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UNC Dental School Uses Team Effort To Tackle Cleft Palate

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CHAPEL HILL, N.C. — For some patients, problems in the mouth need the attention of many different specialists. It may involve everyone from dentists to surgeons and psychiatrists.

That team approach to dentistry at the University of North Carolina at Chapel Hill can make a difficult situation easier on families.

Jonathon Yarnell, 6, was born with a cleft lip and partial cleft palate.

"Basically, it's when the lip fails to fuse in its development or the palate fails to fuse," said Dr. Ronald Strauss, director of the UNC Craniofacial Center.

"We tell Jonathon that he was just born with a boo-boo on his lip and that the doctors had to fix it," said Julie Yarnell, Jonathon's adoptive mother.

Cleft palate occurs in about one in every 600 to 800 births in the United States. Jonathon had surgery in China to connect his lip before he was adopted. He will need more surgery to add bone to complete his upper dental arch to support his teeth, which will eventually need orthodontic work.

The work requires a team of specialists who come together for the convenience of the patient and family.

"One of the miracles of team care is that you can do a variety of treatments, for instance surgical treatments, at the same time," Strauss said.

For example, most children with cleft palate have problems with hearing and, therefore, speech. The structural abnormality of a cleft palate affects the function of the eustachian tube to the ear. Health experts said placing tubes in the ear structure can solve the problem.

Many children with visible problems like Jonathon's may also need psycho-social counseling because school classmates can make things difficult for them.

"I've tried to talk to the kids in his class and say, 'You know, everybody's different and this is what's different about Jonathon,'" Yarnell said.

Yarnell said Jonathon can choose for himself one day whether he wants additional plastic surgery to make his surgical scar and asymmetrical nose less noticeable.

You can find more information about cleft palate at:

Cleft Palate Foundation

104 South Estes Dr., Suite 204 Chapel Hill, N.C., 27514 Cleft Line: 1-800-24-CLEFT Phone: 919-933-9044


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