Orofacial cleft patient referral to a university orthodontic clinic over a 20-year period in Ghana

Merley Afua Newman-Nartey, Gwendolyn N Amarquaye, Kwabena Gyaami Amoah, Alexander Oti Acheampong, Nii Otu Nartey

Journal of Cleft Lip Palate and Craniofacial Anomalies 2019 6(1):43-50

Context: After the first orofacial cleft (OFC) patient was referred to the orthodontic clinic of the University of Ghana School of Medicine and dentistry in 1998, a multidisciplinary clinic at the Korle-Bu teaching hospital (KBTH) was inaugurated and partnered by non-governmental organization, Transforming Faces from 2003 to 2014 and Smile Train from 2014 to date. Aims: The aim of this study was to review and document presentations, management, and associated care influences of OFC patients referred for orthodontic care to influence quality improvement policy. Settings: This study was conducted at the Orthodontic Clinic of the University of Ghana School of Medicine and Dentistry. Design: This was a retrospective design, in which data from patient records were obtained and analyzed. Subjects and Methods: Review of records of all OFC patients who assessed the orthodontic clinic from 1998 to 2018. Statistical Analysis Used: The statistical analysis was done using Microsoft Excel. Results: Thirty-four patients were referred to the orthodontic clinic from 1998 to 2018. The majority (67.65%) was referred from the KBTH multidisciplinary clinic and smaller number (32.35%) from other hospitals and clinics. Their ages ranged from 2 weeks old to 20 years old. The majority of the referred patients were in the 5–9-year-old age group (35.29%). Of the 26 patients who underwent treatment, the majority 38.46% were treated using the less expensive fixed upper-only appliance option and obturators were not routinely used (15.38%). The majority of patients were self-funded (47.8%) and (34.8%) were pro bono cases of which over 50% of discontinued treatment. Conclusions: The multidisciplinary OFC clinic was beneficial as the major source of orthodontic referrals. More stringent criteria for the selection of pro bono cases could decrease loss from care and inclusion of complete OFC care in the National Health Insurance Scheme may remove financial barriers.

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