Cleft Management

Patient Management & Referral Chart


Cleft lip and/or palate are one of the commonest congenital abnormalities. Cleft lip and/or palate are birth defects that happen while is developing in the uterus whereby the tissues in the developing mouth and palate do not fuse. The type of cleft can range from a simple incomplete cleft of the soft palate to a bilateral complete cleft involving both the soft and hard palate. A cleft can have a range of detrimental effects (depending on its severity) including appearance, eating, speech and occlusion, as well as causing ear and dental complications.

The disorder may also cause social impairment, particularly if treatment was not successful. Management of the patients with a cleft is best carried out by a multi-disciplinary team (MDT) of health care professionals who undertake the cleft care from birth through adulthood. With the establishment of a cleft team at Kulliyyah of Dentistry and IIUM Kuantan Campus, we hope that we can give the best and holistic management to these unfortunate patients.


The aim of Cleft Team is to organize and co-ordinate the delivery of an integrated cleft lip and/or palate service by the multi-disciplinary team (MDT) of health care professionals in order to give the best care of cleft patients.

The cleft team members

A cleft-team are made up of the following specialist:

  • Paediatric Dentistry Specialist
  • Surgeon (Oral & Maxillofacial/Plastic)
  • Orthodontist
  • Audiologist
  • Clinical Phsychologist
  • Speech and Language Therapist
  • Paediatric Specialist

Invited members if necessary:

  • Obstetrics and Gynaecology Specialist
  • Feeding and Lactation Consultant
  • Geneticist
  • Neurosurgeon
  • Restorative Dentistry Specialist
  • Plastic and Reconstructive Surgeon

Association to closely liaise with for parental support:

  • Cleft Lip and Palate Association Malaysia (CLAPAM).

MDT care is so important for integrating care for patients. Only with a full team can all disciplines involved with care meet and discuss a treatment plan that is comprehensive.  KOD Cleft MDT join clinic occur on second Wednesday of each month.  In the join clinic, the patient and parents will be evaluated by various specialists, including:


Paediatric Dentistry SpecialistDental Check-up of patient’s teeth, looking for any tooth decay, monitor the development of jaw and teeth or other dental concerns that may need attention.  General dental services are offered at the Paediatric Dentistry Specialist Clinic, KOD.
Surgeon (Oral & Maxilofacial/Plastic)Evaluation of the patient and determine what type of surgery is best for them and when it should take place. Input about speech and orthodontics help make these decisions.  The surgery will be performed at IIUM Medical Centre (IIUMMC)
OrthodontistPlans phases of treatment that will align teeth and facilitate surgery to produce the best dental outcome.  Orthodontic care is offered at the Orthodontics Clinic, KOD.
AudiologistSince hearing difficulties and middle ear problems are often associated with cleft palate, the audiologist will monitor middle ear function and evaluate hearing.  The treatment will be offered at KOM and/or KAHS.
Clinical PsychologistAssessment for psychological distress of the patients and parents.  Also provide support and intervention if required. This service is provided at IIUMMC.
Speech and Language TherapistEvaluates patient’s speech and language development to determine whether speech therapy or surgical intervention is warranted.  Speech therapy is offered at KAHS.
PediatricianEvaluates patient to see if there are any medical issues that need to be addressed. The treatment will be offered at KOM/IIUMMC
Feeding and lactation ConsultantCan answer questions about feeding cleft patient, such as which bottle is best and amount and frequency of feedings. Also monitoring the feeding of the patient during early life.  This service is offered at PCC/KOM.
Restorative Dentistry Specialist/ProsthodontistA Restorative Dentistry Specialist/prosthodontist is a specialized dentists that can make restorations or prosthetics of the patient after 16 years old and will be closely with treating orthodontist.  Prosthodontics services are offered at the Prosthodontics Clinic, KOD.

Patient Management Flow Chart

Patient Referral Chart