Portland Cleft Orthodontics: How a Craniofacial Team Helps Kids Thrive

When your child is born with a cleft lip, cleft palate, or other craniofacial condition, the journey ahead can feel overwhelming. As parents, you want the best possible care for your child, and you deserve to understand exactly how a specialized craniofacial team can help your little one not just survive, but truly thrive.

At Garfinkle Orthodontics, we understand that cleft orthodontics isn’t just about straightening teeth. It’s about giving children the tools they need for proper speech, eating, breathing, and most importantly, the confidence that comes with a healthy, beautiful smile. Dr. Judah Garfinkle’s role as Director of Craniofacial Orthodontics at OHSU means your child receives the most advanced, comprehensive care available in the Pacific Northwest.

Understanding Cleft Conditions: More Than Just Appearance

Cleft lip and palate are among the most common birth differences, affecting about 1 in 700 babies born in the United States. But what many families don’t realize is that these conditions impact much more than appearance. They can affect:

• Speech development and clarity
• Eating and nutrition in early years
• Breathing patterns and sleep quality
• Dental development and tooth positioning
• Hearing due to related ear issues
• Self-esteem and social interactions

This is why successful cleft care requires a team approach, not just a single specialist working in isolation.

The Power of a Craniofacial Team Approach

What Makes Team Care Different?

Traditional healthcare often involves visiting different specialists separately, with little communication between providers. Craniofacial team care flips this model. Instead of fragmented visits, your child sees multiple specialists who work together, communicate regularly, and coordinate treatment plans.

A comprehensive craniofacial team typically includes:

• Craniofacial orthodontist (like Dr. Garfinkle)
• Plastic surgeon specializing in cleft repair
• Speech-language pathologist
• Audiologist for hearing assessment
• Social worker for family support
• Geneticist when needed
• Dental specialists for ongoing care

Why This Matters for Your Child

When specialists work as a coordinated team, several important things happen:

• Better Outcomes: Research consistently shows that children treated by craniofacial teams have better speech, dental, and aesthetic outcomes compared to those receiving fragmented care.
• Fewer Appointments: Instead of scheduling separate visits with each specialist, team clinics allow you to see multiple providers in a single day.
• Coordinated Treatment: Timing is crucial in cleft care. The orthodontist needs to coordinate with the surgeon, who needs to work with the speech therapist. Team care ensures everyone is on the same page.
• Family Support: Having a dedicated team means you always have knowledgeable professionals to turn to with questions or concerns.

Dr. Garfinkle’s Specialized Expertise

As Director of Craniofacial Orthodontics at OHSU, Dr. Garfinkle brings a unique combination of academic excellence and compassionate patient care to Portland families. His specialized training means he understands not just how to move teeth, but how orthodontic treatment integrates with surgical procedures, speech therapy, and long-term facial development.

This expertise is particularly important because cleft orthodontics often involves:

Complex Tooth Movement

Children with cleft conditions may have missing teeth, extra teeth, or teeth in unusual positions. Moving these teeth requires specialized knowledge of how cleft anatomy affects treatment.

Surgical Coordination

Orthodontic treatment often needs to be coordinated with surgical procedures. Dr. Garfinkle works closely with plastic surgeons to ensure optimal timing and results.

Growth Considerations

Facial growth patterns can be different in children with cleft conditions. Understanding these differences is crucial for successful long-term outcomes.

This video features Dahlia, who was born with a cleft lip and palate and needed multiple surgeries and rounds of orthodontics. It shows how the Invisalign ARK program helps doctors provide clear aligner treatment to teens and kids with different health conditions who may have limited options to achieve a straighter smile.

The Journey: What Families Can Expect

Early Years (Birth to Age 7)

• Initial team evaluation within the first few months
• Surgical repairs typically in the first year or two
• Speech therapy support as language develops
• Monitoring dental development and oral health
• Regular team follow-ups to track progress

School Age (Ages 7-12)

• First orthodontic evaluation around age 7
• Possible early orthodontic treatment to create space or improve jaw alignment
• Continued speech therapy if needed
• Bone graft surgery preparation if required
• Social support as children become more aware of differences

Teen Years (Ages 12-18)

• Comprehensive orthodontic treatment with braces or Invisalign
• Final surgical procedures if needed
• Completion of team care transition to adult providers
• Confidence building as treatment concludes

Real Families, Real Results

The families we serve are the heart of everything we do. Here’s what some of our cleft families have shared:

Kari Reed: “We love Garfinkle Orthodontics! Dr Garfinkle has been working on my daughter’s teeth for 10 years due to her being born with cleft lip and palate and we have received nothing but the best care and incredible results! The entire team is welcoming, friendly and very accommodating!”

Kelly Zahniser: “Dr. Garfinkle and his team are amazing! All three of my sons have gone to this clinic for many years, one of them since he was born. Dr. Garfinkle is part of my son’s cleft palate team. This team has taken his mouth through all stages of the cleft journey. They are so precise, kind and knowledgeable.”

Alexis LaBelle: “My son was born with a cleft lip and palate and Garfinkle has been with him every step of the way. I wouldn’t have wanted to work with anyone else he’s been the best person to work with and my son loves him.”

Melinda Dumas: “Judah Garfinkle has been in my son’s life since he was two weeks old (he was born with a cleft lip/palate and now at 8 years old has braces). Judah has been working to make my son’s smile better ever since. He is kind, caring and very knowledgeable.”

Smile Oregon provides additional support, resources, and community connections for families affected by cleft and craniofacial conditions. They offer:

• Family support groups
• Educational resources
• Community events and activities
• Advocacy for improved care and insurance coverage

The Difference Specialized Care Makes

Families often ask us: “Why does it matter where we get treatment? Isn’t orthodontics just orthodontics?” The answer is absolutely not, especially when it comes to cleft and craniofacial conditions.

Specialized Training Matters

Not all orthodontists have training in craniofacial conditions. The anatomy, growth patterns, and treatment considerations are different, and specialized knowledge leads to better outcomes.

Team Coordination Is Crucial

Treatment decisions made by your orthodontist need to coordinate with surgical plans, speech therapy goals, and overall facial development. This requires experience working within a craniofacial team.

Understanding the Whole Child

Children with cleft conditions may face unique social and emotional challenges. Providers with specialized experience understand these aspects and can provide appropriate support and referrals.

Why Families Choose Garfinkle Orthodontics

While Dr. Garfinkle provides specialized cleft and craniofacial care at OHSU, our Portland practice extends this same level of expertise and compassionate care to all our patients. We understand that every child deserves:

• Expert clinical care based on the latest research and techniques
• Compassionate support that treats the whole child, not just the condition
• Coordinated treatment that works seamlessly with other specialists
• Family-centered approach that keeps parents informed and involved

Our comprehensive orthodontic services include specialized treatment for complex cases, whether related to cleft conditions or other challenging orthodontic needs.

Looking Forward: A Lifetime of Healthy Smiles

The goal of cleft orthodontics isn’t just to fix a problem, it’s to give children the foundation for a lifetime of healthy function and confident smiles. With proper team care, children with cleft conditions can expect:

• Normal or near-normal speech patterns
• Healthy dental function for eating and oral health
• Beautiful smiles that boost confidence
• Strong self-esteem to face any challenge

Every child deserves the chance to thrive, regardless of how they were born. With specialized craniofacial orthodontic care, that’s exactly what we help them achieve.

Connect With Specialized Care

If your child has been diagnosed with a cleft lip, cleft palate, or other craniofacial condition, you don’t have to navigate this journey alone. Our specialized team is here to provide expert care and support your family needs.