This post is going to give a brief overview on the craniofacial condition: cleft lip. Cleft lip is a condition where there is a failure in the fusion of two important structures during development of the human fetus. These two structures must fuse on 2 different sides of the upper lip. Failure of one side leads to a “unilateral” cleft lip, and failure of both leads to a “bilateral” cleft lip. There are many causes for this condition, such as genetics, drugs/alcohol/tobacco that the mother ingests while pregnant, and many other environmental influences. A major problem that cleft lip babies experience are issues with suckling during feeding from the bottle and breast. This leads to poor nutritional intake of the child. It is important to see a plastic or oral and maxillofacial surgeon as soon as possible to seek proper and necessary treatment! To treat cleft lip, surgery is needed. Surgery involves suturing important structures of the mouth together, an important muscle around the lip and the skin that sits on top of it. Once the cleft lip has been surgically fixed, major surgeries are rarely needed in the future. Our next topic covered will be Cleft Palate. -MC     Sources: https://www.mayoclinic.org/-/media/kcms/gbs/patient-consumer/images/2013/08/26/10/45/ds00738_im02605_fl7_cleft_lipthu_jpg.png https://www.hopkinsmedicine.org/otolaryngology/specialty_areas/facial-plastic-reconstructive/reconstructive/cleft-palate.html

Craniofacial care teams use the term “team day” to refer to the days in which all providers on the team are present, and several patients are seen. This typically means patients prepare for a 3 to 4-hour appointment depending on how many providers they may need to see that day. Team day usually occurs once a week for teams but once every 3, 6, 9, or 12 months for a patient depending on where they are in their care. On these days, patients can range from a few months old to about 18 years old. For the younger patients it is important to evaluate where they are in their surgery journey as well as their development with both feeding and speech. For the older children, the orthodontist and pediatric dentist typically work together to determine at what time orthodontic treatment should be initiated. Throughout the childhood years, speech pathologists are very important in monitoring speech development and intervening as necessary. Everyone plays a very important role in helping ensure the child develops properly and hits all the necessary milestones. For one particular clinic, team day is everyone’s favorite day. Providers arrive before 8am in order to prepare for the day. This includes exchanging notes with each other and being prepared for each patient that is coming in that day. The first patients arrive at 9am. From 9am to about 1 or 2pm, providers are rotating in and out of several rooms evaluating their patients and giving parents feedback. Between patients, providers must quickly jot down notes and review the chart of the next patient. Once the well-organized, busy schedule has finished for the day, all the providers gather for a meeting. In this meeting, they discuss every patient one-by-one. This allows each provider to update where they are in their treatment. The secretary takes notes and from here compiles a packet of information from the day that is sent [...]

A Craniofacial Team is a multidisciplinary group of medical professionals that aim to comprehensively treat patients born with craniofacial differences. This includes Cleft Lip and Palate, Craniosynostosis, and Apert Syndrome among other conditions. A patient born with a cleft can have a series of procedures including plastic surgery, bone grafting, speech therapy and orthodontic treatment. A team of qualified and experienced professionals can better manage, coordinate and treat the complex nature of these conditions. The American Cleft Palate-Craniofacial Association (ACPA) has a series of standards for what qualifies as a Craniofacial Team. At a very minimum, each team must have a surgeon, speech-language pathologist and orthodontist. These three disciplines are really the foundation of every team. The surgeon may either be a plastic surgeon or an oral and maxillofacial surgeon who specializes in craniofacial surgery. Despite only needing three core professionals, the team must have access to other specialists such as psychologists, social workers, audiologists, geneticists, pediatric dentists, pediatricians and otolaryngologists (ENTs). This means that the team might not have a psychologist with them in clinic, but they know of several in the community to recommend to patients. The frequency of team meetings and team rotation days depends on the volume of patients to treat and the resources at the hospital. For example, some teams may meet every Thursday for Craniofacial Clinic while others may meet just twice a month. Craniofacial Clinic may consist of patient appointments in the morning and team meetings in the afternoon. In these team meetings patient cases are reviewed so that treatment timelines can be coordinated between the different disciplines. For example, the orthodontist may review the bone grafting with the surgeon before the patient has braces. Moreover, team members may recommend referrals to other disciplines such as the psychologist or social worker. I hope this helps your understanding of a Craniofacial Team. Please check out the ACPA at the following link for more [...]

My name is Abdalla Asi, I am a current third year dental student at the University of Pennsylvania School of Dental Medicine. I am interested in am pursuing a career in Oral Surgery after graduation. I graduated in 2013 from Damascus University School of Dentistry in Syria. I moved to the United States to start my residency in Advanced Education in General Dentistry at Case Western Reserve University from 2014 to 2016 to learn more advanced procedures that will allow me to help my patients. After graduating from my residency program, I started working as a general dentist in the Cleveland area. For internationally trained dentist, pursuing Oral and Maxillofacial Surgery is not an easy task. Two major obstacles I faced were being a US citizen or permanent resident and having graduated from a US dental school. During my time in Cleveland I was able to obtain my Permanent Resident Green Card. I also saved money to pay for my own education. I was then very fortunate to be accepted at the University of Pennsylvania School of Dental Medicine as part of the Advanced Standing Education for internationally trained dentists. This is a two-and-a-half-year training that guarantees a US dental degree. With all of this, my application will now be considered during the next cycle for Oral and Maxillofacial Surgery residency. During my residency at Case Western Reserve University, I worked alongside the Orthodontic Team to help a 16-year-old patient with ectodermal dysplasia syndrome. This syndrome is a group of genetic disorders where the individual may have congenitally missing teeth. This can result in difficulty eating, and/or speaking, negatively affecting patient’s quality of life. There are many types of ectodermal dysplasia. All of them affect at least two of the ectodermal structures such as (skin, hair, nails, sweat glands and teeth). Signs of ectodermal dysplasia may include: Abnormal fingernails and toenails. Inability to sweat because of abnormal or absent [...]

Hi Everyone! My name is Brenna Harrington and I am a current 3rd year at Penn Dental. I am originally from just north of Boston and completed my undergraduate education at Case Western Reserve University in Cleveland. I’m excited to continue my involvement in this wonderful organization, and to be joining the Philly Phaces blog team! My passion for Cleft and Craniofacial Care is what sparked my interest in dentistry. I had the opportunity to shadow Craniofacial Teams at Boston Children’s Hospital as well as Case Western Reserve University Hospital. It was through the lens of these multidisciplinary teams that I learned about the extensive care children with skeletal abnormalities require. It was not until these experiences that I realized how critical and complex the dental care is for this community. I hope to one day work on a multidisciplinary team like this to treat children with craniofacial differences as well as intellectual and developmental disorders. I’m currently on a scholarship for dental school with the U.S. Air Force and look forward to working on different Air Force bases after graduation. Select bases have Craniofacial Teams and the opportunity for special patient care. In my free time I love to travel and cook new vegetarian recipes! I am excited to be blogging my journey to Craniofacial Care and I hope you enjoy! Brenna                

About the Author: Cody Dazen My name is Cody Dazen, and I am currently a third year dental student at the University of Pennsylvania. A little bit about me- I am local to the area, originally from southern NJ. My family has since relocated to Old City Philadelphia. I attended college at the University of Pennsylvania, where I played varsity golf. My calling towards a career in dentistry stems from my mom, who is currently practicing as a general dentist in Mt. Holly NJ. In dental school, my love for problem solving, medicine, and surgery has grown in part thanks to my father, a veterinarian and brother, who is currently a fourth year at Robert Wood Johnson Medical School. Family, faith, and fun have always been very important values to me. As I continue my education, I personally hope to specialize as an Oral and Maxillofacial Surgeon. It is this interest that led me to become involved with the Philly Phaces. This organization has provided me with an invaluable opportunity to meet, help, and support such amazing craniofacial patients and families. The Philly Phaces community has taught me fundamental values that continue to shape me as a person and health care professional. I am thankful and blessed to be able to give back to the Philadelphia community of which I have been a part of for the past seven and a half years. I am excited to be blogging along side several of my schoolmates! I plan to post insight into the pathophysiology and patient management of craniofacial differences the patients of Philly Phaces experience.   Pierre Robin Sequence In the profession of dentistry, we are called on to help treat and manage problems surrounding the oral cavity, maxillofacial region and associated anatomy. Some patients may be more complex than others, presenting with a variety of craniofacial differences. It is important to understand these craniofacial differences in order to [...]

When someone asks me the question “What is the path to becoming a dentist?” I am always at a loss of words of how exactly to respond. The path to dentistry is so multifaceted and contains several different routes, but I am always eager to share the path that I took. Growing up with a mom as a general dentist, I was exposed to the field from an early age. After shadowing a few offices in high school, I decided to apply for accelerated programs when applying to college. The goal of accelerated programs is to shorten the amount of time spent in undergraduate. I applied to and was accepted to the University of Pennsylvania 7-year bio-dental program which included 3 years of college and an admission into the 4-year DMD program at Penn Dental Medicine. In my application, I emphasized my ability to use my hands, my dedication to health care, and my drive to serve others. The 7-year bio dental program required that I maintain a cumulative 3.5 GPA and obtain a 19 on the DAT (Dental Admission Test). Because I didn’t feel the pressure to overextend myself in extracurricular activities, I chose to participate in clubs that I was especially interested in. For example, I was active in the Vietnamese Students Association and was a tutor for students in West Philly high schools. When the time came to prepare for the DAT, I spoke to peers who had taken the exam and DAT Bootcamp, an exam prep software was highly recommended. The program outlined a 10-week study schedule which I followed to prepare for the exam. The DAT consists of 4 sections: Survey of the Natural Sciences, Perceptual Ability Test, Reading Comprehension, and Quantitative Reasoning Test. One of the most daunting aspects of pursuing a career in dentistry is the high cost of dental school, average around $37,000/year for public schools and $67,000/year for private schools. [...]

Hello Everyone! I have written a short step-by-step guide to becoming a craniofacial and special care orthodontist. Hope this helps if you are interested! Step 1: Go to college for 3-4 years While in college, you will have the freedom to study any major, as long as certain science courses are completed, and good grades are achieved. Most schools have similar requirements for their science courses, but it is important to check each schools’ criteria. Additionally, each school has a minimum requirement for shadowing hours to apply. Step 2: Take the DAT (Dental Admissions Test) The DAT is a 4.5-hour test that all students applying to dental school must take. It contains 6 different sections: biology, general chemistry, organic chemistry, reading comprehension, quantitative reasoning, and the Perceptual Ability Test (PAT). Step 3: Complete the dental school application and interview Typically started in June between junior and senior year of college if you intend to go straight from college. The important thing to remember is although they have deadlines, it is ideal to complete all the applications, including the secondary questions, by the end of July, early August. By completing the applications early, you will help give yourself the best chance of receiving interviews. In order to help you submit applications early, work on finalizing your personal statement and determine your letter of recommendation writers before June, when the application opens. Step 4: Attend a dental school for 4 years In your time in dental school, it is important to still maintain good grades and to enrich your learning as much as you can. Take advantage of several opportunities your school may provide, join clubs that you are interested in, participate in community service, do research, attend hospital and pediatric rotations, shadow orthodontists and programs you are interested in if you can. Participate in things you are interested in and will separate you as a future applicant. Step 5: Take [...]

Hello Everyone! My name is Ashten Nguyen and I will also be a blogger for Philly Phaces along with Michael and Rachel. I am currently a second-year student at Penn Dental Medicine. I am currently on military scholarship through the US Navy and am looking to pursue general dentistry in my future. Following dental school, I will be serving as a dentist on a Naval Base, treating service members who currently live on the base. I hope to pursue an AEGD (Advanced Education in General Dentistry) through the Navy as well. One of the things that drew me towards general dentistry was the flexibility within this field and the potential to collaborate with other specialists in order to provide the best care to patients. I believe working with Philly Phaces has exposed me to various craniofacial differences that could possibly present as cases to collaborate with specialists in order to treat. Learning about craniofacial differences through Philly Phaces has fueled my passion for pursuing a career in which I can change someone’s smile in order to boost their self-confidence.   Before dental school, I went to the University of Pennsylvania for my undergraduate degree and majored in biology. The semester before I began dental school, I traveled abroad in London and visited many other cities and countries. That following summer, I lived in Cusco, Peru for a month shadowing and assisting a dentist in a local clinic and travelling throughout Peru on the weekends. These experiences made me realize my passion for traveling and inspired me to integrate dental mission trips in my future career.   I look forward to blogging about my dental experience at Penn Dental Medicine and sharing my journey with those interested in craniofacial differences!   Ashten

Hello everyone,   I hope everyone is staying safe during these difficult times! Recently, I had the privilege of shadowing residents at an Oral and Maxillofacial Surgery Program - it was one of the best experiences I have ever had. Meeting the residents and seeing how much they do for their patients was truly a humbling experience. I just wanted to make a post about what a typical day in the life was for a resident and some of the awesome procedures I saw along the way.   5:30 AM - Wake up and get ready - had to make sure I brought comfortable shoes as I would be on my feet all day. Caffeinated myself as well. 6:45 AM - Arrive at hospital 7 AM - Morning Rounds - Morning rounds are when all residents gather in a conference room to discuss the previous night and the day's operating room cases. At morning rounds, the residents who were on-call (meaning that they stayed at the hospital overnight to treat emergencies) would report on what came into the hospital last night. Usually, it was people with large cuts on their face from accidents (typically a motor vehicle accident). The residents who were on-call would also check on people who had surgery the previous day to make sure that they had no issues - this was usually done at 6 AM prior to the morning rounds meeting. The game-plan for the day was then discussed, and the residents would be assigned to their designated operations. At around 7:30, morning rounds would wrap up. 7:45/8 - 8:30 - Breakfast - Luckily, the hospital that I was at had a great cafeteria where the residents would eat their meals. I would, once again, caffeinate myself even more. 8:30 - 1:30/2PM - Surgery, Surgery, Surgery - All residents would go to their designated location. Some of the residents would go to the operating [...]