Orofacial Clefts

What Is a Cleft?

A cleft is when a baby is born with an opening in the lip and/or roof of the mouth (palate). A baby with a cleft might have:

• only a cleft lip
• both a cleft lip and a cleft palate (PAL-it)
• only a cleft palate

Cleft lip alone and cleft lip with a cleft palate happen more often in boys. A cleft palate without a cleft lip is more common in girls.

Together, these are called orofacial clefts. Most kids can have surgery to repair them within the first year of life.

What Are the Types of Clefts?

Cleft Lip

A cleft lip may just look like a small opening on the edge of the lip, or it could extend into the nose. It may also extend into the gums.

A cleft lip can be a:

• unilateral cleft lip: a split on one side of the lip
• bilateral cleft lip: splits on both sides of the lip

Clefts can range in size:

• Some are just a small notch in the lip (an incomplete cleft lip).
• Others extend from the lip through the upper gum and into the nostril (a complete cleft lip). This can make the baby's nose look wider and shorter than normal, especially when there are clefts on both sides of the lip.

Read more about cleft lip.

Cleft Palate

A cleft palate is when a baby is born with a cleft in the roof of the mouth. This leaves a hole between the nose and the mouth. It can be:

• a complete cleft palate: going from behind the front teeth to the back of the palate
• an incomplete cleft palate: affecting just the back of the palate, near the back of the throat

Read more about cleft palate.

Another kind of cleft palate, a submucous cleft palate (SMCP), happens when the cleft is underneath the mucous membrane, the tissue that covers the palate. This makes it harder to see.

Read more about submucous cleft palate.

Cleft Palate With Cleft Lip

A cleft palate with a cleft lip is when a baby's lip and palate (roof of mouth) both do not form properly during pregnancy. How serious the defects are can vary depending on the type of cleft lip and the type of cleft palate.

For instance, one baby might be born with:

• An incomplete cleft palate with an incomplete unilateral cleft lip: The baby has a cleft on one side of the lip only that does not extend to the nostril, and a cleft in the roof of the mouth that does not go all the way to the back of the palate.

But another baby might have:

• A complete cleft palate with a complete bilateral cleft lip: the baby has clefts on both sides of the lip that reach the nostrils and a cleft in the roof of the mouth that goes all the way back.

Read more about cleft palate with cleft lip.