Early intervention and prevention strategies in cleft lip and palate: A comprehensive narrative review

ABSTRACT Cleft lip and palate (CL/P) represent the most common craniofacial birth defects worldwide, affecting approximately 1 in 700 live births with significant geographic and ethnic variations. From a preventive medicine perspective, addressing CL/P requires a multifaceted approach encompassing primary, secondary, and tertiary prevention strategies. Primary prevention focuses on preconception and prenatal interventions, including folic acid supplementation, avoidance of teratogenic exposures, and genetic counseling. Secondary prevention involves early prenatal diagnosis through advanced imaging techniques and preparation for immediate postnatal care. Tertiary prevention emphasizes comprehensive management protocols to prevent complications and optimize long-term outcomes. This narrative review synthesizes current evidence on preventive strategies across the continuum of care for CL/P, examining epidemiological patterns, risk factors amenable to modification, the role of periconceptional nutrition, environmental exposures, and public health interventions. Evidence demonstrates that periconceptional folic acid supplementation reduces CL/P risk by approximately 25%–50%, while maternal smoking and alcohol consumption significantly increase risk. Multidisciplinary team approaches, early feeding interventions, and systematic protocols for preventing otitis media and speech disorders constitute essential components of tertiary prevention. Population-based screening programs and health education initiatives show promise in reducing CL/P burden. Despite advances, significant gaps remain in implementing evidence-based preventive strategies, particularly in low-resource settings. Future directions include enhanced genetic screening, targeted interventions for high-risk populations, and strengthened integration of preventive services within existing healthcare systems to reduce both incidence and long-term morbidity associated with CL/P.