Emmanuel is an adorable seven month old boy, born with a bilateral cleft lip and cleft palate. At his age, he would be a good candidate for repair of his lip. Unfortunately, he arrived with a respiratory infection so surgery was not advisable. The good news was that our dental team could make an obturator for him.

Emmanuel’s cleft palate left him with an opening from the roof of his mouth into his nasal cavity. An obturator is like a retainer without the front wire. It will cover the roof of his mouth and provide many benefits: improved ability to eat and gain weight, better speech development, proper tongue positioning and nasal molding for better appearance. A band across his upper lip will bring the lip together and reduce muscle tension that will allow for a better outcome of his future lip repair.

The first step in creating an obturator is to make a mold of Emmanuel’s palate. Cesar Restrepo, dental technician, prepares three different sizes of the appliance to hold the impression material. Dr. Hector Villegas, orthodontist and Santiago Uribe, dentist, try them out to assure the correct size while mom, Elena, comforts Emmanuel.

The actual impression is made in the operating room with Emmanuel under mild sedation. It takes many hands to get it just right.

Once the obturator is cast, it gets some final shaping for a perfect fit. Emmanuel will wear the obturator for about a year until he is old enough for repair of his palate. A child born with a cleft lip and palate requires multiple operations, dentofacial orthopaedics and orthodontics. Using an obturator is a basic first step that will improve all future procedures.