Cleft palate and complex palatal conditions require specialized prosthodontic solutions — not general dental care. Dr. Nicholas Goetz is one of approximately 150 board-certified maxillofacial prosthodontists in the U.S., with UCLA fellowship training and the reconstructive expertise to restore function, speech, and quality of life.
A cleft palate can affect speech, eating, and confidence long after childhood, and many adults are surprised to learn that a custom prosthesis can restore function in a gentle, lasting way when surgery alone has not closed the gap. For people living with an unrepaired or partially repaired cleft, the right oral appliance can transform how they speak, chew, and smile each day.
At Ocean Breeze Implant & Esthetic Dentistry in Boynton Beach, Florida, Dr. Nicholas Goetz brings advanced training to these complex cases. As one of approximately 150 maxillofacial prosthodontists in the United States, with a maxillofacial prosthodontics fellowship from UCLA and years of service treating patients with intricate needs, Dr. Goetz designs prosthetic solutions that address both the way you function and the way you feel. We treat each plan as a partnership, taking time to understand your goals before any appliance is made.
A cleft palate is a congenital opening in the roof of the mouth that creates a connection between the oral and nasal cavities. When this gap remains, air and food can escape into the nasal passage, which affects clear speech, comfortable swallowing, and confident eating. Prosthodontic care closes that gap with a custom appliance rather than surgery, giving patients a path forward when an operation is not possible, not preferred, or not enough on its own.
The most common solution is an obturator, a precisely fitted device that seals the opening in the palate. According to a clinical case report published in the journal Cureus, a complete denture fitted with a palatal obturator and pharyngeal extension produced marked improvements in a patient’s speech, chewing, and swallowing while also preventing liquid from escaping into the nasal cavity. Outcomes like these show how a well-designed prosthesis can restore both function and quality of life.
Every cleft is different, so the appliance is shaped around the individual rather than a single template. The goal is always to rebuild function while keeping the device comfortable for daily wear.
Several prosthetic options can help patients with a cleft palate, and the right choice depends on the size of the defect and the patient’s needs.
Palatal obturator
This appliance fills and seals the opening in the hard or soft palate, restoring a barrier between the mouth and nasal cavity for clearer speech and easier swallowing.
Speech aid prosthesis
Also called a speech bulb, this removable device helps patients who have trouble closing off the nasal passage during speech, improving sound and resonance.
Complete or partial dentures
For patients missing teeth alongside the cleft, dentures can be combined with an obturator to address tooth replacement and palatal sealing together.
Choosing among these options is a collaborative process, and we guide you through each step so the final result fits your life as well as your mouth.
Dr. Nicholas Goetz completed his undergraduate degree, dental doctorate, master’s degree, and prosthodontic residency all at the University of Florida — one of the country’s premier training programs. He then pursued a Maxillofacial Prosthodontics Fellowship at UCLA, one of only a handful of institutions in the nation that trains specialists at this level. Before returning to private practice in Delray Beach, he served as a civilian maxillofacial prosthodontist with the U.S. Army and VA Medical Hospital — treating veterans and active-duty personnel with some of the most complex reconstructive needs imaginable.
That military experience gave Dr. Goetz exposure to cases that most prosthodontists in private practice will never encounter. Traumatic facial injuries, post-surgical cancer rehabilitation, severe bite collapse from years of neglect — these are the cases where his training becomes most visible. When patients arrive at our Delray Beach office with complex histories and complicated needs, they are in the right place.
For patients whose needs are more routine — dental implants, crowns, dentures, cosmetic work — Dr. Goetz brings the same precision and artistry that his most demanding reconstructive cases require. The result is a level of care that most patients in Palm Beach County have never had access to outside of a major academic medical center.
Dr. Goetz serves patients throughout Delray Beach, Boca Raton, Boynton Beach, and the greater Palm Beach County area. Physician referrals for oncologic and post-surgical cases are welcome.
Cleft palate care often involves a team, and Dr. Goetz is the kind of clinician who can anchor the prosthetic side of that effort. His fellowship training focused on treating patients with complex head and neck conditions, the same skill set that supports thoughtful work on congenital palatal defects.
Technology plays an important role in planning these cases, yet it always supports clinical judgment rather than replacing it. Using detailed imaging and digital design, we can map the shape of the defect and plan an appliance that fits precisely. This is the same careful philosophy that guides our work in oral rehabilitation after head and neck cancer treatment, where restoring function and appearance go hand in hand.
Patients dealing with congenital defects also benefit from the broader scope of our prosthodontic treatments, which range from custom appliances to full restorations. For those who need extensive rebuilding of the bite and palate, our work in full mouth reconstructions shows how complex cases can be approached with patience and precision.
The process begins with a thorough consultation, where we examine the cleft, discuss your history, and listen to what matters most to you. From there, impressions and digital scans help us design an appliance tailored to your anatomy.
During fitting, we evaluate speech, comfort, and swallowing, adjusting the device until it feels right. Many patients are familiar with the precision involved through our approach to CBCT scanning in complex reconstruction cases, which allows detailed planning before any appliance is delivered. Follow-up visits make sure the prosthesis continues to perform well over time.
Living with a cleft palate as an adult can feel isolating, but a thoughtfully designed prosthesis can change daily life in meaningful ways. At Ocean Breeze Implant & Esthetic Dentistry, Dr. Goetz combines advanced training, a maxillofacial prosthodontics fellowship from UCLA, and a deeply personal approach to care that few practitioners can match. Our team in Boynton Beach is here to help you speak, eat, and smile with renewed comfort.
If you or someone you care about is ready to explore prosthodontic solutions for a cleft palate, we would be glad to help you take the first step. Reach out through our contact form to schedule a consultation and learn how a custom appliance can restore both function and confidence.
We believe financial concerns shouldn’t keep you from treatment that can change your daily life. Ocean Breeze Prosthodontics offers flexible financing options so the path to a complete smile feels manageable from the very first visit.
While we are not in-network with insurance companies, we’ll still help you get the most out of your plan. We file claims on your behalf and assist you in securing any reimbursement your PPO plan allows.
Our gallery includes some of the most complex restorative cases seen in private practice in South Florida — full mouth reconstructions, implant-supported restorations, and comprehensive smile transformations that reflect the breadth of Dr. Goetz’s training. View our smile gallery to see the results.
Whether you’ve been referred by an oncologist, a surgeon, or simply want the most qualified specialist in Delray Beach for any restorative need, Dr. Goetz is ready to help. Schedule a consultation at our office today.
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