Study: Orthodontists lack experience with cleft lip/palate

A new study has found that while orthodontists have the motivation to treat patients with cleft lip and palate, training and experience may be lacking (Cleft Palate -- Craniofacial Journal, September 2012, Vol. 49:5, pp. 596-600).

In a survey of orthodontic residents in the U.S. and Canada, respondents 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 41-item survey was conducted online, and 208 residents responded. They were asked about the importance of serving this group of patients, whether they 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, the researchers noted. These patients often seek treatment in hospitals and university centers, which can limit their access to oral healthcare, particularly for those in rural areas and those who rely on Medicaid.

Nearly 55% of the survey respondents said they plan to treat patients with craniofacial anomalies and special needs. However, 58% 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 those surveyed were unaware of established fellowship programs focusing on cleft and craniofacial needs, and 29% indicated they would be willing to complete a one-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, the study authors concluded. 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.