Cleft Palate/Cleft Lip

Oral clefts are one of the most common birth defects. A “cleft” is a split or separation. This occurs when the two sides of the palate and/or lip fail to fuse together during fetal development. The three primary types of clefts are cleft lip/palate, isolated cleft palate, and isolated cleft lip.

Cleft Palate - A cleft palate can involve the hard palate, soft palate, or both. When there is a split in the palate, babies cannot suck or swallow normally. They often have trouble with feeding, speech, hearing, ear infections, sinus problems, and dental problems. A cleft palate can be fixed with surgery which is usually done when the child is 12 to 18 months old.

Cleft Lip - A cleft lip happens when the upper lip fails to come together during fetal development. The divide can be small, or it can extend from the bottom of the upper lip to the nose. A cleft lip can be repaired with plastic surgery.

Oral Lesions

There are many different types of oral lesions (mouth sores) with a range of causes. Mouth sores can be very painful, or they can be completely painless. Some sores can be self-treated with over the counter medications while others should be evaluated by an ENT physician.

Two of the most common types of recurrent mouth sores are fever blisters (cold sores) and canker sores.

Fever Blisters (cold sores) - Fever blisters are painful fluid filled blisters that occur on the lips, gums, and hard palate. They are due to the herpes simplex virus. In people with the condition, the virus can lay dormant for periods of time, then become activated by conditions such as stress, illness, trauma, hormonal changes, and sunlight. Cold sores are contagious and can be spread to other parts of the body as well as other people, so do not touch the blisters. They are treated with an anti viral ointment. To help prevent the spread of fever blisters:

• Wash hands before touching eyes, genital area, or other people
• Do not touch, squeeze, or pick at the blisters
• Avoid mucous membrane contact when you have a blister

Canker Sores - Canker sores (aphthous ulcers) are painful white or red ulcerations that occur on the tongue, soft palate, or inside the lips and cheeks. Canker sores may be brought on by stress, trauma, irritation, or acid foods such as citrus fruits or tomatoes. They are not contagious. Treatment is based on pain relief until the sores heal, which usually takes five to ten days. There are over the counter medications available for treatment or your ENT specialist can prescribe a corticosteroid cream.

It is especially important to see your ENT specialist if you have mouth sores that don’t heal and you use tobacco products. The first sign of oral cancer is a sore that does not heal, therefore you may have a potentially serious precancerous or cancerous lesion requiring a biopsy.

A few other types of oral lesions include:

Leukoplakia - Leukoplakia’s are thick painless white patches that can develop under the tongue, on the inside of the cheeks, or on the gums. They are common in tobacco users and can also be due to other forms chronic irritation. These lesions can progress to cancer.

Candidiasis - Candidiasis (oral thrush) is a fungal infection due to yeast overgrowth. It occurs in the form of white or red patches that develop on the moist areas of the mouth. It is most commonly seen in denture wearers, people with dry mouth syndrome, or people who are immune compromised. It can also occur due to antibiotic treatment for an unrelated problem because antibiotics decrease the normal bacterial development in the mouth.

Torus Palatinus - Torus palatinus is a hard bony growth in the center of the roof of the mouth that rarely requires treatment. On occasion, it may be removed to ensure properly fitting dentures.

Oral Cancer - Oral cancer can appear as a red or white patch, or it can look like an ulcer. It may be found anywhere in the mouth, usually the lips, tongue, or floor of the mouth. A biopsy is often required if oral cancer is suspected.

Contact your physician for an appointment if you experience:

• A mouth sore that doesn’t heal within 2 weeks
• Trouble talking or swallowing
• Feeling a lump in your neck or mouth
• Hoarseness when speaking
• A numb feeling in your mouth or face

Tips for preventing mouth sores:

• Quit smoking and/or using smokeless tobacco products
• Avoid oral injury due to brushing the teeth too aggressively, eating hard foods, chewing on the cheek, or wearing ill-fitting dentures
• Perform good dental hygiene by brushing twice per day, flossing daily, and going to the dentist for regular check ups
• Eat a well balanced, nutrient dense diet
• Decrease stress
• Drink at least 64 ounces of water per day
• Avoid very hot food and drinks

If you have a mouth sore that does not heal, please contact our office and schedule an appointment with one of our otolaryngologists.