The orthodontist's views regarding academic education in cleft lip and palate as well as craniofacial deformities in South Africa

  • Emad Ghabrial University of KwaZulu-Natal, KwaZulu-Natal, South Africa. https://orcid.org/0000-0002-7213-9760
  • Kurt-W Bütow Professor and Head of Department Emeritus, and former Head of the Cleft Lip and Palate Clinic of the University of Pretoria, Pretoria, South Africa
Keywords: Orthodontics, cleft palate, cleft lip, multidisciplinary, education, professional development, survey.

Abstract

Orthodontists are essential members of a craniofacial team (American Cleft Palate-Craniofacial Association Team Standards Committee).1 Because cleft lip/palate (CLP) and craniofacial deformities (CFD) vary in severity and facial growth patterns, treatment is complex and lengthy and requires collaboration among different disciplines. Consequently, orthodontists need specialised training in this field to reach the treatment goals of good facial growth, aesthetically acceptable appearance, and dental occlusion. Therefore, it becomes increasingly important to provide adequate training for orthodontists, so they can not only provide efficient treatment but can also undertake a leadership role in the field. To obtain information regarding:
• the CLP and CFD academic education of orthodontists the professional services that orthodontists offer to CLP and CFD patients
• the educational and training needs of orthodontists in this field A 54-item online survey to collect quantitative data was conducted by means of an interview, using a randomised sample of orthodontists attending the annual scientific conference of the South African Society of Orthodontics. The questionnaire was completed by 53 orthodontists, 54.6% of whom had more than 10 years of professional experience. Of the respondents, 84.8% experienced some clinical exposure in this field during their postgraduate education. Treatment for CLP and CFD patients was offered by 92% of the professionals, but only 21.7% had high confidence in their expertise in treating CLP/CFD patients. Of the respondents, 88% agreed there was a need to improve CLP and CFD education, and the majority recommended fellowship training and certified courses. The rest suggested continuing-education workshops. Most of the orthodontists provided treatment for both CLP and CFD patients despite some of them lacking confidence in treating such cases. The majority agreed that there is a strong need to establish an educational strategy to meet the needs of orthodontists who treat CLP and CFD patients. The respondents suggested that programmes such as fellowship training, degree couses, certified courses, and continuing education workshops could be used.

References

1. Strauss RP. Cleft palate and craniofacial teams in the United States and Canada: A national survey of team organization and standards of care. The American Cleft Palate-Craniofacial Association (ACPA) Team Standards Committee. Cleft Palate Craniofac J. 1998; 35(6): 473-80.

2. Bütow KW. Treatment of cleft lip and palate. Part V: The clinic and the multidisciplinary approach to cleft lip and palate cases. J Dent Assoc S Afr. 1984; 39(8): 543, 5.

3. Marks M. A teamwork approach to cleft palate rehabilitation in South Africa. S Afr J Commun Disord. 1960; 7(2): 8-10.

4. Santiago PE, Grayson BH. Role of the craniofacial orthodontist on the craniofacial and cleft lip and palate team. Semin Orthod. 2009; 15(4): 225-43.

5. Auslander M, Brown A, Dalston R, Elmendorf E, Elster B, Jones M, et al. Parameters for evaluation and treatment of patients with cleft lip/palate or other cranofacial anomalies. Cleft Palate Craniofac J. 1993; 30 (Suppl.).

6. Long Jr RE, Semb G, Shaw WC. State of the art - orthodontic treatment of the patient with complete clefts of lip, alveolus, and palate: Lessons of the past 60 years. Cleft Palate Craniofac J. 2000; 37(6): 533.

7. Prahl-Andersen B. Controversies in the management of craniofacial malformations. Semin Orthod. 2005; 11(2): 67-75.

8. Vig KW, Mercado AM. Overview of orthodontic care for children with cleft lip and palate, 1915–2015. Am J Orthod Dentofacial Orthop. 2015; 148(4): 543-56.

9. Pruzansky S. The role of the orthodontist in a cleft palate team. Plast Reconstr Surg. 1954; 14(1): 10-29.

10. Dabed CC, Cauvi DL. Survey of dentists' experience with cleft palate children in Chile. Cleft Palate Craniofac J. 1998; 35(5): 430-5.

11. Gadbury-Amyot CC, Simmer-Beck M, McCunniff M, Williams KB. Using a multifaceted approach including community-based service-learning to enrich formal ethics instruction in a dental school setting. J Dent Educ. 2006; 70(6): 652-61.

12. Kobes HR, Pruzansky S. The cleft palate team - a historical review. Am J Public Health Nations Health. 1960; 50(2): 200-5.

13. Lass NJ, Gasperini RM, Overberger JE, Connolly ME. The exposure of medical and dental students to the disorder of cleft palate. Cleft Palate J. 1973; 10(56): 306-11.

14. Parameters for evaluation and treatment of patients with cleft lip/palate or other craniofacial differences. Cleft Palate Craniofac J. 2017; 55(1): 137-56.

15. Berkowitz S. Teaching orthodontic residents and clinicians about cleft palate treatment. Am J Orthod Dentofacial Orthop. 2010; 138(2): 127.

16. McCarthy JG. Development of craniofacial orthodontics as a subspecialty at New York University Medical Center. Semin Orthod. 2009; 15(4): 221-4.

17. Berkowitz S. The need to establish an online cleft palate teaching program for orthodontic residents and practicing orthodontists. Am J Orthod Dentofacial Orthop. 2010; 137(5): 577.

18. McDonald J, Adamidis J, Eaton K, Seeholzer H, SieminskaPiekarczyk B. A survey of postgraduate (specialist) orthodontic education in 23 European countries. Br J Orthod. 2000; 27(1): 83-98.

19. Kern DE, Thomas PA, Hughes MT. Curriculum development for medical education: A six-step approach. 2nd ed. Baltimore, MD: Johns Hopkins University Press. 2009.

20. Modi N, Ross E. The current practices, training and concerns of a group of hospital-based speech therapists working in the area of dysphagia. The South African Journal of communication disorders. 2000; 47: 3-14.

21. Thandeka M, Penelope F, Robin J. Are South African speech-language therapists adequately equipped to assess English Additional Language (EAL) speakers who are from an indigenous linguistic and cultural background? A profile and exploration of the current situation. South African Journal of Communication Disorders. 2016; 63(1): e1-5

22. Medpages, South Africa: [updated 7 Sep 2016; cited 28 July 2017]. Available from: https://www.medpages. info/sf/index. bphp?page=services.

23. Manana PN, Kuonza L, Musekiwa A, Koornhof H, Nanoo A, Ismail N. Feasibility of using postal and web-based surveys to estimate the prevalence of tuberculosis among health care workers in South Africa. PloS one. 2018; 13(5): e0197022.

24. Adeyemi TA. Cleft lip and palate care in Nigeria: Current status of orthodontic residents' training in the management of children with cleft lip and palate. J Craniofac Surg. 2015; 26(4): 1106-8.

25. Keim RG, Sinclair PM. Orthodontic graduate education survey. Am J Orthod Dentofacial Orthop. 2002; 121(1): 2-8.

26. Noble J, Karaiskos N, Wiltshire WA. Future provision of orthodontic care for patients with craniofacial anomalies and cleft lip and palate. World J Orthod. 2010; 11(3): 269-72.

27. Pannbacker M, Lass NJ, Scheuerle JF, English PJ. Survey of services and practices of cleft palate–craniofacial teams. Cleft Palate Craniofac J. 1992; 29(2): 164-7.

28. Bedwinek AP, Kummer AW, Rice GB, Grames LM. Current training and continuing education needs of preschool and school-based speech-language pathologists regarding children with cleft lip/palate. Lang Speech Hear Serv Sch. 2010; 41(4): 405-15.

29. Flanigan TS, McFarlane E, Cook S, editors. Conducting survey research among physicians and other medical professionals: A review of current literature. Proceedings of the Survey Research Methods Section, American Statistical Association. 15 May, 2008; 1: 4136-47. Available from: https://pdfs.semanticscholar.org
/097a/47c2221285aa0529300a1add9015844 edc35.pdf.

30. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997; 50(10): 1129-36.

31. Pannbacker M, Lass NJ, Starr P. Information and experience with cleft palate: Students, parents, professionals. Cleft Palate J. 1979; 16(2): 198-205.

32. Accreditation Standards for Clinical Fellowship Training Programs in Craniofacial and Special Care Orthodontics. Commission on Dental Accreditation. American Dental Association 2013. Available from: https://www.ada.org/~/media/CODA/ Files/ortho_fellowship.pdf?la=en.

33. Schoenbrunner AR, Dalle Ore CL, Lance S, McIntyre J, Jones M, Gosman A. Effect of surgeon volume and craniofacial fellowship training on cleft palate complication rates. Ann Plast Surg. 2017; 78 (5 Suppl 4): S229-S32.

34. Plana NM, Massie JP, Stern MJ, Alperovich M, Runyan CM, Staffenberg DA, et al. The drivers of academic success in cleft and craniofacial centers: A 10-year analysis of over 2000 publications. Plast Reconstr Surg. 2017; 139(2): 450-6.

35. Grewal NS, Spoon DB, Kawamoto HK, Jones NF, Da Lio AL, Crisera C, et al. Predictive factors in identifying subspecialty fellowship applicants who will have academic practices. Plast Reconstr Surg. 2008; 122(4): 1264-71.
Views
  • Abstract 0
  • PDF 0
Views and downloads are with effect from 11 January 2018
Published
2021-05-31