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Oral Surgeon

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Real-Life Communication

Yvette has recently given birth to her son, George. She is thrilled to be a new mom, but is concerned by George's facial deformity. Her doctor has called it a cleft palate, and has sent her to you for further information and possible surgery for her child.

First, you must explain to Yvette exactly what a cleft palate is, and how it can affect her son's eating and speaking. You will also discuss when and how the deformity may be surgically repaired.

"Communications are an extremely important skill," says Benjamin Davis. He is an oral and maxillofacial surgeon. "Interacting with patients is a large part of this work. It's a skill that's first learned in dental or medical school and it remains important."

This is what you tell Yvette about George's cleft palate:

As you can see on George, his lip has a slight notch in it. This is called a cleft lip. It can range from this type of small notch to a complete separation of the lip right up to the nose. The gum can also be notched, but this isn't the case with George.

The reason we recommend repairing a cleft lip is to adjust the facial appearance of the child, and to make it so they can make all speech sounds. In some babies with more severe cases, the cleft lip can also interfere with sucking.

Most people are born with a palate on the roof of their mouth. Towards the front is a hard palate and at the back is a soft palate. George is missing the soft palate. This will make it difficult for George to speak. The palate prevents air from going up the nose instead of out the mouth during speech. The palate also prevents food and drink from going up the nose.

The recommended surgery is to close the hole between the mouth and the nose, and to reconnect the muscles to make the palate work. In some cases, the child will develop a new hole (called a fistula) after the surgery, which may require additional surgery.

Both cleft lips and palates occur early in pregnancy when the different areas of the face don't join together properly.

That is a bit about cleft lips and palates. Do you have any questions before I continue speaking?

Yvette nods her head. "Yes, I do. If you don't mind."

These are Yvette's questions:

  1. How will a cleft palate interfere with George's ability to eat and speak?
  2. How did George get a cleft lip and palate?
  3. What is a fistula?

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