Craniofacial Orthodontics – Cleft Lip and Palate

What is Craniofacial Orthodontics?

Craniofacial orthodontics is a sub-specialty of orthodontics that focuses on the treatment of patients with a wide variety of birth defects including cleft lip and palate. A craniofacial orthodontist plays an important role in the diagnosis and management of dentofacial anomalies and craniofacial malformations. Patients with these conditions can recieve absolutely excellent treatment outcomes when cohesively managed by a talented hospital based craniofacial team. 

Dr. Gibson has over 30 years of experience and extensive expertise working with craniofacial patients of all types. He has been a member of the University of Florida Shands Hospital Craniofacial Deformities Team, The FACES Craniofacial Deformities Team of San Antonio, and is curently appointed with the University Hospital Cleft and Cranciofacial Team.

The Univeristy Health Cleft and Craniofacial Team is comprised of very talented nurses, speech pathologists, oral and maxillofacial surgeons, craniofacial plastic surgeons, neruosurgeons, pediatric dentist, otolaryngologist, orthodontist, geneticist and social workers who collaborate in planning treatment to correct cleft lip and palate, as well as other jaw and facial abnormalities. As a member of a craniofacial team, a craniofacial orthodontist carefully evaluates and treats problems affecting facial growth, temporomandibular joints, developmemnt of the dentition ,and malocclusion of the teeth. To schedule an appointment please call the Claudia Galaviz RN, Universtiy Health Cleft and Craniofacial team, 210-743-1402 or Dr. Gibson's office 210-822-1222. 

What is a Cleft Lip and Palate?

Cleft lip and cleft palate are facial malformations in which the parts of the face that form the upper lip and mouth remain split, instead of sealing together before birth. Similar splits can occur in the roof of the mouth, or palate. Clefting results when there is not enough tissue in the mouth or lip area, and the tissue that is available does not join together properly. While the defect occurs in early fetal development, in most cases, the cause is unknown. However, there appears to be a link with genetics and maternal environmental exposures during pregnancy.

While there are certainly aesthetic considerations associated with cleft lip and palate, having this birth defect can affect people in many more serious ways.

  • Difficulty Eating – When there is a separation or opening in the palate, food and liquids can pass from the mouth back through the nose. While waiting for surgery, patients can use specially designed prosthetics to help keep fluids flowing downward towards the stomach, ensuring that they receive adequate nutrition.
  • Speech Difficulties – Because the upper lip and palate are not properly formed, it may be difficult for children to speak clearly, and when they do, it may produce a nasal sound. As speech may be hard to understand, a speech pathologist may be used to resolve these issues.
  • Ear Infections – Cleft lip and palate can lead to a buildup of fluid in the middle ear, leaving children at a higher risk for ear infections, and if not properly treated, even deafness. To prevent infections, small tubes may be placed in the eardrums to facilitate fluid drainage.
  • Dental Problems – Children who suffer from cleft lip and palate also often have missing, malformed, or displaced teeth, leading to a higher number of cavities and other dental and orthodontic issues.


The treatment for cleft lip and palate is multidisciplinary and will likely include surgery and orthodontic treatment .This is where your craniofacial orthodontist and team of specialists come in. Depending on the severity of the case, more than one surgery may be necessary. In children, the initial surgery usually takes place between three and six months of age.