Palate formation anomalies: Dental assisting

Palate formation occurs early in prenatal development, which is the stage of development that begins at conception and continues until birth. Prenatal development occurs in three periods: the preimplantation period during the first two weeks; the embryonic period, from weeks three through eight, which marks the development of the major layers that will eventually become all tissues and organs; and the fetal period from week nine until birth, which is a time for growth and maturation.

During this critical time, the foundation is laid for oral-facial growth and development. In the late embryonic and early fetal periods, cells rapidly undergo proliferation and differentiation, meaning they multiply and become specialized to form structures like the face and oral cavity. If this growth is disrupted, developmental and dental anomalies can occur. As a dental assistant, your knowledge of oral-facial development is essential to understanding dental anomalies that affect your patients.

Now, the development of the face and oral cavity occurs primarily during weeks five through twelve, following a highly coordinated sequence of growth and fusion. The process begins with two embryonic structures: the frontonasal process and the first branchial arch, also referred to as Meckel’s cartilage. The first branchial arch is especially important because it contributes to formation of the maxilla, or upper jaw, and the model for the mandible, or lower jaw, as well as the muscles of mastication and two bones of the middle ear.

Beginning with the fifth week of development, the palate starts to develop; and it occurs in three stages. The first stage involves the formation of the primary palate which forms the anterior part of the roof of the mouth, while the second stage involves the formation of the secondary palate directly behind the primary palate. Finally, around the ninth week of development, the third stage occurs when the primary palate and secondary palate come together in a Y-shaped pattern forming the fully combined hard and soft palates. From there, the palate continues to mature through week twelve of pregnancy.

Now that we’ve covered the normal process of palate formation, let’s talk about what happens when development doesn’t proceed normally. When the primary and secondary palates fail to fuse, it results in a cleft palate, which is a gap in the roof of the mouth.