Comprehensive care before and after surgery

Babies with cleft conditions are nine times more likely to die within the first year of life. It’s a staggering figure that illustrates why comprehensive care is so vital, both before and beyond that first surgery.

From ongoing nutritional support, palate repair surgery and speech therapy, to dentistry and orthodontic care – our medical volunteers and specialists walk alongside patients every step of their journey, no matter how long it takes.

1. Nutritional support
2. Cleft palate surgery
3. Speech therapy
4. Dentistry
5. Orthodontics
6. Speech surgery

1. Ongoing nutritional support

Pre-and post-surgery nutritional support is vital. Malnutrition contributes to the deaths of 3.1m children under five each year – it’s a significant problem for children with cleft conditions, because of problems they face with feeding. Children often need further nutritional support after cleft lip repair surgery to help them recover quickly and stay healthy and strong for future palate surgery and other procedures they may need.

Everything we do with nutrition, everything is for them to be able to qualify for their surgery, and this definitely changes their lives in all aspects.
Monica Arredondo, Nutritionist from Guatemala
Ensuring healthier lives through nutrition

2. Cleft palate surgery

Unlike a cleft lip, you can’t tell if someone has a cleft palate just by looking at them – but this gap in the roof of the mouth can cause issues with eating, speaking and in some cases, breathing. It takes around two hours for a surgeon to repair a cleft palate, but the results last a lifetime, a vital step on a patient’s journey towards a happier, healthier life.

As a child grows, they start to form in their mind how to make the sounds they need to speak. Because a cleft palate means a child is unable to pronounce certain sounds, if the palate isn’t repaired early enough, they start to readjust how they try to make those sounds and it becomes very difficult for them to unlearn those habits after surgery.
Dr Elliot Arko-Boham, Ghana

3. Speech therapy – giving children a voice

We often take for granted our ability to communicate and be understood by those around us. Children with cleft conditions – particularly those with a cleft palate – often struggle to form the sounds needed for speech. Palate surgery significantly reduces the need for speech therapy, but some children will need ongoing support with their speech even after their palate is repaired, so our volunteer speech and language therapists are on hand to help.

Communication really is what makes us human. I know so often parents focus on physical abilities and being able to be physically independent, but that misses out the whole humanity of someone, because who we are is who we communicate ourselves to be. Our wishes and our desires, our preferences and our thoughts. If we can’t communicate those, it takes away our humanity.
Erika Bostock, Speech Therapist from South Africa
Read an interview with Erika

4. Dentistry

Children with cleft conditions face a number of significant oral heath challenges, including missing teeth, extra teeth or malformed teeth. They also suffer from dental abnormalities such as poor bone support, a smaller-than-normal mouth, and deformations of the roots that hold the teeth in place. Dental cavities and gum disease are also issues faced by many Operation Smile patients, which is why dental surgeons play such an important role in the comprehensive care we provide.

For our patients with cleft conditions, dental cavities are very common. There’s a lot of gum disease and different stages of periodontitis. There isn’t enough early intervention, so often cavities can develop into abscesses which causes a lot of discomfort and infections.
Dr Paa-Kwesi Blankson, Ghana
Read an interview with Dr Blankson

5. Orthodontics

Orthodontic treatment helps improve the alignment and appearance of the teeth and can include braces or other dental appliances. If the cleft has affected the gum and part of the jawbone where the teeth sit, then a child may also need bone graft surgery to bridge the gap in the gum before their adult teeth come through.

Orthodontic treatment is one of the most important treatments for patients after the first surgery. It’s very important for these patients because they have a lot of dental discrepancies.
Dr. Lachen Oussehal, Orthodontist from Morocco

6. Speech surgery

After cleft palate repair surgery, many children still need further procedures to repair holes or fistulas in their palate. These surgeries are scheduled after an evaluation from speech therapists and surgeons. This collaborative approach ensures the best possible results for the patient.

After their surgeries, we start working formally with the babies’ language abilities, their articulation, and just making sure that their surgeries are doing what they’re supposed to be doing and to determine if there is need for additional surgery. If the patients are having trouble with their language or speech, they will most likely need more surgeries. They will also need to keep working with us to achieve those language goals.
Gloria Vilches, Speech Therapist from Honduras

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