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State-Endorsed Multidisciplinary Care

Alaska Cleft Lip & Palate Program

Serving both Alaska Native and non-Native residents. As the state's sole endorsed cleft lip and palate team, we deliver comprehensive, coordinated assessments and life-transforming corrective surgeries.

1 in 1,500 Cleft Lip Births
1 in 2,000 Cleft Palate Births
3.6 in 1,000 Total Cleft/Palate Births

Program Overview

Understanding cleft lip and palate conditions and team-based diagnostics

When part of the lip or roof of the mouth (palate) does not form properly early in pregnancy, it leaves a gap, or cleft. Clefting of the muscles at the back of the palate (the soft palate) affects speech and feeding, allowing food or liquid to pass between the throat and nose.

Cleft Lip Variations:
  • • Partial/Incomplete: Limited to upper lip
  • • Complete Cleft: Extends to base of nose
  • • Unilateral: One side of lip
  • • Bilateral: Both sides of lip
Risk Factors (United States):
  • • 60% are not linked to pregnancy events
  • • Smoking double the incidence rates
  • • Phenytoin (Dilantin) increases risk 10x
  • • Alcohol and anti-seizure links

For Parents & Families

Surgical milestones and child guidance cycles

Your Child's Dental Home

Having a child with a cleft lip or palate can seem challenging at first. We schedule comprehensive evaluations **six times a year (about every two months)**. During these evaluations, you will meet with the entire multidisciplinary team to set a lifelong treatment plan.

Corrective Surgery Timeline

The exact course of action varies depending on individual severity:

1

4 - 6 Months: Primary Lip Repair

Corrective surgery to close the gap in the upper lip and reconstruct muscle fibers, aligning skin tissue and nearby facial features.

2

9 - 16 Months: Primary Palate Closure

Closes the opening in the roof of the mouth to keep food and liquid inside, creating muscular structures required for normal speech.

3

7 - 9 Years: Alveolar Bone Grafting

Working with the orthodontist, bone is placed into the cleft gum line to facilitate proper permanent tooth development.

4

16 - 22 Years: Orthognathic & Nose Revisions

Optional jaw alignment (maxillary advancement) and septorhinoplasty revision surgeries following maturity of skeletal facial growth.

Meet Our Cleft Specialists

Over 20 years of collaborative clinical experience in Alaska

Dr. Jeff Symonds
Oral & Maxillofacial Surgeon

Dr. Jeff Symonds

Performs alveolar bone grafting (ages 7-9) and orthognathic jaw advancements during teen years.

Dr. Allison Gallen
Pediatric Dentist

Dr. Allison Gallen

Monitors primary tooth eruption, guides jaw development, and establishes a safe dental home.

Dr. Julia Swayne
Plastic & Reconstructive Surgeon

Dr. Julia Swayne

Leads initial primary lip repairs (4-6 months) and palate closures (9-16 months).

Laramee Hartman
Parent Navigator

Laramee Hartman

A dedicated parent advocate who walks families step-by-step through surgery dates and clinical evaluations.

Charlene DiFilippo
Speech-Language Pathologist

Charlene DiFilippo

Assesses soft palate muscular coordination to optimize speech articulation and swallowing.

Referral Standards

For Medical Providers

We welcome referrals of all Alaskan children with cleft lip and palate diagnoses. Prenatal consultations are also offered for expectant mothers following an OBGYN prenatal diagnosis:

Prenatal Diagnoses:

Referrals are processed immediately to allow the parent navigator to establish coordinates with the family before birth.

Extended 2-Day Clinics:

Some evaluations are scheduled across two full days to allow deep examinations by audiologists, plastic surgeons, pediatricians, and speech therapists.