This is one of the most important steps in the success of the surgery. The patient will be advised to take antibiotics and painkillers. Also, oral hygiene instructions to follow will be discussed with the patient. In general following instructions should be followed by the patient

1. Restrict the diet to cold/lukewarm liquids or semi-solids for the initial 5 days after surgery. Semi-solid/ no chew diet can be followed for the next two weeks. A regular diet can be started from 3rd week after surgery once you get clearance from the surgeon.

    

2. Oral hygiene should be maintained well after the surgery. The first week after the surgery patient is asked to avoid toothbrushing in the area of the surgery. But frequent gargling is very important. Patients will be asked to use mouth rinse containing antibiotics. Gargling after every meal is a must. Toothbrushing can be resumed after one week of the surgery. It is advisable to use a soft toothbrush and toothpaste of your choice. Gum massage can be started after 3 weeks of the surgery.

    

3. Donor site wounds must be maintained carefully. We usually use waterproof dressing for the wound on the hip bone. So that patients can have regular baths. Stitches of this wound can be removed after 7 days if healing is satisfactory. Walking is encouraged from the next day of surgery.

    

4. Stitches inside the mouth are usually self resorbable and will dissolve after 4-5 weeks of surgery.

    

5. Regular follow up appointments should be maintained with the surgeon.

Once the healing is complete, the surgeon and orthodontist will decide the next course of action. Almost all the patients with cleft lip and cleft palate will need comprehensive orthodontic care to align the teeth. 

This fixed orthodontic treatment is usually started around 14-15 years of age when most of the permanent teeth have erupted in the mouth (except wisdom teeth). The orthodontist will advise x rays and decide on the treatment plan. Since many patients with cleft lip and cleft palate may have few missing teeth, maintaining the available teeth is very important and hence oral hygiene instructions should be followed meticulously. 

The course of orthodontic treatment is usually for 2-3 years depending on the complexity of the treatment. During this period, braces will be put on patients’ upper and lower teeth. The orthodontist will start teeth alignment so that the patient can chew properly, have a good well-aligned dental arch and a pleasant smile. 

Some of the patients with cleft lip and cleft palate will further require Orthognathic surgery (corrective jaw surgery) to reposition the jaws. This surgery will require further orthodontic support.