B. Neonatal

Some clinicians have used either lip adhesions, a presurgical orthopedic appliance or a head bonnet with elastics to initiate palatal molding. These forces will ventroflex a protruding premaxilla in a complete bilateral cleft lip and palate. In some instances, depending upon the presurgical orthopedic appliance utilize, the premaxilla may be bodily retracted rather than ventroflexed.  Caution should be utilized.  Early alveolar bone surgery such as primary bone grafting  and gingivoperiosteoplasty have been shown to be harmful causing  midfacial growth retardation and a bad position (anterior crossbite) of the upper front teeth, which is very difficult to correct.

C. Infant

When the primary teeth begin to erupt, the parents are advised as to the immediate expectation of minor irregularities of the dentition, particularly an incisor or supernumerary tooth erupting in the palate. There is no long-term consequence for leaving these ectopic teeth in place. The long-term facial/palatal treatment is outlined in general terms, in a positive manner by showing records of completed cases.