Orofacial cleft is a birth difference where the lip, the roof of the mouth, or both do not fully join before birth. It is usually recognized on prenatal ultrasound or at birth, and feeding, speech, hearing, and dental problems can follow depending on the type and size of the cleft. Not everyone will have the same experience, and some babies have an isolated cleft while others have related genetic or health conditions. Orofacial cleft is lifelong, but treatment often includes feeding support, surgery in infancy or childhood, speech therapy, dental and orthodontic care, and hearing checks. Most children with orofacial cleft do well with coordinated care, and life expectancy is usually normal unless there are severe associated conditions.
How many people live with Orofacial cleft?
Modeled estimates suggest that about 10 million people worldwide are living with an orofacial cleft, meaning a cleft lip and/or cleft palate (IHME Global Burden of Disease Study, 2024). In the United States, the same source suggests roughly 400,000 to 500,000 people are living with one (IHME Global Burden of Disease Study, 2024).
Overview
Orofacial cleftSymptoms
Orofacial cleft often affects how the lip, roof of the mouth, or both form before birth. Signs can include a visible opening in the lip or mouth, feeding trouble, nasal-sounding speech, frequent ear infections, and dental problems.
Outlook and prognosis
For many with orofacial cleft, the outlook is very good with timely surgery and follow-up care. Feeding, speech, hearing, teeth, and facial growth often improve step by step. Some need several treatments during childhood.
Causes and risk factors
Orofacial cleft usually results from a mix of genetic changes and early pregnancy factors. Risk can rise with family history, smoking, alcohol, certain anti-seizure medicines, poorly controlled diabetes, obesity, and low folate intake.
Genetic influences
Genetics matter in orofacial cleft, but they are usually only part of the picture. Many cases are linked to a mix of inherited gene changes and non-genetic factors, while some happen as part of a broader genetic syndrome.
Diagnosis
Diagnosis of Orofacial cleft often starts before or at birth, based on visible clinical features and ultrasound imaging. After birth, the diagnosis is confirmed with an exam, and some babies may also have genetic tests to look for related conditions.
Treatment and drugs
Treatment for orofacial cleft often includes surgery to close the lip or palate, plus feeding support early on. Many living with orofacial cleft also need speech therapy, dental and orthodontic care, hearing checks, and follow-up from a cleft team.
Symptoms
Feeding can be one of the first day-to-day challenges, and some babies need extra help to latch and feed well. Orofacial cleft can affect the lip, the roof of the mouth, or both, so the signs depend on the type and size of the opening. For many people with orofacial cleft, the most noticeable features are visible changes around the mouth or nose, along with feeding, speech, hearing, or dental issues. The early features of orofacial cleft are often clear at birth, although a cleft affecting only the palate can be missed at first.
The upper lip may have a small notch or a wider opening on one side or both sides. Some babies also have a change in the shape of the nose on the same side.
There may be an opening in the roof of the mouth, sometimes hard to see unless the mouth is examined closely. This can make sucking harder and can let milk or formula come through the nose during feeds.
Many babies have trouble making a strong seal around the breast or bottle and may tire easily while feeding. Longer feeds and slow weight gain can happen, especially with a cleft palate.
As children grow, speech may sound nasal or some sounds may be hard to say clearly. This happens because air can escape through the nose when the roof of the mouth does not close well.
How people usually first notice Orofacial cleft?
Orofacial cleft is usually first noticed before birth on a routine prenatal ultrasound or at birth, when a baby has a visible opening in the lip, the roof of the mouth, or both. The first signs of orofacial cleft can also show up in the first days of life if feeding is difficult, milk comes through the nose, or a healthcare team notices that the palate has not fully closed even when the lip looks normal. For many families, how orofacial cleft is first noticed depends on the type and size of the cleft, since some are obvious right away while others are found during an early newborn exam.
Types of Orofacial cleft
Many living with orofacial cleft are affected in different ways from birth, and day-to-day challenges can vary from feeding issues in a newborn to speech or dental concerns later on. In medical terms, these are called clinical variants, which describe where the opening affects the lip, the roof of the mouth, or both. The main types of orofacial cleft differ by the body area involved, and that often shapes how symptoms show up and how treatment is planned.
Cleft lip
This type affects the upper lip and can range from a small notch to a wider opening that reaches toward the nose. Many babies with cleft lip can feed well, but some may have trouble latching or keeping a seal around the nipple. A cleft lip may happen on one side or both sides.
Cleft palate
This type affects the roof of the mouth, even when the lip looks typical from the outside. Babies often have more feeding difficulty because milk can pass into the nose, and later some children develop speech that sounds nasal or have repeated ear infections. For many, this can mean symptoms are noticed only after birth when feeding or speech concerns appear.
Cleft lip palate
In this variant, both the lip and the palate are affected, so symptoms can be broader than with either one alone. Feeding support is often needed early, and many children also need help with speech, hearing, and dental development as they grow. This is one of the more recognized variants of orofacial cleft.
Submucous cleft palate
In this less obvious form, the muscles of the palate do not join fully, but the lining over them remains in place. Because the mouth may look nearly typical, signs can be subtle at first, such as feeding trouble, nasal-sounding speech, or frequent ear problems. Symptoms don’t always look the same for everyone.
Can I slow down the onset of symptoms?
No. A cleft lip or cleft palate, also called an orofacial cleft, develops very early in pregnancy, so there is no proven way to slow its onset or stop it once it has started. Research suggests that lowering certain pregnancy risks before and in early pregnancy, such as not smoking, avoiding alcohol, reviewing medicines with your doctor, controlling diabetes, and getting enough folic acid, may lower the chance in some pregnancies, but that reduces risk rather than preventing the condition. Regular prenatal care and ultrasound can sometimes find it early and help families plan treatment after birth, and while that cannot change when it starts, early support can still make a real difference.
What genetics can tell you about symptoms
Genetics can sometimes help explain why orofacial clefts look different from one child to another, including whether the cleft affects the lip, the roof of the mouth, or both, and whether it happens alone or as part of a broader genetic syndrome. Certain genetic changes can raise the chance of a more severe cleft or other related features, such as differences in facial development, hearing, speech, or growth, and in some syndromes they can also affect when other health concerns show up. Even so, genetics does not predict symptoms perfectly, because the final pattern is often shaped by a mix of genes and non-genetic factors during early pregnancy.
Causes and risk factors
Orofacial cleft usually starts very early in pregnancy, when the lip or roof of the mouth does not close fully. Family history and gene changes can raise the chance. Some gene changes are inherited, and some happen for the first time in the child. Risk factors for orofacial cleft also include smoking, alcohol use, not getting enough folic acid, some medicines, diabetes, and obesity before or during pregnancy. It is rarely just one factor, and the mix matters.
What are the most common causes or risk factors?
An orofacial cleft, such as a cleft lip or cleft palate, usually does not have one single cause and most often happens because genes and early pregnancy factors work together, so the chance is higher if it runs in the family or is part of a genetic condition. Well-known risk factors include smoking during pregnancy, heavy alcohol use, diabetes that is not well controlled, obesity, and some medicines taken early in pregnancy, especially certain anti-seizure drugs. Not getting enough folic acid, a B vitamin found in prenatal vitamins, may also raise the risk, although many babies born with an orofacial cleft have no clear risk factor at all.
Environmental and biological risk factors
Orofacial cleft usually develops very early in pregnancy, often before someone knows they are pregnant. Doctors often group risks into internal (biological) and external (environmental). For this condition, the main concerns are certain maternal health conditions and early-pregnancy exposures that can affect how the lip and palate come together. When people ask about risk factors for orofacial cleft in pregnancy, it is usually this early window that matters most.
Diabetes present before pregnancy, especially if blood sugar is high early on, can increase the chance of an orofacial cleft. This matters most in the first weeks, when the lip and palate are forming.
Having obesity before pregnancy has been linked with a small increase in risk for some types of orofacial cleft. Researchers think this may relate to inflammation and blood sugar changes, although most pregnancies in people with obesity do not result in a cleft.
Some medicines taken in early pregnancy can raise risk, especially certain anti-seizure drugs, retinoid acne treatments, and methotrexate. Medication changes should always be made with a doctor, because safer options are often available.
A high fever or significant overheating in early pregnancy may slightly increase the chance of an orofacial cleft. The concern is greatest during the short period when facial tissues are joining together.
Genetic risk factors
Orofacial cleft often happens because the tissues of the lip or roof of the mouth do not join fully very early in pregnancy, and genes can play an important part in why that happens. Some risk factors are inherited through our genes. The genetic causes of orofacial cleft are varied: in many families, several genes each add a small effect, while in others a single genetic change or a broader chromosome difference is involved. Many people with an orofacial cleft have no clear family history, so genetics can matter even when this seems to happen out of the blue.
Family history: Having a close relative with a cleft lip, cleft palate, or both raises the chance in a future child. The risk is usually still low overall, but it is higher than in families with no history and depends on the exact type of cleft and how many relatives are affected.
Multiple genes: For many living with orofacial cleft, there is not one single gene behind it. Instead, many small gene differences can act together and slightly change how the face develops before birth.
Single-gene changes: In some families, one changed gene plays a major role in causing the cleft. When this happens, the pattern may appear across generations or come with related features such as small lip pits or missing teeth.
Genetic syndromes: Some orofacial clefts are part of a broader genetic condition, sometimes called a syndrome. In these cases, the cleft may occur along with other findings, such as differences in growth, hearing, vision, heart structure, or learning.
Chromosome differences: Sometimes a piece of a chromosome is missing, extra, or rearranged, and this can raise the chance of an orofacial cleft. These changes may also affect other parts of the body, which is one reason doctors may suggest genetic testing.
New changes: A genetic change can happen for the first time in a child instead of being passed down from a parent. This helps explain why some babies are born with an orofacial cleft even when no one else in the family has had one.
Lifestyle risk factors
Orofacial cleft develops before birth, so lifestyle habits do not cause the condition itself. However, how lifestyle affects orofacial cleft can be important for feeding, growth, speech, dental health, wound healing, and recovery around surgeries. The main lifestyle-related influences are the day-to-day habits that change nutrition, oral health, smoke exposure, and access to therapies and follow-up care.
Feeding technique and bottle or nipple choice can strongly affect milk intake in infants with an orofacial cleft. Poor positioning or ineffective feeding routines may increase choking, nasal regurgitation, and slow weight gain. Specialist feeding support can improve nutrition before surgery.
Adequate calories, protein, iron, and vitamins help support growth and tissue healing in children with an orofacial cleft. Poor diet can worsen faltering growth and make recovery after cleft repair more difficult. Balanced nutrition also supports immune function during repeated treatments.
Careful brushing, fluoride use, and regular dental routines matter because clefts can increase the risk of tooth decay and gum problems. Inconsistent oral care may complicate orthodontic treatment and later surgery planning. Good oral hygiene can also reduce mouth infections and discomfort.
Tobacco smoke and secondhand smoke do not cause the cleft after birth, but they can irritate the airways and raise the risk of ear, nose, and throat problems. Smoke exposure may also impair wound healing after procedures. Avoiding smoke can support breathing comfort and surgical recovery.
Risk prevention
Orofacial cleft cannot always be prevented, because it often happens from a mix of genetic and pregnancy-related factors. Prevention is about lowering risk, not eliminating it completely. For many families, this means focusing on health before and during pregnancy, especially if there is a family history of cleft lip or cleft palate. Knowing the main risk factors for orofacial cleft can help guide those steps.
A preconception visit can help review family history, medicines, and health conditions that may raise the chance of an orofacial cleft. This is especially helpful if you have had a prior pregnancy affected by cleft lip or cleft palate.
Taking folic acid before pregnancy and during early pregnancy may help lower the risk of some birth differences, including some orofacial clefts. Many doctors advise starting before conception, because the face develops very early in pregnancy.
Smoking during pregnancy can increase the chance of an orofacial cleft. Avoiding cigarettes, vaping, and secondhand smoke is one of the clearest steps that may reduce risk.
Drinking alcohol during pregnancy may raise the risk of problems with early fetal development, including orofacial cleft. If you are trying to conceive or could become pregnant, avoiding alcohol is the safest choice.
Can you prevent Orofacial cleft?
You cannot fully prevent an orofacial cleft, such as a cleft lip or cleft palate, because it often happens from a mix of inherited factors and things that affect early pregnancy. The risk may be lowered by getting enough folic acid, a B vitamin, before and during early pregnancy, avoiding smoking and alcohol, and talking with a doctor about medicines and health problems like diabetes before pregnancy. Even when someone does everything right, some babies are still born with a cleft.
Transmission
Orofacial cleft is not infectious, so it cannot be passed from one child or adult to another through contact, coughing, kissing, food, or sex. Many people with orofacial cleft are born with it because of a mix of inherited genes and other influences during early pregnancy, so it may run in families even when no one else is affected.
When people ask how orofacial cleft is inherited, the answer is often that there is no single cause: several genes may raise the chance, and sometimes a new genetic change happens for the first time in a family. In a smaller number of cases, orofacial cleft is part of a genetic syndrome, which can make the pattern of inheritance clearer and may increase the chance in future pregnancies.
When to test your genes
Consider genetic testing if a cleft lip or palate occurs with other birth differences, developmental delays, hearing loss, heart problems, or a strong family history. Testing can help identify a syndrome, clarify recurrence risk for future pregnancies, and guide care such as heart, hearing, feeding, and speech follow-up.
Diagnosis
Orofacial cleft is often diagnosed very early, sometimes before birth and sometimes right after delivery, when the lip, roof of the mouth, or both can be clearly seen. In many babies, the diagnosis of orofacial cleft begins with a careful physical exam and is then confirmed with imaging or other tests if needed. Getting a diagnosis is often a turning point toward answers and support.
A routine pregnancy ultrasound can sometimes show a cleft lip before birth, especially later in pregnancy. A cleft affecting only the roof of the mouth is harder to see on ultrasound and may be missed.
After birth, doctors carefully look at the baby's lip, mouth, and palate to confirm whether an orofacial cleft is present. This exam also helps show how wide the cleft is and whether one or both sides are affected.
Doctors may gently examine inside the mouth to look for a cleft palate that is not obvious at first glance. This is especially important when feeding is difficult, milk comes through the nose, or the cry sounds more nasal than expected.
In some cases, imaging such as ultrasound or other scans may be used to look more closely at the palate, jaw, or nearby structures. These tests can help with treatment planning rather than making the first diagnosis alone.
How is Orofacial cleft diagnosed?
Orofacial cleft is usually diagnosed by seeing a split in the lip, the roof of the mouth, or both during a physical exam after birth, and many cases are also picked up on a routine ultrasound scan during pregnancy. A split in the roof of the mouth can be harder to spot before birth, so doctors may find it by carefully looking inside the baby’s mouth, especially if there are feeding problems. If the cleft happens along with other birth differences or there is a strong family history, doctors may suggest genetic testing to look for an underlying cause, but the diagnosis itself is most often based on the exam and the pregnancy scan.
Stages of Orofacial cleft
Orofacial cleft does not have defined progression stages. This is because it is a structural difference present before birth, rather than a condition that gradually worsens over time. Doctors usually start with a conversation about feeding, speech, hearing, and dental concerns, then confirm the type and extent of the cleft with a physical exam and, in some cases, imaging or hearing tests. For many families wondering about early symptoms of orofacial cleft, it is often identified at birth or on prenatal ultrasound, and follow-up focuses on growth, feeding, speech, hearing, and planning treatment over time.
Outlook and prognosis
Outlook for people with orofacial cleft is generally very good, especially when care is provided early by an experienced cleft team that can address feeding, hearing, speech, dental, and surgical needs over time. Most children survive, grow, and develop well, and many achieve good facial appearance, speech, and quality of life after staged treatment, although some need additional operations or therapies as they get older. Prognosis is influenced by the type and severity of the cleft and whether it occurs alone or as part of a genetic syndrome or other birth defects, which can increase medical complexity. Mortality from an isolated cleft lip or cleft palate is low in settings with access to modern neonatal, surgical, and nutritional care, but the risk can be higher in infancy where feeding difficulties, infections, limited access to surgery, or associated anomalies are present. Long-term challenges may include recurrent ear problems, hearing loss, dental issues, speech differences, and psychosocial stress, but these are often manageable with coordinated follow-up. Overall, the prognosis for isolated orofacial cleft is favorable, while syndromic cases have a more variable outlook depending on the underlying condition.
Long-term effects
For many people, orofacial cleft can have effects that continue from infancy into childhood and adult life, especially when the lip, palate, or both are involved. The long-term picture is often shaped by the type of cleft, how severe it is, and whether it happens on its own or as part of a broader genetic condition. Many living with orofacial cleft do very well, but some continue to have differences in feeding, speech, hearing, dental health, facial growth, or emotional well-being over time.
Early feeding can be harder for some babies with orofacial cleft, especially when the palate is involved. This may affect weight gain at first, although growth often improves as care progresses.
Children with a cleft palate may have long-term speech differences because air can escape through the nose during talking. Even after repair, some may continue to have nasal-sounding speech or trouble making certain sounds.
Repeated ear fluid and ear infections are more common with clefts that involve the palate. Over time, this can lead to temporary or sometimes longer-lasting hearing loss that may affect language development and school learning.
Teeth may come in late, be missing, be extra, or grow in unusual positions near the cleft. Many people with orofacial cleft also have a higher chance of bite problems and cavities over the years.
How is it to live with Orofacial cleft?
Living with an orofacial cleft can affect everyday things that many people take for granted, such as feeding in infancy, speech, hearing, dental care, and feeling comfortable with appearance in social settings, although the impact varies widely depending on the type and severity of the cleft and the treatments received. Many people with an orofacial cleft grow up with surgeries, speech therapy, orthodontic care, and regular medical visits, so daily life can include extra appointments and planning, but with support, most can do very well at school, work, and in relationships. Families and other loved ones are often affected too, not only by the time and cost of care, but also by the emotional work of helping a child or adult navigate questions, teasing, or self-confidence, which is why strong medical, family, and community support can make such a meaningful difference.
Treatment and drugs
Treatment for orofacial cleft usually starts early and often involves a team that may include a surgeon, feeding specialist, dentist, speech therapist, and ear, nose, and throat doctor. In babies, care may begin with help for feeding and weight gain, since some infants have trouble creating enough suction to breastfeed or bottle-feed well. The main treatment is surgery to close the cleft lip, cleft palate, or both, usually in stages during infancy and early childhood, and many children also need speech therapy, dental or orthodontic care, and treatment for hearing problems or repeated ear infections. Treatment plans often combine several approaches. Not every treatment works the same way for every person, so follow-up over time helps the care team adjust care as your child grows.
Can you cure Orofacial cleft?
Orofacial cleft, often called a cleft lip or cleft palate, is not something that can be cured with medicine, but it can usually be repaired and managed very well. Surgery can close the opening, and follow-up care such as feeding support, speech therapy, dental care, and hearing treatment can help many living with this condition eat, speak, and grow more comfortably. Most children need care over time, and the exact treatment plan depends on how large the cleft is and which areas are affected.
Non-drug treatment
Feeding, speech, dental care, and appearance can all be affected in everyday life for people with orofacial cleft, so care usually involves several kinds of support over time. Treatment often starts in infancy and continues through childhood, with the plan tailored to whether the cleft affects the lip, the palate, or both. Managing this condition often means working with a team that may include surgeons, speech specialists, dentists, orthodontists, hearing specialists, and mental health professionals.
Babies with orofacial cleft may have trouble making a strong seal to breastfeed or bottle-feed, so special bottles, nipples, and feeding guidance are often used. This can help with weight gain, reduce tiring during feeds, and make day-to-day feeding less stressful for families.
Surgery is a main treatment for orofacial cleft and is used to close the lip, the palate, or both at planned stages of growth. Repair can improve feeding, speech development, and facial form, though some children need more than one operation over time.
Speech therapy can help if air escapes through the nose or certain sounds are hard to make after a cleft palate. If one method doesn’t help, there are usually other options, and some children also need further assessment to see whether another procedure would improve speech.
Teeth may come in crowded, missing, or out of position near the cleft, so regular dental visits and orthodontic treatment are common. For many, treatment begins not at the pharmacy, but with careful monitoring of jaw growth, bite changes, and the early symptoms of orofacial cleft that affect eating and speech.
Your genes may have an impact on how drugs work for you
For people with orofacial cleft, medicines often come up around surgery, dental care, and recovery, and small inherited differences can affect how well some pain medicines work or how strongly the body reacts to certain anesthesia or other drugs. This can mean one child gets good pain relief with a standard dose, while another may have less relief or more side effects like sleepiness, nausea, or trouble breathing. In some situations, doctors may use information about these inherited differences, sometimes called pharmacogenomics, to help choose safer or more effective medicine, but this is not yet routine for everyone living with orofacial cleft.
Pharmacological treatments
For people living with orofacial cleft, medicines do not close the gap itself, but they can play an important part around surgery, recovery, feeding, and comfort. Medication can feel like a big step, but most drug treatment for orofacial cleft is short term and aimed at specific needs such as pain, infection prevention, or reflux. The exact medicines depend on whether the issue is a cleft lip, cleft palate, or both, and on a child’s age and surgery plan. When families ask about medications used after cleft lip and palate surgery, the answer is usually a small group of well-known drugs rather than one long-term medicine for the cleft itself.
Acetaminophen and ibuprofen are commonly used after cleft repair to ease pain and help children feed and sleep more comfortably. In some cases, a short course of an opioid such as morphine or oxycodone may be used after surgery if pain is stronger.
Some surgical teams use antibiotics such as cefazolin during surgery or amoxicillin-clavulanate afterward to lower the risk of infection. The need for antibiotics varies by procedure and surgeon, so they are not used the same way for every child with orofacial cleft.
Dexamethasone is often given around the time of surgery to reduce swelling and help with nausea. This can make the first day after surgery a little smoother, especially when mouth and throat tissues are irritated.
Ondansetron is commonly used if anesthesia or pain medicine causes vomiting after surgery. Keeping nausea under control can help protect the repair and make drinking fluids easier.
Genetic influences
When a baby is born with an orofacial cleft, many families want to know why it happened and what it may mean for future pregnancies. It’s natural to ask whether family history plays a role. In many cases, orofacial cleft develops from a mix of genetic factors and non-genetic influences during early pregnancy, rather than from a single inherited cause. That means the genetic causes of orofacial cleft can be complex: several genes may slightly raise risk, and those effects can combine with factors such as certain medicines, smoking, alcohol exposure, or low folate intake. A smaller number of people with orofacial cleft have it as part of a broader genetic condition or chromosome change, especially if there are other birth differences, growth concerns, or developmental delays. Even so, many babies with an orofacial cleft are born into families with no known history, while the chance of it happening again can be a bit higher if a parent, child, or sibling is also affected, so genetic counseling can help make sense of that risk.
Is Orofacial cleft genetic?
Genetics matter in orofacial cleft, but they are usually only part of the picture. Many cases are linked to a mix of inherited gene changes and non-genetic factors, while some happen as part of a broader genetic syndrome.
Having a genetic risk is not necessarily a diagnosis
Across the general population, genetic variants are common and are a normal feature of human biology. Most have no direct impact on health and simply reflect natural differences among people. For many genes, carrying a variant associated with a condition points to a possible connection, not a definite diagnosis, especially when several genes and environmental factors contribute. In some cases, though, a single well-understood variant in a particular gene can be enough to confirm a diagnosis.
Pharmacogenetics—how genetics influence drug effects
For many families, treating orofacial cleft means planning surgeries, feeding support, dental care, and speech therapy over several years. Genetics can matter because some cases of orofacial cleft happen by themselves, while others are part of a broader genetic condition; knowing which is the case can help doctors decide what other checks are needed, such as hearing, heart, or growth evaluations, and can shape the timing of treatment. Orofacial cleft is usually not treated with a specific gene-based drug, and medicines used around surgery are generally chosen by age, weight, and overall health. Not every difference in response is genetic, but if testing shows an associated genetic condition that affects breathing, the heart, bleeding, or how the body handles certain medicines, the team may adjust anesthesia, antibiotics, or pain control more carefully. This is one reason genetic counseling or genetic testing for orofacial cleft treatment may be offered, especially when there are other birth differences, developmental concerns, or a strong family history. Even when a genetic cause is found, it often helps guide safer, more personalized care rather than changing the cleft repair itself.
Interactions with other conditions
For many living with orofacial cleft, the main challenge is not just the cleft itself but the other health problems that can come along with it. In day-to-day life, this can mean a baby who struggles with feeding and weight gain, or a child who has frequent ear infections, fluid behind the eardrum, or hearing problems that make speech development harder. Doctors call it a comorbidity when two conditions occur together. Some people with orofacial cleft also have dental differences, breathing or sleep problems, or other birth conditions such as heart defects, especially when the cleft is part of a broader genetic syndrome. The pattern can vary a lot: many people have an isolated cleft and are otherwise healthy, while others may need care from several specialists because the cleft overlaps with other medical needs. If there are signs beyond the cleft itself, such as delayed growth, unusual facial features, or concerns picked up during pregnancy or infancy, the care team may look for an underlying syndrome or inherited condition.
How genes can cause diseases
Humans have more than 20,000 genes, each carrying out one or a few specific functions in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the body's cells from beginning to multiply uncontrollably and developing into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call these hotspots "Genetic Variations" or "Variants" in short. In many cases, studies have been able to show that having the genetic letter "G" in the position makes you healthy, but having the letter "A" in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
What other conditions can cause similar symptoms to Orofacial cleft?
Feeding, speech, or repeated ear problems that can happen with an orofacial cleft may also be seen with a hidden split in the roof of the mouth, called a submucous cleft palate, as well as tongue-tie or hearing loss. In babies, a very small lower jaw with the tongue falling back, known as Pierre Robin sequence, can also seem similar because it can cause trouble feeding and breathing. Doctors may also check for broader genetic conditions linked with clefts, such as Van der Woude syndrome or 22q11.2 deletion syndrome, especially if there are other differences in the face, heart, or development.
History
Across cultures and time periods, people have described babies born with a split in the lip, the roof of the mouth, or both. What we now group under orofacial cleft was recognized long before modern medicine, often because it affected feeding, speech, and appearance in ways families noticed right away. In older records, these differences were sometimes misunderstood, and many living with orofacial cleft faced stigma as well as practical challenges.
As medical care improved, doctors began to describe different forms of orofacial cleft more clearly, separating a cleft lip from a cleft palate and recognizing that some children have both. Early treatment was limited, but surgeons gradually developed safer ways to close the lip and palate, especially during the 1800s and 1900s. For families, this changed day-to-day life in important ways: a baby who struggled to latch and feed, or a child whose speech was hard for others to understand, increasingly had access to care that could help.
The history of orofacial cleft is also the history of team-based care. Over time, treatment expanded beyond surgery alone to include feeding support, dental care, hearing checks, and speech therapy. This mattered because the early symptoms of orofacial cleft can touch several parts of daily life at once, from weight gain in infancy to speech and school confidence later on. Researchers later identified genetic and environmental factors that can play a role, but the biggest change for many families has been practical: earlier diagnosis, often before birth or soon after, and coordinated care from specialists who plan treatment step by step.
Today, orofacial cleft is far better understood than it was in the past, and outcomes are often much better than many families expect at first. Modern care has grown out of centuries of observation, surgery, and support, along with a better understanding that people with orofacial cleft need not only medical treatment but also help with feeding, speech, hearing, teeth, and emotional well-being.