Daley Oral Surgery | Springfield, PA
Cleft lip and cleft palate affect thousands of babies each year in the United States. And while these conditions are often diagnosed early, sometimes even before birth, the treatment process is a journey that unfolds over time, often into the teenage years. It’s not a single surgery. It’s a team effort.
At Daley Oral Surgery in Springfield, PA, we play a key role in that team. From the early stages of diagnosis to the final stages of repair, our work often overlaps with the efforts of plastic surgeons, speech therapists, pediatricians, and orthodontists. Together, we help patients and their families move through each stage of care with the right timing and the right plan.
If you’re a parent facing a cleft diagnosis or an adult looking into your own cleft revision options, here’s what to know about how we collaborate, and what you can expect at different points along the way.
First, What Are Cleft Lip and Cleft Palate?
A cleft lip happens when the upper lip doesn’t form completely during early pregnancy, leaving a gap or split. A cleft palate is similar, but it affects the roof of the mouth. These conditions can occur separately or together. Sometimes the cleft is small. Other times, it extends into the nose or affects how the jaw and teeth grow.
They may seem like cosmetic issues at first glance, but clefts can affect speech, eating, breathing, hearing, and dental development. That’s why treatment typically involves several specialists working together from infancy through adolescence, and sometimes into adulthood.
How Oral Surgeons Fit Into the Treatment Team
While plastic surgeons are often the first providers to perform cleft lip or palate repair surgery, oral and maxillofacial surgeons are brought in later for more specialized procedures. Our training allows us to manage the bones, teeth, and soft tissues of the face and jaws. This becomes especially important once a child begins to grow.
At Daley Oral Surgery, we often get involved when:
- A bone graft is needed to close a cleft in the upper jaw
- Adult teeth begin coming in and require surgical exposure or guidance
- The jaw requires surgical alignment (orthognathic surgery) for function or appearance
- Revisions or additional repairs are needed later in life
- Dental implants are considered to replace missing teeth
We work closely with the rest of the care team to ensure timing, healing, and growth are all taken into account. Every patient is different, and so is every plan.
Early Collaboration with Plastic Surgeons
For babies born with a cleft lip or palate, surgery often begins within the first year of life. Plastic surgeons usually lead these early repairs, closing the lip first (around 3 to 6 months old), followed by the palate (typically by age 12 months). These procedures focus on restoring normal facial structure and function so the child can eat and speak as naturally as possible.
During this early stage, our team may not be involved directly in surgery, but we’re often brought in for consultation. We provide input on how the early repairs might affect future bone development or tooth eruption. In some cases, we work with plastic surgeons on presurgical planning using 3D imaging or models of the child’s face and mouth.
Bone Grafting: A Key Milestone in Cleft Care
One of the most important contributions we make as oral surgeons happens around age 8 to 12. That’s when we often perform an alveolar bone graft. This procedure fills the gap in the upper jaw (the alveolus) where a cleft has left an opening. The graft usually comes from the patient’s own hip bone and helps support the eruption of permanent teeth, particularly the canine.
Why is this so important? Without bone in that area, teeth may drift, remain impacted, or fail to erupt altogether. The bone graft also helps stabilize the nasal base and improve long-term facial symmetry.
Timing is everything here. We coordinate with your orthodontist to make sure the graft is placed before the permanent canine starts to erupt. That way, the tooth can grow into healthy, supported bone.
Partnering with Speech Therapists
Speech development is another major part of cleft care. Even after surgical repair, some children need help learning to make certain sounds or using their soft palate effectively. If the palate remains too short or doesn’t move properly, it can lead to a condition called velopharyngeal insufficiency (VPI), which causes nasal-sounding speech.
We work closely with speech therapists and ENT specialists to identify when surgical revision may help. Sometimes we assist in procedures to lengthen or reposition soft palate tissues, or to reconstruct muscle function in the area. These surgeries are usually done after age 5 or 6 if needed, once a child’s speech patterns have begun to develop and can be evaluated more clearly.
Orthognathic Surgery and Adult Cleft Care
As cleft patients grow into adolescence, jaw development can sometimes fall out of sync. The upper and lower jaws may grow at different rates, leading to a misaligned bite or visible facial imbalance. In these cases, we may recommend orthognathic (jaw) surgery to reposition the jaws and improve both function and appearance.
This is one of the more involved steps in cleft care, and it requires careful planning alongside your orthodontist. Patients typically wear braces before and after surgery to fine-tune tooth alignment, and we work together to create a timeline that fits your needs.
Adults who were born with a cleft but didn’t have access to early repairs may also seek care later in life. We help these patients plan staged procedures that address bone gaps, missing teeth, or jaw misalignment. Even decades after birth, meaningful improvements are possible with the right approach.
Follow-Up and Long-Term Support
We don’t just see patients once and say goodbye. Cleft care often involves a long relationship between providers and families, especially when care continues through teenage years. At Daley Oral Surgery, we check in regularly before and after major procedures to make sure healing is on track and that each phase of care is timed correctly.
We also help families coordinate imaging, referrals, and treatment planning with other providers. Our role is part surgical, part supportive, and we take both seriously.
Our Approach in Springfield, PA
Families facing cleft care want to know they’re not alone. At Daley Oral Surgery, we’ve worked with cleft teams throughout Pennsylvania and the wider Philadelphia area. Whether you’re just beginning this journey or returning for a new phase of care, we’re here to help.
We believe collaboration is the key to success. That’s why we stay in close communication with your plastic surgeon, orthodontist, pediatrician, and any other specialists involved in your or your child’s care. We don’t take shortcuts, and we don’t lose sight of the big picture.
FAQs About Cleft Lip and Palate Surgery and Team Care
When is cleft lip surgery usually done?
Cleft lip repair is often done between 3 to 6 months of age. Timing may vary depending on your child’s overall health and any other conditions present at birth.
What is an alveolar bone graft, and why is it important?
An alveolar bone graft fills the gap in the upper jaw left by a cleft. It’s typically done around ages 8 to 12 and helps support permanent teeth and jaw development.
Can speech problems return after cleft surgery?
Some children may still need speech therapy or additional surgery even after a cleft palate is repaired, especially if the palate doesn’t move effectively during speech.
Will my child need braces?
Most children with cleft lip or palate will need orthodontic treatment. Braces are usually part of the overall plan and help align the teeth before and after surgery.
Is jaw surgery always necessary for cleft patients?
Not always. Some patients have balanced jaw growth and don’t require orthognathic surgery. Others benefit greatly from jaw repositioning to improve their bite and facial profile.
Cleft care takes time, teamwork, and trust. If you’re looking for a local oral surgeon with experience in these complex cases, we’re here when you’re ready. Contact Daley Oral Surgery in Springfield to learn more or schedule a consultation. We’re proud to support families every step of the way.