When I was four and a half months pregnant, my husband and I learned, through a Level 2 ultrasound, that our daughter would be born with a bilateral cleft lip and palate. We were devastated initially, and once we recovered from the shock, we spent the remaining months leading up to the delivery (which occurred two months early, in fact) researching and investigating this fairly common medical condition.
Children with clefts are more prone to a larger than average number of cavities and often have missing, extra, malformed, or displaced teeth, requiring dental and orthodontic treatments, we learned. Fortunately, there are orthodontists in our area that specialize in the treatment of children with this condition, and other craniofacial deformities and special needs, including Dr. Efstathios (Steve) Giannoutsos, who is known to his patients as “Dr. G,” and his part-time associate Dr. Ankush Khanna DMD, MBE, with offices in Redding and Norwalk, and Dr. Perry Opin and Dr. Gary Opin, the father-and-son team that owns Opin Orthodontics, located at 266 South Broad Street in Milford.
“Approximately one out every 700 to 800 children is born with some type of cleft issue,” reports Dr. Perry Opin, who has worked with hundreds of craniofacial patients for the last 50 years. “We treat this and many other types of craniofacial syndromes, with 15% of our practice comprising children with these issues.”
Both Dr. Perry Opin and Dr. Gary Opin have received specialized training in the field of craniofacial syndromes, and they treat children from all over the United States and overseas. “We’ve had patients come from as far as Switzerland, and we will never turn away a child with a special need, regardless of their economic situation,” Dr. Perry says.
Since opening Georgetown Orthodontics and Norwalk Orthodontics, which are located at 73 Redding Road in Georgetown, Conn., and 10 Mott Avenue in Norwalk, Conn., respectively, Dr. G has also treated numerous patients with cleft palate and craniofacial issues. Each patient is given a tour of the office and introduced to Dr. G and the various staff team members before beginning treatment. Dr. G speaks with them to learn what their behaviors and concerns are so that he can tailor his orthodontic work to their individual needs.
“Children with craniofacial deformities and special needs require highly trained specialists, including orthodontists, to manage their sensitivities and specific set of treatment needs,” explains Dr. G, who received additional orthodontic training specifically to work with special needs patients. “For example, since many children on the spectrum have oral aversion, we must apply pressure on the mouth continually while the work is being performed. Transitions (both acutely during treatment and as well as at the various stages) are also a real challenge for these patients so it takes them longer than most to become comfortable with the process.” Dr. G and his assistants also distract children by engaging them with conversation, music and video, which helps keep them calm.
Taking impressions is one of the first steps before putting braces on the teeth, and it is usually a relatively simple procedure. However, it can be extremely difficult for patients on the spectrum. Dr. G makes the process look effortless, but the reality is that sometimes one child requires 10 appointments before allowing an impression to be done. Patients are often desensitized through simulation processes, such as using a fluoride tray at home with parents and siblings, making the office experience a more familiar one. Simulation is also necessary for managing taste aversions, so before putting braces on these patients’ teeth, Dr. G. practices several times to allow them to become comfortable with the plan.
“I work as a therapist and an orthodontist with these patients. It takes tremendous understanding of their particular issues, as well as trial and error, to determine the best procedure that works for a given patient on a given day,” Dr. G says.
Children born with craniofacial issues typically meet with several specialists throughout the course of their treatments, including orthodontists. “Gary and I are clinical professors in the department of dentistry and plastic surgery at Yale-New Haven Children’s Hospital,” Dr. Perry Opin explains. “We work with a team of specialists, including a plastic surgeon, pedodontist, prosthodontist, periodontist, speech pathologist, geneticist, ENY and psychologist, some or all of whom may be working with our young patients at different points throughout their childhood and into their teen years.”
The Opins generally have young patients come in to meet them for the initial visit, according to Dr. Gary. “Next visit, we’ll have them sit in the chair. After that, we’ll try and take molds … then, X-rays,” he says. “We want to establish a rapport with them, and let them know that they don’t need to fear the men and women in their ‘white coats.’
Aside from their highly trained staff, the Opins have another special member of their team: Cooper, Gary’s therapy dog, who greets patients as they enter the office and jumps from lap to lap while the kids are in the chair.
“Cooper received training and certification from Pet Partners,” Gary explains, “and he is a great comfort to our young patients.”
Dr. Perry concludes, “We can’t say enough for the many children with craniofacial problems and their understanding parents that we have treated over the past five decades. These young patients have taught us much about the human spirit and joy that can spring from surmounting nature’s adversities. We receive such gratification from seeing not just the physical transformation of these children but also how their personalities and confidence emerge as they progress through the various treatments.”
To reach Dr. G’s office, call 203-544-9338 or visit georgetownorthodontics.com; for Opin Orthodontics, call 203-877-3231 or visit opinorthodontics.com.