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This one is about: Toddlers and Obturators


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We have a 21 month old daughter named Ginny who was born with unilateral cleft lip and bilateral cleft palate. Her palate broke down after surgery, and she will need a re-repair in the future. The plastic surgeon told us that he does not want to work on her palate until at least next Spring.

The orthodontist who works with our team made her an obturator a couple days ago. We are hoping it helps with her speech since she will have an open palate for at least another 6 months. (I was worried about her aspirating when they made the mold for the obturator, but the orthodontist had a loose gauze netting over the mold material and
it did not look to me like any of the material could possibly get away from him. I add this in case anyone else is worried about aspiration during the process of making an obturator.)

Ginny wore her new obturator the rest of that day and seemed very comfortable with it. We were instructed to take it out once per day, clean it, and reinsert it. By the way, denture adhesive is used to hold it in. The second day she did let me put it in again and she wore it for 24 hours with absolutely no noticeable problems.

Now for my problem - Ginny does not want to let me put the obturator back in her mouth after it is cleaned. I tried involving her in the cleaning process, which she seemed to enjoy, and then making a game out of putting it back in. I would put it in my mouth and then her mouth and did this back and forth for awhile.  But when I tried to gently position it in back of her top teeth, she protested and started clamping her teeth shut. I tried playing more, being firm, offering a candy reward (I was getting desperate here), and finally, totally frustrated, left the room and ate the candy myself.

Does anyone have ideas or suggestions as to how to get that obturator in and out? I feel like I made such a big deal about it today that she will now be even more set against putting it in.

Also, could the obturator be a choking hazard?  It is a little over 1" x 1" x .5" in size and irregularly shaped and fits behind her top teeth to cover the front part of her palate. As I mentioned before, we have been instructed to use denture adhesive to hold it in.

The first night it came out. I found it in her crib in the morning. (I am not sure why the orthodontist said she should wear it at night - I guess I should ask about this.)

Thanks for reading this!  I will appreciate any suggestions or experience you can share.

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>Now for my problem - Ginny does not want to let me put the obturator
>back in her mouth after it is cleaned.
 
Is it possible that it hurts her?  Like maybe a raw spot or something?

>Also, could the obturator be a choking hazard?

Sounds small enough to create a problem  Maybe you should voice that concern with the orthodontist.

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I can relate to the problem getting Ginny to take the obturator again. EvaJessie and I still "discuss" her eye patch -- it seems to be a constant problem. I wish I had some tricks for you, but I share your position -- which is something close to resignation!

EvaJessie had an obturator from age 1 week to 10 months when she had her palate repair. She had a new one from about 5 months onward because the newborn one was then too small.

I worried about her choking on it, too. She wore it 24 hours a day and we cleaned it everyday with clear water and a soft toothbrush. We did not use any adhesive to keep it in. She often used to play with it with her tongue, slipping it out of position and twisting it around in her mouth. We were assured by the orthodontist that it was too big to get
stuck in her throat. That seemed fine until she moved it back in there sideways -- then it seemed more a possibility.

We were told that the obturator had two purposes -- one to help with feeding because it somewhat blocked the nasal area and two to help narrow the cleft in preparation for surgery.

I do recall that closer to the time of her palate surgery, we were having similar problems in that she would twiddle it around with her tongue and sometimes gag on it. She always dislodged it herself though. We began decreasing its use about two weeks before surgery and stopped giving it to her at night when we couldn't watch her.

Wish I could give you some other information, especially a few good tricks, but I find that age particularly challenging. My only advice is make sure the candy you offer her is something you enjoy! :-)
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> The first night it came out. I found it in her crib in the morning.
>(I am not sure why the orthodontist said she should wear it at night
>- I guess I should ask about this.

Hi, Paul has had an obturator since he was 4 weeks old (he is 8 months old now) and it is my understanding that if they fit correctly, they should NOT come out! I'd have it checked and make sure it is fitting properly.

We use Fixodent in Paul's and it has never come out on its own, unless I pull on it. He has started to fight some with me when I take it in and out for the last month or so. I try to grab it real quick before he can clamp down. When putting it back in, I have found if I hold it out near his mouth and wait, he will open up and let me put it in, but if I
try to force him, he clamps shut.... Hope this helps!


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