cleft palate) and half with only cleft palate have other major birth defects. ref_book-7507704
bullet-8344302 There is some racial/ethnic variation in oral clefts. Blacks have a lower rate of cleft lip with/without cleft palate. Whites have a higher rate of cleft palate alone. ref_book-7507704
bullet-8344302 Males are more likely than females to have cleft lip with or without cleft palate. Girls are more likely than boys to have cleft palate alone. ref_book-7507704

RISK AND PREVENTIVE FACTORS

Many studies by the California Birth Defects Monitoring Program look at oral clefts and factors such as nutrition, smoking and drinking, stress, and environmental concerns such as hazardous waste sites.

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