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Orthodontists Lack Experience, Not Motivation, for Treating Patients with Craniofacial Anomalies

Posted on Wednesday, October 9, 2013

Cleft Palate–Craniofacial Journal – Access to oral health care can be a challenge for people with cleft lip and palate. The greater complexity of treatment for these patients creates issues of time, cost, and scope of orthodontic practice. A study finds that while orthodontists have the motivation to treat this population, training and experience may be lacking.


The Cleft Palate–Craniofacial Journal presents results of a survey of orthodontic residents in the United States and Canada. They were asked if they planned to treat patients with cleft lip and palate, craniofacial anomalies, and special needs such as Down syndrome, cerebral palsy, and autism.


The survey was conducted online, and 208 residents responded. The 41-item survey asked residents about the importance of serving this group of patients, whether these residents planned to serve such patients in their future practices, and if they would charge higher than typical fees.


The added difficulties of orthodontic treatment for patients with cleft lip and palate and other special needs may cause private practices to limit such treatment. Hospitals and university centers are often where these patients seek treatment. This can limit access to oral health care for these patients, particularly those in rural areas and those who rely on Medicaid.


Nearly 55 percent of residents said they plan to treat patients with craniofacial anomalies and special needs. However, 58 percent responded that they would charge a higher fee. Among those who indicated they did not plan to treat these patients, the primary reasons given were inadequate experience and lack of access to an interdisciplinary team.


Nearly half of the residents surveyed were unaware of established fellowship programs focusing on cleft and craniofacial needs. About 29 percent indicated they would be willing to complete a 1-year fellowship program. Many favored the creation of a subspecialty in orthodontics for treating patients with craniofacial anomalies.


While the motivation exists, the means are lacking to guide more orthodontic residents into confidently providing care for this special needs population. Professional organizations, academic institutions, and government agencies could use the information provided by this study in strategic planning efforts to create greater access to care for patients with craniofacial anomalies.

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