Lip Incompetence Research Articles

Prevalence of Traumatic Dental Injuries and Associated Risk Factors Among Preschool Children in Goa: A Cross-Sectional Study.

Primary teeth trauma has received very little attention compared to permanent teeth due to their eventual exfoliation. Enamel discolorations, hypoplasias, and enamel-surface abnormalities have been reported in the permanent dentition following primary tooth trauma. Traumatic dental injuries (TDI) also have an impact on the quality of life of an individual. The study aims to determine the prevalence of TDI and its association with various risk factors in preschool children in the state of Goa. The primary objective is to determine the prevalence of TDI in primary anterior teeth in preschool children in the state of Goa. The secondary objective is to determine the association of various risk factors with TDI in preschool children in the state of Goa. A cross-sectional survey was conducted among preschool children aged three to five years across the state of Goa. A total of 971 children were included in the study. Parents or guardians of participants who reported trauma answered an interview addressing the history of the injury. The anterior dental trauma and associated factors such as age, gender, time of injury, month of injury, place of injury, occlusal relationship, lip competence, oral habits, and ordinal position of the child were assessed and analyzed. Out of the 971 children examined, TDI was reported in 157 (16.1%) children. Of these, 83 of 157 (52.8%) children had experienced TDI at home. Three-year-old children had the highest TDI prevalence of any age group, with 32 of 145 (22.0%) experiencing TDI. The most commonly affected tooth (100 of 233, 10.3%) was the primary maxillary right central incisor. Of the 233 traumatized teeth, 100 (42.9%) had code 2 injuries (enamel fractures only), which were the most frequently reported injuries. Mesio-incisal angle fracture was detected in 84 (34.3%) teeth affected with TDI. With respect to the number of teeth traumatized, 99 of 157 (63.0%) of children had a single tooth traumatized. Among all children who had sustained TDI, 103 (65.6%) were firstborns, 50 (31.8%) were secondborns, and four (2.5%) were thirdborn children. Only eight children received treatment, of which seven received medications and only one child received dental treatment. Parents being unaware of TDI was the main reason for not seeking treatment. This study highlights the critical need for educating parents and teachers about TDI prevention and the importance of prompt dental care. The findings offer valuable insights for formulating state- and national-level policies and preventive strategies for managing TDI.

Management Of Skeletal Class Ii Malocclusion With Twin Block And Headgear: A Case Report

Background. The main concern of patients and their parents seeking orthodontic treatment has always been the sagittal relationship between the jaws and dentition. The most commonly observed sagittal problems are skeletal class II maxillomandibular relationship which affects about one-third of the examined patients who seek orthodontic treatment. This case report demonstrates the use of the Twinblock appliance and high-pull headgear in a skeletal Class II Division 1 patient with a prognathic maxilla and a retrognathic mandible. A 9 year old male patient reported to Department of Paediatric and Preventive Dentistry with a chief complaint of forwardly placed upper front teeth. On extraoral examination, it was found that the patient had a convex profile, incompetent lips, increased maxillary anterior teeth visibility, acute nasolabial angle, receded chin and deep mento labial sulcus. Superimposition of Post treatment with pre-treatment lateral cephalograms showed a reduction in the sagittal discrepancy. With the retraction and intrusion of maxillary anteriors by the use of head gear along with mandibular advancement by the use of twinblock gave the desired result.

Surgical orthodontics in a patient with β-thalassaemia major. A case report

Treating patients with prognathic maxillae is a multifaceted process, especially when dealing with thalassaemia complications. This case study addresses the issue of severe maxillary protrusion in a woman living with β-thalassaemia major who had presented with pronounced maxillary protrusion, lip incompetence and an everted upper lip. Following initial alignment and levelling using the 0.018inch standard edgewise system, the patient underwent a Le Fort I osteotomy procedure. Segmental osteotomy was ruled out owing to the heightened risk of excessive bleeding. The outcomes demonstrated successful management of the thalassaemic patient through presurgical orthodontics, LeFort I osteotomy, and subsequent post-surgical orthodontics and periodontics. The patient exhibited improved facial aesthetics after an active treatment period of 4 years. CPD/Clinical Relevance: Orthodontic treatment for patients with β-thalassaemia major and skeletal Class II malocclusion with prognathic maxillae requires a multidisciplinary approach, including Le Fort I osteotomy and careful management of elevated bleeding risks

Evaluation of Incisor Position in a Sample of Orthodontic Patients.

To achieve a successful result, the orthodontist must use a systematic approach to plan the orthodontic treatment. Defining the correct position of the upper and lower incisors and evaluating their relationship with intermaxillary discrepancy and facial divergence have been recognized as the starting point for the diagnostic decision regarding extractions and anchorage requirements. The aim of our study was to analyze the relationship between intermaxillary discrepancy (ANPg^), mandibular inclination (SN^GoGn), lip incompetence, and the positioning of the upper and lower incisors (UIPs and LIPs) in a group of orthodontic patients. This retrospective study included 290 lateral cephalograms in 122 males (42.1%) and 168 females (57.9%) aged 8 to 53 years (median 14; interquartile range IQR 12-17). Data were analyzed by means of one-way Analysis of Variance (ANOVA) and linear regression analysis. This study showed a statistically significant increase in LIP values in patients with lip incompetence (p < 0.001). Moreover, the distribution of LIPs in groups with various SN^GoGn and ANPg^ angles was significantly different (p < 0.001). The regression analysis also showed a positive association between the LIP and SN^GoGn and between the LIP and ANPg^. The LIP presented a statistically significant difference in patients with and without lip incompetence, which varied significantly in subjects with different sagittal malocclusions and vertical face patterns.

Characteristic Features of Bimaxillary Proclination: A 5-Year Review in Najran, a Saudi Arabian Sub-population.

Background Bimaxillary proclination (BP) has been described as a clinical condition depicted by proclined upper and lower incisors with an amplified lip incompetence. The current study aimed to investigate the prevalence and characteristic features of bimaxillary proclination in Najran. Methods This was a retrospective study to appraise bimaxillary proclination in an orthodontic specialist clinic and research complex in Najran, Saudi Arabia from January 2018 to December 2022. Patients requesting orthodontic treatment for malocclusion were evaluated. Data retrieved include: age, gender, presence of bimaxillary proclination, and facial profile of affected patients. IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp) was used for analysis. Results were presented as simple frequencies and descriptive statistics. Results Three hundred and twenty-six (326) patients sought treatment for different types of malocclusion out of which 277 (84.9%) had bimaxillary proclination. There were 123 (44.4%) males and 154 (55.6%) females with an M:F ratio of 1:1.3. Age ranged from 6 to 55 years with a mean SD of 22.6 ± 8.98. More females had bimaxillary proclination. The majority of the patients with bimaxillary proclination had convex facial profiles and a Class I relationship(241 (73.9%) and (135 (48.7%)), respectively. Conclusion Bimaxillary proclination is a common orthodontic health issue with high prevalence in the Najran region. Female preponderance was observed. Most of the patients have a Class I Angle's relationship.

Comparative evaluation of postoperative functional and esthetic outcomes for lip reconstruction with Fujimori gate flap versus Abbe-Estlander flap in patients being operated for oral squamous cell carcinoma

Background: Lip carcinomas account for 23.6% to 30% of tumors affecting the oral cavity. Lip reconstruction aims to achieve a competent oral sphincter with a good cosmetic appearance while avoiding microstomia. There are various techniques for lip reconstruction like Fujimori gate flap, Abbe-Estlander Flap, Gillies fan flap, Nasolabial flap, Karapandzic flap, bilateral advancement flap, perialar crescentic advancement flap, Bernard-Burow flap, and free flap. Aims and Objectives: To compare the Fujimori gate flap and Abbe-Estlander flap in terms of functional and esthetic outcomes when used for reconstruction of the lip. Materials and Method: Ten patients diagnosed with oral squamous cell carcinoma requiring resection and reconstruction of lip were included in the study. Functionally, maximal interincisal opening, lip competence, speech intelligibility and esthetically, scar, symmetry of lip during mouth opening, and symmetry of lip at rest were evaluated at the end of 1 week and 1 month. Results: On evaluation of functional and esthetic parameters, the Fujimori gate flap provides superior results in terms of mouth opening, speech intelligibility, and symmetry of lip at rest. However, results were comparable in both groups in terms of lip competence, scar, and symmetry of lip during mouth opening. Conclusion: The results of this study suggest that the Fujimori gate flap provides superior results with respect to function and esthetics when used for the reconstruction of lower lip defects with minimal or less complications.

Active vertical control with skeletal anchorage for optimizing facial profile in a severe Class II high-angle protrusion case.

This case report describes the nonsurgical management of a patient with a Class II skeletal pattern, retrognathic mandible, steep mandibular angle, maxillary vertical excess, and lip incompetence. The treatment approach involved orthodontic mechanics supported with skeletal anchorage to achieve maximal intrusion and retraction of the dentition. A novel elastic hanging rack appliance, supported by midpalatal miniscrews, was used. A maximal anchorage setup for active vertical control on both arches was illustrated. Significant improvement in the facial profile was achieved with optimal occlusion. Cephalometric analysis revealed successful incisor retraction and intrusion, as well as a forward rotation of the mandible. The treatment outcome illustrates the impact of active vertical control on orthodontic camouflage treatment for severe protrusion.

Successful completion of orthodontic therapy in a patient with osteopetrosis: Case Report.

Orthodontic therapy in patients with osteopetrosis (OP) of the jaws has typically been contraindicated owing to the presence of poorly perfused and extremely compact bone, and the potential risk for infection and osteomyelitis. As such, completed orthodontic cases in association with OP have rarely been published. A patient aged 14 years 6 months, with no known diagnosis of OP, sought orthodontic assessment for anterior crowding. The patient exhibited a straight facial profile and increased mandibular facial height, competent lips, shallow mentolabial sulcus with mild mentalis strain, flat/reverse smile arc and wide buccal corridors on smiling. The patient had a Class I incisor relationship on Class I skeletal bases with bilateral Class I molars and Class II canine relationships. This was complicated by a crossbite involving the lateral incisors and a Bolton discrepancy due to small maxillary lateral incisors. A radiologic assessment revealed polyostotic OP of the oromaxillofacial complex. Treatment consisted of maxillary and mandibular fixed orthodontic therapy, bite turbos and elastics to level and align the dentition. Extractions of permanent teeth were not needed. At the conclusion of treatment, there was a slight left Class II malocclusion, with incomplete intercuspation on the left side due to tooth size discrepancy, possibly attributed to inadequate elastics compliance and the presence of osteopetrotic bone. The treatment was completed in 3 years, 1 year longer than anticipated. This report represents the second published account of a patient with OP successfully managed with comprehensive orthodontic care and without osseous complications. Obtaining cephalometric measurements on OP-affected patients may be imprecise owing to the presence of extremely dense bone and difficulty to identify bony landmarks. To reduce osteopetrotic sequelae, attending clinicians should consider reduced exertional orthodontic forces and closely monitor patients for adverse alveolar events.

Facial soft-tissue shape changes after fixed edgewise treatment with premolar extraction in individual artificial-intelligence-classified facial profile patterns

ObjectiveTo examine the patterns of pretreatment facial soft tissue shape in orthodontic cases with premolar extraction using artificial intelligence (AI) and to investigate the corresponding changes.MethodsOne hundred and fifty-two patients who underwent orthodontic treatment with premolar extraction were enrolled. Lateral cephalograms were obtained before and after the treatment. For each record, the outlines of the nose-lip-chin profile and corresponding 21 cephalometric variables were extracted. The AI method classified pretreatment records into three subject groups based on the feature variables extracted from the outline. Dentoskeletal and soft tissue facial form changes observed after treatment were compared statistically (P < 0.05) between the groups using ANOVA. Multivariate regression models were used for each group.ResultsGroup 1 (n = 59) was characterized by Class II high-angle retrognathic mandible with an incompetent lip, group 2 (n = 55) by Class I malocclusion with retruded and thin lips, and group 3 (n = 38) by Class I malocclusion with an everted superior lip before treatment. The ratios of anteroposterior soft tissue to hard tissue movements in Group 1 were 56% (r = 0.64) and 83% (r = 0.75) for the superior and inferior lips, respectively, whereas those in Group 2 were 49% (r = 0.78) and 91% (r = 0.80), and 40% (r = 0.54) and 79% (r = 0.70), respectively, in Group 3.ConclusionsThe modes of facial form changes differed depending on the pre-treatment profile patterns classified by the AI. This indicates that the determination of the pre-treatment profile pattern can help in the selection of soft tissue to hard tissue movement ratios, which helps estimate the post-treatment facial profile with a moderate to high correlation.

Case Study: Facemask Protocol for Growing Patient

This case report describes the orthodontic treatment of a 9-year-old Egyptian male with a Class III incisor relationship and skeletal Class III base, characterized by a -3 mm reverse overjet, 70% reverse overbite, and masticatory difficulties. The patient exhibited full unit Class III molar relationship, unclassified canine relationship, lower and upper crowding, concave profile, acute nasolabial angle, and competent lips. Treatment involved two phases: Phase 1 utilized an orthopaedic appliance (facemask) with banded hyrax and posterior acrylic bite planes, while Phase 2 employed upper and lower fixed pre-adjusted edgewise appliances with MBT prescription and class III elastics. This comprehensive approach aimed to address the malocclusion effectively and achieve improved dental alignment and facial aesthetics.

Myofunctional Speech Therapy for Facial Rejuvenation and Orofacial Function Improvement: A Systematic Review.

This review aims to reveal the effectiveness of myofunctional speech therapy on facial rejuvenation and/or improvement of orofacial function. A systematic review of four medical electronic databases (Medline, Google Scholar, SciELO, and LILACS) was conducted between January and March 2023. The research question was defined using the PICO model: Population (P): adult subjects with signs of physiological aging of facial skin. Intervention (I): aesthetic speech therapy (facial exercises and/or myofunctional therapy). Control (C): absence of treatment. Outcome (O): facial rejuvenation. Through the search process, a total of 472 potentially relevant articles were identified. A total of 21 studies were included in the review. Most of the studies required the participants to perform exercises learned during the weekly session on a daily basis. The subjects underwent an integrated treatment with facial exercises and worked on the stomatognathic functions for different durations. Many differences were found in the evaluation tools used to investigate the starting situation and the effects obtained following the treatment. At the diagnostic level, there was no concordance in the choice of the most appropriate scales and assessment tools, but great heterogeneity was observed. Indeed, forty-eight percent of the studies collected objective data through the use of various instruments (oral devices, electromyographs, cutometers, muscle ultrasound scans, and laser scans of the face). The observed improvements included not only a reduction in wrinkles and frown lines but also decreased muscle tension and slackness, enhanced facial symmetry and lip competence, improved skin elasticity, and restored stomatognathic function. These changes led to myofunctional restoration and facial rejuvenation, resulting in increased satisfaction with self-image and proprioception.

Association of clinical indicators in TMJ, craniofacial, occlusal, and upper airway changes with symptoms of pediatric obstructive sleep apnea and mouth-breathing

ABSTRACT Objective To assess the association between self-reported symptoms of pediatric OSA and clinical signs in MB children. Methods Seventy-three MB children aged 7–14 years answered an interview questionnaire on OSA symptoms in childhood, focusing on chewing, nasal, and sleep disturbances. MB children were checked for changes on the craniofacial, occlusion, TMJ, upper airway, and body posture by a multi-disciplinary team, consisting of medical residents, dental, and psychology postgraduate students. Multiple logistic regression analysis verified the association between clinical signs and self-reported symptoms. Results Reported symptoms of chewing disturbance as TMD noise, muscle pain, and morning headache were significantly associated with the presence of lip incompetence and Class II malocclusion. Sleep disturbances as snoring, waking up at night, daytime sleepiness, and sleeping with the mouth open were significantly associated with the presence of hypertrophic tonsils and obstructive Mallampati score. Conclusion Symptoms of pediatric OSA were found in mouth-breathing children, which should be carefully investigated in order to prevent OSA in the future.

Traumatic Dental Injuries and their Association with Demographics and Other Predisposing Risk Factors in School Children Aged between 8-13 Years: A Descriptive, Cross-Sectional Study.

Traumatic dental injuries are most commonly seen in school age children. This not only affects physical, but, also, the psychological and social well-being of a child. The aim of the present study was to assess the prevalence of traumatic dental injuries in school children aged between 8 and 13 years and their association with the demographics and other predisposing risk factors. The present study was conducted as a cross-sectional study design on 1500 school children aged between 8 and 13 years. Apart from clinical examination, all the participants were asked to complete a questionnaire related to the injuries sustained. Statistical analysis was conducted using Statistical Package for Social Sciences (SPSS) version 21.0 (IBM, Chicago). Pearson's Chi-square (Χ²) test was used for categorical data analysis and distribution to determine the association between categorical variables, while P < 0.05 was considered statistically significant. The prevalence of traumatic dental injuries in the present study was calculated at 9.7%. Also, the occurrence of such injuries was found to be higher in the age group of 8-11 years with 10 years being the peak age of incidence for sustaining such injuries. Again, crown fracture involving enamel was found to be the most common type of injury sustained, while proclination observed in relation to upper anterior teeth, and incompetent lips were found to be the independent, significant risk predictors associated with the frequency and severity of such injuries. The results obtained in the present study suggested a high prevalence of traumatic dental injuries in school children aged between 8 and 13 years highlighting the need for conducting educational programs, for increasing knowledge and awareness of parents, school children and school faculty in this regard to save the affected child patients from the more dreaded sequelae including complete loss of tooth structure, and social and emotional trauma.

Salvage Reconstruction of Composite Defects of the Anterior Mandible, Floor of Mouth, and Lip.

Anterior mandible defects result in loss of support for the tongue, floor of the mouth and lower lip, resulting in impairment of airway, feeding, and speech. We treated four patients with these "Andy Gump" deformities. Reconstruction was performed with two free flaps: a fibula osteocutaneous flap for the anterior mandible and floor of the mouth, and a soft tissue free flap for the lip, chin, and anterior neck. The lower lip was suspended cranially with fascia or tendon grafts ± mini-temporalis turndown flaps. All flaps survived completely. All patients were tube feed-dependent before surgery; they all resumed an oral diet. All tracheostomies were decannulated. Lip competence was restored as evidenced by cessation of drooling. Speech improved from unintelligible to intelligible with frequent repetitions. Objective assessment was performed with the functional intraoral Glasgow scale; the mean FIGS score improved from 3.25 (range 3-4) to 11 (range 9-13). We conclude that composite anterior mandible and tongue defects have large tissue requirements that require multiple free flaps. Reconstruction leads to significant improvement in function.

Treatment of Vertical Maxillary Excess in Skeletal Class II Hyperdivergent Face Using Skeletal Anchorage—An IBO Case Report

This case report was presented at the Indian Board of Orthodontics (IBO) examination under category III in September 2022. It describes the case of 13-year-old female with hyperdivergent facial pattern and class II skeletal base, treated using microimplant anchorage. Patient presented with vertical maxillary excess, increased lower facial height, gummy smile, and incompetent lips. All four first premolar extraction treatments were planned with simultaneous retraction and intrusion of maxillary and mandibular dentition. The case was treated using 022 slot MBT prescription appliance. Lip exercises were prescribed to increase the tone of lips, which would aid in attainment of lip seal. Case was completed with class I molars, normal overjet–overbite, and improved smile aesthetics. The patient exhibited competent lips and reduced anterior–posterior gingival show.

Dento-maxillary disharmony class I malocclusion with severe crowding, crooked canine, midline shifting and lip incompetence management: A case report

Objective: This case report aimed to provide treatment sequential DDM to meet the patient’s expectations. Case Report: Before starting the treatment, 2 first upper premolar needed to be extracted to gain space for severe anterior crowding teeth and 2 second lower molar because the teeth were not in good condition. After extraction, bracket placement with fixed appliance 0,22” MBT prescription and NiTi wires sequences were done for initial leveling. When it has already leveled, start for canine retraction using an elastomeric chain in wire SS 0,016x0,022-inch. Then, T-loop bends were used for anterior retraction in the same wire. Finishing detailing using SS 0,017x0,025-inch. The last one, Hawley Retainer, was used as a retainer. Results: The final results were as expected by the patient. She gained confidence through her new smile, and the orthodontist obtained what it needed for ideal occlusion except for Class I molar relationship because mesialization of the second lower mandibular tooth, and distalization of the anterior mandibular region but Class I canine were obtained, no rotation, no space, flat occlusal plane, and excellent crown angulation and inclination. Also, the patient’s lip became competent. Conclusion: This case concludes that the patient was happy with the overall treatment results and was satisfied with the pleasant and esthetic smile achieved at the end of the treatment.

Bilateral Maxillary Duplication in Tessier No. 7 Cleft: An Uncommon Congenital Deformity with a Challenging Radiological Diagnosis.

Tessier No. 7 cleft, known as lateral facial cleft, is a rare and understudied entity with an incidence of 1/80,000-1/300,000 live births. Besides perioral tissue abnormalities manifesting as macrostomia, Tessier 7 cleft also involves anomalies of the underlying bony structures. It can appear as part of a syndrome, such as Treacher-Collins syndrome or Goldenhar/Orbito-Auriculo-Vestibular Spectrum, or as an isolated form (unilateral or bilateral) with variable expressions. Bilateral maxillary duplication in Tessier 7 cleft is considered extremely rare, accounting for only two previously presented cases. Given that the cases presented in the literature mainly focus on clinical appearance and surgical treatment, without providing sufficient imaging, we aim to present key radiological features of Tessier 7 cleft in terms of evaluating the involved structures, which is essential for the therapeutic approach and final outcome. A 17-year-old male with incompetent lips and orthodontic abnormalities was referred to our Radiology Department for orthopantomography (OPG) and CT examinations. Hetero-anamnestic data revealed a history of surgical treatment of the commissural cleft conducted 2 months after the birth to enable feeding. Intraoral examination showed a maxillary cleft and supernumerary teeth. Since the given clinical presentation was inconclusive, radiological diagnostics took precedence in elucidating this complex entity.

Impact of initial lip competence on the outcome of class II functional appliances therapy

ObjectivesThe aim of this prospective clinical study was to evaluate the impact of initial lip position on class II functional appliance therapy.Materials and methodsIn total, 34 class II division 1 patients (23 females, 19 males; mean age 12.4 ± 0.9 years) that met the inclusion criteria (> ½ class II molar relationship, overjet > 6 mm, ANB > 4°, neutral or horizontal growth pattern, cervical vertebral maturation stage (CVMS) II – III, mean wear-time > 10 h/day) were consecutively divided into two groups (lip incompetence (LI); lip competence (LC)). All patients were treated with the Sander bite jumping appliance (BJA). Wear time was microelectronically measured. Lateral cephalograms were taken at the beginning (T0) and after 1 year of treatment (T1). An untreated class II group served as a control (CG). Inter-group comparisons were determined with Mann–Whitney U tests for independent samples.ResultsSignificant skeletal treatment effects were found in both treated groups when compared to the CG with significantly more pronounced mandibular skeletal effects in the LI than in the LC group (mandibular base length p < 0.001, composite mandibular base length p < 0.001, condylar head growth p = 0.002, co-pg p < 0.00, go-pg p = 0.003, reduction of the ANB angle p = 0.009, and Wits appraisal p < 0.001).ConclusionThe more pronounced mandibular effects in the LI group were composed of the functional orthopedic effect plus harmonization of the lip competence.Clinical relevanceFunctional harmonization of lip incompetence with BJA enhances mandibular growth stimulation. Lip incompetence seems to impede mandibular growth and its harmonization seems to be a preventive approach.

Investigation of Anterior Teeth Fractures Among Students Aged Between 8 and 13 Years in Hyderabad, India.

Introduction Trauma involving anterior teeth stands as a prevalent type of dental injury among school-age children, impacting physical, psychological, and social well-being. This study aimed to assess the occurrence of fractures in anterior teeth among school children in Hyderabad and its associated risk factors. Materials and methods This research incorporated a cross-sectional analysis, involving 2046 children in the age group of 8 to 13 years from different schools in Hyderabad City. Alongside clinical evaluations, all participants completed a questionnaire regarding traumatic dental injuries. Results Results indicated a prevalence rate of 8.5%, notably higher among younger boys. Factors such as lip competence coverage, increased overjet, and malocclusion with maxillary incisor proclination were associated with a heightened risk of such injuries. The peak incidence was observed at age 12, with fractures involving enamel and dentin being the most common type, predominantly affecting the maxillary central incisors. Conclusion The findings emphasize the significance of educational programs aimed at enhancing awareness and understanding of dental injuries among parents, students, and school staff.

An Adult with Untreated Isolated Cleft Palate Since Birth: A Rare Case Report

Introduction: Orofacial clefts are one of the most common congenital anomalies involving the craniofacial region. An isolated cleft palate is the rarest (33% of all orofacial clefts) among individuals with female predominance. Individuals born with these clefts manifest craniofacial, functional, and psychological anomalies. Sometimes, patients cannot receive the required therapies due to a lack of awareness and lack of medical access or economic factors. Untreated clefts may adversely impact the patient’s life both physically and psychologically.&#x0D; Case Description: This study presents a case report of a 45-year-old male with an untreated cleft palate since birth due to a low socioeconomic background, leading to several oro-dental anomalies, speech defects, and psychological and social challenges.&#x0D; Results: Extraoral examination revealed mild facial asymmetry, dry and incompetent lips, and underdeveloped philtrum. Intraorally, there was a cleft palate, macroglossia, soft and edematous gingiva with bleeding on probing, gingival recession, and periodontal pockets, along with various dental anomalies. Full mouth orthopantomogram showed discontinuity of the palatal line, collapsed maxillary arch, root stumps, and crowding. The final diagnosis of isolated cleft palate was made. The patient was advised for surgery regarding the cleft palate, dental treatment, speech therapy, and psychological counseling. However, the patient refused all treatments except a few dental aids due to economic difficulties.&#x0D; Conclusion: The present case report highlights the need for these patients to receive particular concerns. Patients must be motivated to get proper treatment at a suitable stage to prevent future complications. Cleft teams must be advised to initiate some encouraging steps in imparting treatment aids to such patients, especially in rehabilitation therapy, considering their surrounding environment, psychological makeup, socioeconomic status, and motivation. In addition, social groups should also treat these patients with a positive approach, helping them to live healthy and normal lives just like any other individual.