What causes this condition?

A cleft lip and cleft palate result from a genetic defect that is not inherited.  In other words, this issue is not passed down from parent to child, although it does occur through mutations and teratogenic agents.

Now in plain English:

Some genes that are transmitted to your children change for unknown reasons. We believe that it results from the diet, the air or even a chemical substance that is absorbed through the skin and then alters the genes that otherwise would result in your child having a normal lip or palate. However, we still do not know what substances can cause this condition, therefore neither parent can be blamed for the cleft lip or plate of their child and, even more important, your child is not going to pass this condition onto their children or grandchildren.  In my experience children with cleft lip or palate are isolated cases within their families, that is there is no parent, grandparent or even great-grandparent suffering with the condition nor none of their children, grandchildren or great-grandchildren.

So please do not worry any longer about the causes and instead concentrate on the treatment.

When should Cleft Palate be operated on?

There are two opinions on the matter:

Opinion 1:

Of primary importance is that the teeth will appear in the best possible condition and, therefore, we should only operate after the teeth have fallen (more or less after the child is one year in age). 

Opinion 2: 
Of primary importance is that the child speaks well and does not have any language issues, meaning we should operate before the child begins to make his first attempts at speech. 

What is my opinion?

I prefer that my patients speak well and consult with an orthodontist in order to collaborate on aesthetic dental issues, because it really doesn’t matter if the surgery is before or after seven months from that standpoint since children with Cleft Palate will need orthodontia work anyway.

In other words, if we operate on a child with Cleft Palate after the teeth have fallen in the best way possible, this child is going to need orthodontia work anyway because the teeth are just not going to look right.

But if we operate on a child after he or she begins to speak those first sounds (from about 9 months in age to a year) then he or she will grow with language issues that will be very difficult to later eliminate.