"I have searched the world over looking for just the right toothbrush to make brushing easier and more effective for kids with a cleft lip and palate.  After the lip is repaired many children have a very thick and tight top lip.  This is especially true for kids with a bilateral cleft lip.  It makes it very difficult to fit a regular toothbrush under the lip to brush the top teeth.  I have tried every toothbrush I could find and tested them on my own son, Kyle.  (Thanks Kyle!)  We finally found one that works fabulous and it makes brushing a much more enjoyable time for both Kyle and myself.  We highly recommend the Blue Rx Ultra Suave Elite Toothbrush.  The bristles are possibly the softest on the market and they are shorter than regular brushes.  Since they are softer and shorter it easily fits between the top lip and the teeth.  Although probably not necessary, you could also cut down the bristles so that they are even shorter for extremely tight lips.  Since they are so soft this will not cause the bristles to be much firmer and it will still be softer than regular brushes.  This toothbrush has greatly improved the cleanliness of my own son's teeth and reduced the struggle over properly brushing.