Understanding and Prevention of Orofacial Clefting: A Myth or Possibility?

The incidence of orofacial clefting across the world is showing a different trend in recent past. The trend is different for a different population. In spite of best of the efforts including but not limited to folic acid and other nutritional supplementation, prevention of exposure to infectious agents and second-hand, tobacco smoke, etc., are being aggressively promoted, the sustained efforts are not giving desired results.[1] In India alone, a substantial number of cleft patients live and often do not have access to cleft care. It is estimated that at least about 72,000 people still do not have access to surgery.[2] In spite of the best care, complications do arise after surgeries.[3]

Given this burden of disease, prevention and early diagnosis is the key to prevent such disorders.[1] The Journal of Dental Research recently published a special series of articles focusing on this area, especially on the recent scientific and technical advances in craniofacial development and genetics.[4567]

Topics that are of interest to surgeons include contemporary human and animal genetic studies on orofacial clefting, the pathways required for palatogenesis and experimental articles on the periderm structures.[456] Interesting manuscript is that one that describes a potential drug therapy articles that rescue cleft palate in mutant mice via a single gene disorder.[7] While the clinical translation is questionable, it offers immense hope that in coming days the complete set of genes and pathways involved in orofacial clefting will be decoded. The present results, although in animals, offer a clue to the potential of harnessing the power of advanced antibody therapy to cure orofacial clefting even before birth.

As they say, we are living in interesting times. We witnessed the evolution of surgical therapy and saw it reaching its plateau and are probably witnessing the birth and evolution of evidence-based orofacial clefting prevention before birth through advanced molecular biology treatment methods.

Hopefully, the world will be rid of the orofacial clefting soon.