Cleft and Craniofacial Team Orthodontic Care in the United States: A Survey of the ACPA

Nima Khavanin, Hillary Jenny, Diana S. Jodeh, Michelle A. Scott, Stephen Rottgers, Jordan Steinberg

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To better understand the capacity for orthodontic care, service features, and finances among members of the American Cleft Palate-Craniofacial Association (ACPA). DESIGN: Cross-sectional survey. SETTING: ACPA-approved multidisciplinary cleft teams. PARTICIPANTS: Cleft team coordinators. INTERVENTIONS: Coordinators were asked to complete the survey working together with their orthodontists. MAIN OUTCOME MEASURE: Model for orthodontic care. RESULTS: Coordinators from 82 out of 167 teams certified by ACPA completed the survey (response rate = 49.1%). Most orthodontists were private practice volunteers (48%) followed by university/hospital employed (22.8%). Care was often delivered in community private practice facilities (44.2%) or combination of university and private practice facilities (39.0%). Half of teams reported offering presurgical infant orthopedics (PSIO), with nasoalveolar molding being the most common. Cleft/craniofacial patients typically comprise 25% or less of the orthodontists' practices. The presence of a university/hospital-based orthodontist was associated with higher rates of offering PSIO (P < .001) and an increased percentage dedication of their practice to cleft/craniofacial care (P < .001). CONCLUSION: Orthodontic models across ACPA-certified teams are highly varied. The employment of full-time craniofacial orthodontists is less common but is highly correlated with a practice with a high percentage of cleft care and the offering of advanced services such as PSIO. Future work should focus on how to effectively promote such roles for orthodontists to ensure high-level care for cleft/craniofacial patients requiring treatment from infancy through skeletal maturity.

Original languageEnglish (US)
Pages (from-to)860-866
Number of pages7
JournalThe Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association
Volume56
Issue number7
DOIs
StatePublished - Aug 1 2019

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Cleft Palate
Orthodontics
Private Practice
Orthopedics
Anniversaries and Special Events
Orthodontists
Surveys and Questionnaires
Volunteers
Cross-Sectional Studies

Keywords

  • facial growth
  • nonsyndromic clefting
  • orthodontics
  • orthognathic surgery
  • orthopedic treatment

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

Cite this

Cleft and Craniofacial Team Orthodontic Care in the United States : A Survey of the ACPA. / Khavanin, Nima; Jenny, Hillary; Jodeh, Diana S.; Scott, Michelle A.; Rottgers, Stephen; Steinberg, Jordan.

In: The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association, Vol. 56, No. 7, 01.08.2019, p. 860-866.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To better understand the capacity for orthodontic care, service features, and finances among members of the American Cleft Palate-Craniofacial Association (ACPA). DESIGN: Cross-sectional survey. SETTING: ACPA-approved multidisciplinary cleft teams. PARTICIPANTS: Cleft team coordinators. INTERVENTIONS: Coordinators were asked to complete the survey working together with their orthodontists. MAIN OUTCOME MEASURE: Model for orthodontic care. RESULTS: Coordinators from 82 out of 167 teams certified by ACPA completed the survey (response rate = 49.1{\%}). Most orthodontists were private practice volunteers (48{\%}) followed by university/hospital employed (22.8{\%}). Care was often delivered in community private practice facilities (44.2{\%}) or combination of university and private practice facilities (39.0{\%}). Half of teams reported offering presurgical infant orthopedics (PSIO), with nasoalveolar molding being the most common. Cleft/craniofacial patients typically comprise 25{\%} or less of the orthodontists' practices. The presence of a university/hospital-based orthodontist was associated with higher rates of offering PSIO (P < .001) and an increased percentage dedication of their practice to cleft/craniofacial care (P < .001). CONCLUSION: Orthodontic models across ACPA-certified teams are highly varied. The employment of full-time craniofacial orthodontists is less common but is highly correlated with a practice with a high percentage of cleft care and the offering of advanced services such as PSIO. Future work should focus on how to effectively promote such roles for orthodontists to ensure high-level care for cleft/craniofacial patients requiring treatment from infancy through skeletal maturity.",
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