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Clefts of the lip and palate are the most common congenital craniofacial anomaly. They are generally divided into two broad categories, which include cleft lip with or without cleft palate and isolated cleft palate. The incidence of these anomalies varies according to cleft type, geographical location and ethnicity. This article aims to give an overview of the genetic links and the known environmental influences that may contribute to the development of a cleft. In addition, the embryological development of the lip and palate and the patient care pathway from birth to adulthood are highlighted.
Clinical Relevance: A basic understanding of cleft lip and palate is important for clinicians involved in the delivery of regular dental care for a patient born with an oro-facial cleft.
Article
Clefts of the lip and palate are the commonest congenital craniofacial abnormalities in humans. Clefts are most often discussed as either those that involve the lip, with or without the palate (CL/P), or those that involve the palate only (CP). The prevalence of clefting varies considerably according to geographical location, racial and ethnic background,1 socioeconomic status and cleft type.2 In general, the Asian and Native American populations have the highest reported prevalence rates of CL/P, which are often as high as 1 in 500.3 In the United Kingdom (UK), non-syndromic CP occurs approximately once in every 1000 live births, whilst CL/P has a higher prevalence of 1 in 700 live births.3 Currently, the CRANE database is used to register birth and demographic data of all children born with an oral cleft in England, Wales and Northern Ireland (Table 1).4 Clefting can occur either unilaterally or bilaterally and may be complete or incomplete (Figure 1). There is also laterality in that CL/P has an increased frequency of left-sided over right-sided unilateral clefts and this is more frequent in males compared to females in a ratio of 2:1. Cleft palate, however, is most typical in females.
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