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Other cleft services

This page outlines some of the speech and language and dentistry services offered by our South Thomas cleft service.

For more information about treatment options for cleft and palate conditions, see the cleft service patients page.



Orthodontics and dentistry

Children with a cleft lip and/or palate are introduced to the children's dentist or orthodontist when they visit the cleft palate clinics.

The dentist helps children with a cleft maintain healthy teeth. This is done by giving lots of preventative dental advice from an early age, right up until your child is 16. We work with your local dentist to provide any necessary treatments.

Beyond 16 years, your child may also access our adult restorative dental care services if needed.

The orthodontist monitors the growth and development of your child's teeth and jaws and coordinates the taking of photos, models and x-rays throughout their development. The specialist orthodontic team may provide care at the cleft headquarters or they may work with orthodontists at a cleft service closer to your home to avoid extra travel.

The aim of orthodontic care is to deliver a healthy set of teeth that both look good and work / function well. We'll need your help to maintain your child's oral health and will often work with the wider cleft team and you to manage treatments. We often help prepare children for surgery using a variety of orthodontic braces.

In the long-term we will try to help your child maintain their teeth using different retainers. One year after the completion of care we will likely discharge them and your child will be responsible for managing their retainers.

Clinical nurse specialists

The clinical nurse specialist (CNS) team works closely with the nursing and medical staff in the maternity unit at St Thomas' Hospital and also at our partner maternity units around the region.

Cleft CNS help manage care both in hospital and following discharge home into the community. They will continue to see your child at home to support you and monitor and manage your child's feeding, growth and development.

The CNS team provide specialist cleft support in addition to the routine care that the midwife and health visitor offer.

The CNS team also provide support for your child's surgery, assessing their readiness for surgery, ensuring investigations are carried out appropriately, and liaising with other health professionals. The team provides ongoing support through admission, surgery and care and assessment after surgery.

Speech and language therapy

All children born with a cleft lip and/or palate are seen by a specialist speech and language therapist in the cleft service. If your child has a cleft lip only, individual appointments are not required. However a speech and language therapist is always available at the cleft clinics should you have any concerns about your child's speech and language.

Your child will be seen by our speech and language therapists at specific points in their development, but we also offer additional assessment and therapy if needed.

You child's care plan

Age 0-6 months

A speech and language therapist will be present at the cleft clinic you attend with your child. If you want to have a separate appointment with the therapist to discuss speech and language development, please ask.

6-12 months

Following palate repair surgery, a speech and language therapist will spend time with you to talk about speech and language development. You will be given advice on how you can help your child's speech and language and we'll also give you more detailed information about how the palate functions during speech.

Two years

A therapist will assess your child's speech and language to see how it is developing. We'll spend time talking with you about all aspects of your child's development and we'll watch you and your child play together in order to assess their communication skills.

At this age your child may be able to use a range of single words and may be starting to put them together into short sentences. We may give you advice on how to stimulate language or sound production. You'll be able to ask questions about any concerns you may have.

Follow-up appointments will depend on the outcome of your child's assessment. Sometimes we will carry out another review six months later at age two and a half.

Three years

Your child's speech will be assessed at a cleft clinic and we will continue to monitor your child's speech sound progress. We'll also check whether their palate is closing effectively in order to make strong oral consonant sounds for speech.

As your child grows

We will carry out assessments and speech recordings of your child when they attend cleft clinic appointments at ages five, 10, 15 and 20.

Your child will be seen in the local cleft clinic nearest to your home for routine speech assessments by our service. If regular speech and language therapy is needed, it will be offered as close to home as possible. This could be a local clinic, school or at an outreach cleft clinic. Specialist investigations take place at St Thomas' Hospital.

Patients without a cleft palate diagnosis

We also see children where there is a concern that their velopharyngeal function for speech is not working well enough. This is where the soft palate does not close with the back of the throat properly in order to make strong oral pressure sounds such as “b, d, s, k” etc. Speech may sound overly nasal in tone, it may have some accompanying nasal airflow alongside it or unusual speech patterns may have developed. We are able to provide assessment, management and therapy where required.

For further information on how to refer children with suspected affected velopharyngeal function, see our hospital speech and language therapy referral page.


The clinical psychology team within the South Thames cleft service provide psychological support for children with a cleft lip and/or palate and their families.

Although we do not expect children born with a cleft lip and/or palate to have psychological problems, a cleft can have a direct or indirect impact on the emotional well-being of children and their families.

We offer a confidential space for you and your child to talk about how you are feeling. We will work closely with you and your child to find ways of improving emotional health. We offer support and can suggest strategies to try to improve psychological well-being.

We are available to both children and adults under the care of the South Thames cleft service. We also work with parents and carers of children with a cleft lip and/or palate as well as any other family member who may need our help.

Common issues that we can help with include:

  • how to answer other people's questions and comments about cleft lip and/or palate
  • confidence and self-esteem
  • bullying and teasing
  • appearance concerns
  • decision making and treatment planning
  • support around surgery
  • antenatal concerns, post-natal concerns and support around the diagnosis of cleft
  • low mood.



Tel: 020 7188 1321


How to find us

South Thames cleft service
1st floor, South Wing
St Thomas' Hospital
Westminster Bridge Road
London SE1 7EH

Map of First Floor, South Wing, St Thomas' Hospital (PDF 219Kb)

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