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Cleft Lip and Cleft Palate Care Team

Each year approximately 4,200 babies in the United States are born with cleft lip or cleft palate. Oral clefts are the fourth most common birth defect in the U.S. and are more common in children of Latino, Asian or Native American origins. Clefts develop very early in a woman's pregnancy and result when there is not enough tissue in a baby's mouth and lip area to join properly. Ultrasound can often detect a cleft in an unborn baby. This allows the family to meet with a member of the cleft palate team before birth, receive educational materials, and begin a treatment plan.

The Children's Hospital Cleft and Craniofacial Clinic is the only approved cleft palate team in Tennessee. Cleft palate management is complicated, so the team must include:

  • Audiologists
  • Nurses
  • Doctors
  • Dentists
  • Orthodontists
  • Social workers
  • Speech language pathologists
  • Nutritionists
  • Geneticists
  • Oral surgeons

See The Cleft Clinic With Dr. Mark Ray


The cleft palate team is approved by the Commission on Approval of Teams and currently treats more than 200 patients in our region with both efficiency and compassion. The cleft palate birth defect causes abnormal facial appearance, unclear speech, poor hearing, learning issues and poor dental health. Our cleft palate team understands that better hearing, improved speech and positive self-image are essential tools for children to develop and grow into adults.

More Information About Cleft Lip and Cleft Palate

Providing Cleft Palate Treatment Near & Far

At East Tennessee Children’s Hospital, our ear, nose and throat specialists and reconstructive surgeons can begin treating a child with an oral cleft before they take their first breath. They will meet with parents whose baby has been diagnosed with a cleft to inform and reassure them about their child's condition and treatment. They will also work with parents adopting out-of-country children who may have an oral cleft.

In 2015, Dr. Mark Ray and members of his team volunteered to go on a medical mission to the Middle East as part of the Palestine Children's Relief Fund (PCRF) and The Smile Train. While there, they treated children with cleft lips and palates and helped train health care providers there to do so in the future.

Dr. Justin Daggett served several years as a missionary surgeon in Kenya where he co-directed the first multidisciplinary cleft team in east Africa and served as the only craniofacial surgeon for several countries.

"A cleft lip or palate is no longer a roadblock, it's merely a speed bump that, with proper treatment, can be overcome."
- R. Mark Ray, M.D.


Cleft Palate - Before & After

Cleft Palate Child 1

Before & After

Cleft Palate Child 2

Before & After

Cleft Palate Child 3

Before & After

Cleft Palate Child 4

Before & After

Cleft Palate Child 5

Before & After

Contact Cleft Lip/
Cleft Palate Office

Cleft Lip and Palate Team

R. Mark Ray

R. Mark Ray, M.D.

Cleft Lip and Palate Team, Otolaryngology, Pediatric


Justin R. Daggett

Justin R. Daggett, M.D.

Cleft Lip and Palate Team, Pediatric Hand Surgery, Plastic Surgery, Craniofacial (facial and skull) Surgery, Pediatric Breast Surgery, Brachial Plexus Surgery, Jaw Surgery


Turner Emery

Turner Emery, D.D.S.

Cleft Lip and Palate Team, Oral & Maxillofacial Surgery


James Pickering, DDS

James Pickering, DDS

Cleft Lip and Palate Team, Dentistry/Orthodontics


Chelsea K. Pressley, NP

Chelsea K. Pressley, NP

Nurse Practitioner, Cleft Coordinator


Sara Holland, CPNP

Sara Holland, CPNP

Nurse Practitioner, Cleft Coordinator