Dental Surgery Before Reconstruction of Cleft-like Lip?

My upper lip is totally split in half and appears to look like a cleft. It's due to a prior surgery gone wrong, in the meantime, I caught an infection under my gums that cracked majority of my teeth. 14 of them the need to be extracted only the bone exist! Should it be teeth first before surgery?

Mind you, I am a single mom of 3 and 45 yrs. of age! I have totally lost all my self esteem due to this misfortune! We live in a Cruel World & I need some help fast! I can't take not being myself anymore! ADVICE PLEASE! Thank You!

Doctor Answers 7

Cosmetic Considerations for Cleft Lip and teeth

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In my practice, I do a quite a bit of work with Cleft lip/palate patients.  As the restoring dentist I coordinate the treatment with the oral surgeon and or plastic surgeon.  In your case, it seems that taking care of the infected teeth or gums should come first as this can interfere with surgical results.  After this, consults with a dentist who handles these cases is in line.  This dentist should arrange consult with the appropriate surgeon.  This is to ensure that the gameplan  or blueprint is completed and doable. 

In a lot of cases, we build the teeth and gums to help support the lip. So sometimes some form of temporary teeth are used to allow the surgeon an idea of what needs to be done.  These temporary teeth can then be altered if necessary to help compensate for support that could not be achieved with the surgery.

There are not a lot of dentists who handle this type of work so you may have to reverse this consultation protocol I mentioned and see the surgeon first and ask for a dental referral.  By all means have a game plan on both ends before anything is done.

Finally be hopeful as I have been involved in some really bad cases and the results have changed their lives!

Houston Dentist

Get rid of the infected teeth

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I would take care of the infected teeth first.  Bacteria bathing a new surgical site (such as if your lip were repaired first) would likely affect wound healing.  Good luck to you.

Jennifer Keagle, MD
Los Angeles Plastic Surgeon

Dental work prior to cleft surgery

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I would do any extensive oral surgery prior to lip revision.  You will probably have a better result with the lip repair is staged for a latter date since any reconstructive dentistry will probably change underlying lip support.  Donald Nunn MD, DDS Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Cleft lip repair and teeth extraction can be done at the same time

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While the shape of the upper lip is highly influenced by the support from the underlying upper teeth, the devastating psychosocial effect of your split upper lip would benefit by immediate repair. If teeth do need to be removed, there is no reason that both procedures can not be done at the same time. It would be in your interest to find a surgeon who feels comfortable doing both procedures in a single operation.

Oral infection

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My advice is first you should get rid of the  infected teeth. Once all the local infection is completely cleared and the gums are healed you may have the lip restored. If you try to fix the lip before the oral infection is cleared there is a good possiblity that your lip also may get infected with calamitous results.

Zain Kadri, MD
Los Angeles Facial Plastic Surgeon

Teeth or lip -- it depends what bothers you

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It really depends what bothers you the most.  If you can afford to have them both done, then I suggest that you have the teeth pulled first, followed a few weeks later by the lip.  However, your lip deformity is so severe, that if you could only do one thing, I would fix the lip first.

Kevin F. Hagan, MD (retired)
Nashville Plastic Surgeon

Teeth or lip first?

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Due to the extensive manipulation required by the dental surgery, I would likely recommend that you undergo these procedures first before undertaking the delicate repair of the lip

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.