University of Virginia Health System

The palate is made of bone and muscle and is covered by a thin, wet skin that forms the red covering inside the mouth. It's purpose is to separate your nose from your mouth much like a floor separating the basement from the ground floor. The palate has an extremely important role during speech because when you talk, it prevents air from blowing out of your nose instead of your mouth. The palate is also very important when eating. It prevents food and liquids from going up into the nose. During swallowing, the tongue presses up against the palate and pushes the chewed food to the back of the throat where it then goes down into the stomach.

The lips and palate originate from three areas of the baby's developing face. These areas are also called prominences. They are the Central or "Frontal Nasal" prominence, the Left "Maxillary" prominence, and the Right "Maxillary" prominence. The Central prominence will grow and become the infant's forehead, nose, middle portion of the upper lip (called the philtrum or Cupid's bow) and the primary palate, which is the part of the upper jaw that holds the middle four teeth. The Left and Right "Maxillary" prominences will grow and become the lower face, the lower lip and jaw, all but the middle portion of the upper lip and jaw, and the "secondary" palate (this is the part of the palate from behind the middle four upper teeth to the back of the mouth.).

Normally, the three prominences on the child's developing face will grow towards the center of the face and fuse together during the sixth to thirteenth weeks of pregnancy. When this happens correctly the lips, mouth, and palate of the child develop normally. However, sometimes this growth process is disturbed in some way, preventing the prominences from meeting. When growth is disturbed, the lips and mouth do not form properly, leaving a cleft in the lip.

How Does The Normal Palate Form?

As demonstrated above, the prominences grow and come together, fusing to create the nose, the mouth, the lips and the front part of the palate.  Next to the prominences are the palatine shelves which start out as ledges on either side of the mouth.  As the fetus grows, these ledges lengthen and join in the middle to form the back of the palate in the same way that a zipper closes.  The joining process, or "closing of the zipper" starts up front by the teeth and moves backwards towards the throat. If the process of growth and joining is interrupted at any stage, a gap or split will develop, resulting in a cleft of either the lip or of the palate. The type of cleft that develops in the lip and/or palate depends upon when the joining process is interrupted. 

Click here to see a short Quicktime movie showing development of the palate (592K).

What is a Cleft Palate?

A cleft is defined as a gap or split between two objects. A cleft palate is a palate that has not formed properly during the baby's growth inside of the mother. There is a split in the palate leaving a hole between the nose and the mouth.

If the split is not fixed, the child may develop problems with eating, swallowing, talking, and sometimes with hearing. Examples of such problems include food or liquids coming out from the nose while eating, repeated sinus and ear infections, and poor speech with a nasal sounding voice that is very hard to understand. If the cleft involves the bone of the upper jaw, the child's teeth may also be affected which can alter the child's ability to chew.