Cleft teams who wish to select the best treatments for patients in their care face a difficult task. The present lack of well designed studies means that large numbers of old techniques are enthusiastically practiced on the basis of unfounded hopes and prejudices, while new innovations come and go with the seasons. In many instances children and families appear to be burdened by unnecessarily complex surgical and orthodontic protocols that achieve no more than simple ones.

This presentation will review the evidence for: centralised -vs- local services, complex -vs- simple surgery, multiple episode -vs- targeted orthodontics, prosthetic-vs-orthodontic space closure, and the scope of single centre-vs-multicentre research.