Sharif Center for Cleft Lip and Palate

Cleft lip and palate affects one in 700 births and requires lifelong dental and surgical treatment. Sharif Center for Cleft Lip and Palate was inaugurated on April 19, 2017 as a state-of-the-art department aimed at the medical, dental, and surgical treatment of individuals affected by the deformity of cleft lip and palate. Sharif Medical and Dental College is fully equipped with the latest dental and surgical armamentarium, along with highly trained and skillful doctors and technicians for the management of cleft lip and palate. The multi-disciplinary approach includes Orthodontics, Maxillofacial Surgery, Plastic surgery, Clinical Psychology, ENT, Pediatrics, and Speech Therapy. So far this treatment is being carried out free of cost by the doctors of the Orthodontics Department of College of Dentistry, Sharif Medical and Dental College.

The patients present to the Dental OPD with complaints of problems associated with cleft lip and/or palate. They are then referred to the Department of Orthodontics and Dentofacial Orthopedics, where they are thoroughly interviewed and examined, before prescribing further treatment. The cleft patients usually comprise of new-born infants with unrepaired clefts, children aged 2 to 5 years in primary dentition stage with speech abnormalities, children aged 6 to 12 years in mixed dentition stage with repaired lip and palate but underdeveloped jaws and mutilated dentition, and young adults with deformities of the nose, lips, and jaws requiring further surgeries. The parents of newborn infants have so far reported to SCCLAP from Lahore and other districts including Abbottabad, Rawalpindi, Jehlum, Gujranwala, Bahawalnagar, and Faisalabad. The parents of cleft patients attach high hopes with the treatment outcome of their child's treatment. More than a hundred cleft patients who reported to SCCLAP to date have been successfully treated.

Each family of the cleft patient is counseled initially and shown records of treated patients at SCCLAP as reassurance that they have come to the right place for a solution to their problem. They are then given a prescription of materials to be applied on the patient as part of Naso-alveolar Moulding, which has been made easily available in the Sharif Hospital Pharmacy. The parents are taught the techniques of NAM which they have to repeat at home on daily basis till they return to SCCLAP for weekly follow-up. Two impressions are taken for every patient to construct a feeding plate in the Orthodontics laboratory by a highly trained technician. After an active NAM treatment period of 3 months, the patient is ready for lip repair surgery. In case of any health concerns during the NAM period, the babies are referred to the Department of Paediatrics and Neonatology for any medical intervention and NAM is sometimes temporarily discontinued. After surgical repair, the patient is recalled for insertion of nasal conformers to prevent relapse.

Patients also present at a higher age with previously repaired cleft lip and palate along with multiple skeletal and dental problems. These patients have been treated at SCCLAP via dentofacial orthopedics with various removable and fixed expansion devices to expand the maxilla, followed by protraction of the upper jaw and lip with a facemask. Strict compliance is required from the patient's end for positive treatment outcomes. The SCCLAP doctors are always reachable on the phone by the patients for any emergency or appointment rescheduling. At a later phase in treatment, fixed braces are bonded to the erupted teeth for their alignment. Alveolar bone grafting, oronasal fistula closure, revision of lip and palatal repair, orthognathic surgery, and rhinoplasty are crucial surgeries needed in these patients, hence, demanding extensive time, resources, skill, and planning.

Record keeping is an essential part of this center’s functioning. Every new patient is entitled to a new SCCLAP case file which is filled and handed over to the patient on the first visit. A photocopy of the history form is kept in the department for record. The procedures done are entered in the OPD Registers. Some volunteers have also donated materials for NAM to be used in cases of extremely poor and patients who can't afford them. It can be claimed with pride that the services of SCCLAP have been exceptional in the field of health care. With continued support, this unique center can cater to a rising patient load keeping in view the increased prevalence of cleft deformity in this region of the world.