A cleft is a highly visible “flaw”. Depending on its size and severity the children are disfigured more or less. Because they are perceived as different, the children are often teased or shunned. Often they live their lives in isolation. The psychological and emotional stress for child and parents is enormous. Children who have no access to treatment or are treated late in life suffer more.
If the hard palate is affected there is no separation of the mouth and nasal cavity. This means that the muscles of the lips, tongue and palate do not work together properly, and there is often a change in the position of the tongue, which moves backwards into the cleft. Serious functional problems are the result: swallowing and breathing, sound formation and tone of voice are affected.
In babies the breathing and feeding problems can be deadly. Later in life, food entering the nose can continue to be a problem and a source of shame for patients if the cleft is not treated. The difficulty in forming certain sounds means that speech development is impaired. Hearing deficits due to chronic middle ear infections worsen these problems. The children are often stigmatized because of their difficult to understand pronunciation and often nasal voice.
Together with the formation of scars due to the surgeries, these functional disorders can also lead to impairments in the position of the teeth and the development of the jaw and face as the child grows.