A cleft of the alveolus (gum tissue) is a defect in the bone around the teeth in the front of the palate. It may sometimes be as simple as a notch, or it can be a full gap in the bone from the floor of the nose to the teeth, producing a communication between the nose and the mouth. It is rare for a cleft to only involve the alveolus without an associated malformation of the lip and/or palate. An infant with a cleft involving the alveolus may have loose fluid from the nose or experience difficulty in sucking a bottle. The hearing may also be affected as fluid can develop in the ears.
Diagnosis a Cleft Alveolus
A cleft alveolus as part of the lip and/or palate can be detected through a routine sonogram as early as 18 weeks of pregnancy. By knowing about the cleft ahead of time, parents can plan for the baby's care while the child is still in the womb. The diagnosis after the baby is born is made by simple inspection of the gum tissue behind the teeth. Similar to other cleft malformations, a cleft alveolus can part of a syndrome. Some syndromes may require additional treatment in addition to taking care of the alveolus. Mount Sinai has the oldest cleft team in the metropolitan area with extensive experience in the care of patients with an alveolar cleft.
Cleft Alveolus Treatment
Placement of a bone graft to the alveolus may be performed anywhere during the period of mixed teeth development and growth from 6 to 12 years of age. A bone graft is usually taken from the hip through a small incision. Small pieces of bone are borrowed and placed in the defect of the alveolar ridge behind the lip where liquids may reflux into the nose while drinking. After the surgery is performed, the child may go home if he or she does not experience difficulty eating. Thereafter, office follow-up is more routine to monitor the healing. Mount Sinai's surgeons have particular knowledge and skill in bone grafting the alveolar cleft.
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