Community Orthodontists and Craniofacial Care: Results of a Washington State Survey

Abstract

Background Little is known about community orthodontists’ previous training in, experience with, or receptivity to caring for children with craniofacial disorders. Objectives (1) To characterize the current level of participation by Washington state orthodontists in craniofacial care; and (2) to identify factors that promote or impede community orthodontists’ involvement in caring for children with craniofacial conditions. Design Mail survey. Methods A 26-item questionnaire was designed and mailed to all active orthodontists in Washington state (N = 230). Question topics included practice characteristics, training and experience with craniofacial conditions, concerns related to public and private insurance, and communication with craniofacial teams. Results Of eligible respondents, 68% completed the survey. Most orthodontists’ patient panels were made up of patients who either have private insurance or pay cash for services. On average, 2% of respondents’ patients were Medicaid beneficiaries. Only 20% of respondents had seen more than three patients with cleft lip and/or palate in the past 3 years. Although a minority of orthodontists receive referrals from (27%) or are affiliated with (11%) craniofacial teams, most orthodontists perceived craniofacial care positively and were interested to learn more about craniofacial care and to accept additional patients with these conditions. Conclusions Results of this survey can inform potential strategies to increase access to orthodontic care for children with craniofacial disorders. These would include developing an organized training, referral, and communication system between community orthodontists and state craniofacial teams and considering a case-management approach to facilitate this process.