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Orofacial clefts are among the most common congenital anomalies, with an average worldwide prevalence of approximately 1 in 700 live births.1 Individuals with orofacial clefts require longitudinal, multidisciplinary coordinated care from birth through adulthood to optimize hearing, speech, oral health, and occlusion.2- 5 Despite the fact that orofacial clefts are common and that individuals with a cleft require comprehensive, staged treatment plans, we observe tremendous variation in the delivery of health care within and among countries.5,6 Two children with the same clinical diagnosis may receive very different treatments depending on where they are born. For example, an individual with a unilateral cleft of the lip and palate treated at center A might undergo 4 separate surgical procedures for repair of the cleft lip, placement of tympanostomy tubes, palate repair, and an alveolar bone graft. The same child cared for by center B may undergo 10 procedures by the age of 18 years.
Heike CL, Evans KN. Evaluation of Adults Born With an Oral CleftAren’t Adults Just Big Kids?. JAMA Pediatr. Published online September 26, 2016. doi:10.1001/jamapediatrics.2016.2639