Year : 2019 | Volume
: 6 | Issue : 1 | Page : 1--2
Evolution of cleft orthodontics in India
Honorary Professor of Orthodontics, HS Judge Institute of Dental Sciences, Punjab University, Chandigarh, India
Dr. Ashok Utreja
Honorary Professor of Orthodontics, HS Judge Institute of Dental Sciences, Punjab University, Chandigarh
|How to cite this article:|
Utreja A. Evolution of cleft orthodontics in India.J Cleft Lip Palate Craniofac Anomal 2019;6:1-2
|How to cite this URL:|
Utreja A. Evolution of cleft orthodontics in India. J Cleft Lip Palate Craniofac Anomal [serial online] 2019 [cited 2019 May 26 ];6:1-2
Available from: http://www.jclpca.org/text.asp?2019/6/1/1/251474
With the founding of the Indian Society of Cleft Lip, Palate and Craniofacial Anomalies (ISCLP and CA), in March 2001, comprehensive cleft care in India got the much-needed fillip. Although there were barely four orthodontists, who enthusiastically joined as founder members of the society, the number has grown to a significant count. Out of the total membership strength of 444, Orthodontists are the third largest group consisting of 113 (25%) as per the current membership status of ISCLP and CA. I have personally seen this growth and feel proud of the steady increase in the commitment of orthodontists for cleft care.
It would not be out of place to trace the progress of cleft orthodontics in India. The undisputed credit of comprehensive cleft care goes back to the time when the Father of Plastic Surgery in India, Prof. C Balakrishnan started the very first course in Plastic Surgery at Nagpur in early 60s. At that time orthodontists were a rare commodity and were limited to cosmopolitan cities only. However, his conviction was so great that he encouraged a general dentist to extend the required dental care to the patients with cleft. As he moved to Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh from Nagpur, he ensured the formation of a Cleft Team in late 60s, by including a Speech Therapist and a Prosthodontist. In 1974, an Orthodontist became available at the PGIMER and Prof. Balakrishnan not only persuaded him to join the Cleft Palate team but also encouraged him to play a leading role in cleft care as an orthodontist. That was my induction in cleft care, and rest is history. During the same period, the Plastic Surgery Department was established at King George's Medical College, Lucknow, Uttar Pradesh, India, for plastic surgery training and it included a full-time faculty post for an orthodontic specialist. It is a matter of great satisfaction that till today a full-time orthodontic faculty is part of the plastic surgery team, extending comprehensive orthodontic care for all age groups.
It has been my pleasant experience to have observed Indian orthodontists rising to the occasion and getting involved in cleft care. Over the years, since my founding role in ISCLP and CA, I have seen a steady increase in interest by orthodontic colleagues, so much to the extent that an increasing number of orthodontists are attending the ISCLP and CA conferences every year. Furthermore, a number of articles, related to cleft orthodontics are being published in Indian and International Journals by orthodontic colleagues. These articles cover a range of topics; PNAM, Face-mask, pre alveolar bone graft (ABG)arch preparation, Pre and postsurgical orthodontics, Comprehensive Orthodontics and coordination for rigid external distraction devices and alveolar distraction, highlighting the positive role of orthodontics in cleft rehabilitation. There is also an increase in the scientific presentations related to cleft orthodontics at the annual conferences of Indian orthodontic society (IOS). The bug of cleft care seems to have bitten the orthodontic profession, and there is an increasing demand for training courses related to cleft orthodontics. It is worth mentioning that the IOS very recently organized an extensive program titled “National Training Program in Cleft and Craniofacial Orthodontics” with three modules at Bhubaneswar. In this connection, I am trying to convince the IOS to conduct a Half-day session dedicated to Cleft Orthodontics during its annual meetings, may be every alternate year. It is my belief that the PGs during MDS training should be exposed to cleft orthodontics so that they are well prepared to face the challenge of taking up such cases in their course of orthodontic practice. It is a well-known fact that some of the private practitioners have done exceptionally well in cleft orthodontics and are being invited at various events to share their experience. Most of such achievers have had an exposure to institutional cleft orthodontics during the formative years of their learning, and their passion for cleft care has been praiseworthy.
IOS with its current life-member count of 3900 needs to contribute more towards cleft orthodontics. There are some roadblocks to this which need to be addressed. More institutes should come forward to adopt the responsibility of extending clinical training to willing practitioners. Since cleft orthodontics is not routinely covered in most of the PG programs, the departments must make efforts to treat cases needing orthodontic care.
Personally, I am not too happy with the current scene of available orthodontic care to patients with cleft, and there is a lot more to be done by all stakeholders; institutes, surgeons, teachers, NGOs, and orthodontists. Since a significant majority of patients, with repaired clefts, require orthodontic care, the gap between supply and demand is too large and needs to be filled.
It may not be out of context to recollect the pivotal role played by few Indian Orthodontists in carrying forward the concept of team care through their passion for cleft care, as endorsed by the members of ISCLP and CA, by electing them to the office of Presidents of the Society, Prof. Ashok Utreja, Prof. O. P. Kharbanda, Prof. Satinder Pal Singh and more recently, Prof. Puneet Batra.