IDA Recommendation

• Healthcare authorities need to recognize craniofacial anomalies as a notifiable disease.
• It is important that the issue of registering of cases of birth deformity should be taken seriously in India.
• Various studies on cleft cases should be performed along with collection of data from different centres covering the various geographical and economical section of India, presence of consanguinity and high and low incidence areas as noted in previous studies.
• IDA recommends that a team for the multidisciplinary treatment of a child with an orofacial cleft includes the following specialists:
  • Pediatrician
  • Nurse practitioner
  • Plastic surgeon
  • Pediatric dentist
  • Otolaryngologist
  • Geneticist
  • Genetic counselor
  • Speech pathologist
  • Orthodontist
  • Maxillofacial surgeon
  • Social worker
  • Psychologist
• No single treatment concept has been identified, especially for a Cleft Lip and Palate . The timing of the individual procedures varies in different centers and with different specialists.
• We Recommend the Following Treatment Protocol to be used in Healing Smile Foundation cleft treatment center:
  • Newborn - Diagnostic Examination, General Counseling of Parents, Feeding Instructions, Palatal Obturator (if necessary); genetic evaluation and specification of diagnosis; empiric risk of recurrence of cleft calculated; recommendation of a protocol for the prevention of a cleft recurrence in the family
  • Age 3 months - Repair of Cleft Lip (and placement of ventilation tubes)
  • Age 6 months - Pre-Surgical Orthodontics, if Necessary; First Speech Evaluation
  • Age 9 months - Speech Therapy Begins
  • Age 9-12 months - Repair of Cleft palate (placement of ventilation tubes if not done at the time of Cleft lip repair)
  • Age 1-7 years - Orthodontic Treatment
  • Age 7-8 years - Alveolar Bone Graft
  • Older than 8 years - Orthodontic Treatment Continues
• Other surgical procedures can be performed in patients with severe clefts as necessary.