Clefts of lip and palate are amongst the most common of congenital abnormalities. Although perhaps generally considered rather low on the list of disabling deformities, a more severe cleft (such as complete bilateral cleft lip and palate) can pose a major developmental and psychological challenge to a growing child by potentially affecting appearance, speech, hearing, maxillary growth and dentition. Increasing evidence suggests that the quality of outcome is very dependent on the skill and experience of surgeon, orthodontist, speech therapist and other specialist cleft team members1.