Dr.David C. Hoffman - Oral & Maxillofacial Surgery School of Dentistry: NY Univ.- College of Dentistry Residency :Oral & Maxillofacial Surgery Univ. Texas Health Science Center Parkland Memorial Hospital

Video Transcription

What we have in United States and in most of Europe, but it was found by the United States, we have the American Cleft Lip and Craniofacial Association, which is a listing of people that treat children with cleft lip or cleft palates. But more so, they are advocate as you mention a cleft lip or cleft palate team. That is a lot of advantages to a cleft lip and a cleft palate team because at first, what is a team? A team is as you mentioned a group of not just surgeons, it is a group of dentists, speech pathologists, geneticists, pediatricians, ear, nose and throat doctors. The first approach is that rather than apparently taking your baby to 10 different doctors, they can come to one setting and have that baby seen by all those doctors who can then communicate. The alternative would be that a parent would make 10 visits to 10 different medical specialists and then ask that he try to make call to each other which would be impractical. So, most hospitals like Mamani’s Hospital have a cleft lip and cleft palate team and the doctors meet once a month. They see all their patients and discuss the treatment. Now, there is a second really good thing for cleft team. If you think about it, a parent is now faced with a baby born with a cleft lip and a cleft palate. They are running to the internet and look out things, but it is a little confusing because the textbooks they now use have thousands of pages so how was a parent in a matter of an hour to an internet can really become an expert and try to guide the care of their baby. They do not know a lot and they cannot read a lot. But it is frightening for a parent because they are going read, not only are they going to read what they have to do, they are going to read a lot of opinions. A cleft team reassures the parent. It says, “Listen, we will guide you through the care of the baby. Now we will guide through the care of getting the baby treated, lip closed, the palate closed and then all subsequent care.” For example, at eight months of age, the baby needs her palate closed. At two years of age, the baby needs to see his special children’s dentist who knows how to treat kids with cleft lip and cleft palate. At four years of age, they need to see an ear, nose and throat doctor to evaluate their tonsils and their hearing and they also need to see a speech pathologist at two years or three years, every year. At five or six, then you can get potentially something that done for their speech if there is a problem. At seven or eight, they need to begin orthodontics. At 9 or 10, they may need a bone graft and as you could see at different stages, kids will need different procedures. At 11 or 12 they may need braces. At 14 or 15, they may need some secondary surgery. For a parent to try to .figure all these out, from the internet .is very hard or just picking up a book. So, a cleft team can reassure a parent to just listen, “We are going to follow your baby. We are going to see the baby at least once a year, sometimes, twice a year. And we are going to make sure that that baby gets all the recommended care at any time in his life. So a cleft team commission is to follow a newborn until they are an adult and make sure that those kids have normal appearance and normal teeth, and speak normally just as you want for any other child.