Cleft lip ( cheiloschisis) : a split in the upper lip appears as openings or gaps on the external surface of the lip . This split often extends up to the upper gum or beyond the nose involving the bones of the upper jaw. Cleft palate (palatoschisis ) : It is a fissure in the roof of the mouth. This split may affect the hard palate (which is the anterior part of the roof of the mouth), or the soft palate (the posterior part of the roof of the mouth. • Genetic factors: Most scientists believe that the causes of cleft lip and/or cleft palate refers to a group of genetic and environmental factors. Therefore, the risk of occurrence of these malformations happens in in a newborn if a sibling, parent, or relative has had the problem. Medications : Another potential cause of the lip and palate malformations may be related to a medication a mother may have taken during her pregnancy and have side effects on the fetus . Among them: anti-seizure/anticonvulsant drugs, cardiovascular drugs , acne drugs containing Accutane, and methotrexate, a drug commonly used for treating cancer, arthritis, and psoriasis. • viral diseases: Cleft lip and cleft palate may also occur as a result of exposure of the mother during embryonic development to viruses or harmful chemicals . Orthodontics or other types of treatments offered by dentists. Plastic surgeon to evaluate and perform necessary surgeries on the lip and/or palate. An otolaryngologist (an ear, nose, and throat doctor) to evaluate hearing problems and consider treatment options for hearing problems An oral surgeon to reposition segments of the upper jaw when needed, to improve function and appearance and to repair the cleft of the gum An orthodontist to straighten and reposition teeth A dentist to perform routine dental care A speech therapist to assess speech and feeding problems and work with the child to improve his speech An audiologist (a specialist in communication disorders stemming from a hearing impairment); to assess and monitor hearing A social worker/psychologist to support the family and assess any adjustment problems Treatment usually begins in infancy and often continues through early adulthood. Where most of them achieve a high degree of successful appearance and speech . Do the children suffering from cleft lip and/or cleft palate need the care of a dentist ? Generally, the preventive and restorative dental care needs of children with clefts are the same as for other children. However, children with cleft lip and cleft palate may have special problems require close monitoring and high dental care as -Missing teeth . - malformed, or incomplete . -malposition of teeth . Early dental care ( in the initial stages of disease ) Like other children, children born with cleft lip and cleft palate require -proper cleaning, - good nutrition, - fluoride treatment in order to have healthy teeth. Appropriate cleaning with a small, soft-bristled toothbrush should begin as soon as teeth erupt. If a soft children's toothbrush will not adequately clean the teeth because of the modified shape of the mouth and teeth, a toothette may be recommended by your dentist. A toothette is a soft, mouthwash-containing sponge on a handle that's used to swab teeth. Many dentists recommend that the first dental visit be scheduled at about 1 year of age or even earlier if there are special dental problems. Routine dental care can begin around 3 years of age. Orthodontic care. A first orthodontic appointment may be scheduled before the child has any teeth. The purpose of this appointment is to assess facial growth, especially jaw development. After teeth erupt, an orthodontist can further assess a child's short and long-term dental needs. After the permanent teeth erupt, orthodontic treatment can be applied to align the teeth. Prosthodontic care. A prosthodontist is a member of the cleft palate team. He may make a dental bridge to replace missing teeth or make special appliances called "speech bulbs" or "palatal lifts" to help close the nose from the mouth so that speech sounds more normal. The prosthodontist coordinates treatment with the oral or plastic surgeon and with the speech pathologist to provide the required care .