Craniofacial Orthodontics

Craniofacial orthodontics is a sub-specialty of orthodontics that focuses on the treatment of patients with birth defects such as cleft lip and palate. Rather than addressing tooth alignment alone, craniofacial orthodontics manages the complex dental and skeletal relationships that arise when a patient's facial structures have developed differently from birth. At Chang Orthodontics in Los Alamitos, Dr. Russell Chang and Dr. Christine Chung bring advanced academic training in craniofacial biology directly to this work — Dr. Chang earned a Master of Science in Cranial Facial Biology at Northwestern University, and Dr. Chung earned a Master of Science in Craniofacial Biology at the University of California School of Dentistry.

What Conditions Fall Under Craniofacial Orthodontics

The most common condition treated in craniofacial orthodontics is cleft lip and palate, a birth difference in which the lip, the roof of the mouth, or both do not fully close during fetal development. Other craniofacial conditions may include jaw asymmetries, missing or malformed teeth associated with syndromes, and skeletal discrepancies affecting how the upper and lower jaws relate to each other.

These conditions are not simply cosmetic concerns. Patients with cleft palate, for example, often face challenges with feeding in infancy, speech development, hearing, and the alignment of permanent teeth as they erupt into a mouth where the underlying bone and soft tissue anatomy differ significantly from typical development.

How Craniofacial Treatment Works as a Team Effort

One of the defining features of craniofacial orthodontics is that no single specialist handles treatment alone. The orthodontist works as part of a coordinated team that typically includes oral and maxillofacial surgeons, plastic surgeons, speech-language therapists, and sometimes ear, nose, and throat specialists or pediatric dentists.

The orthodontist's role within this team is to manage tooth eruption, arch development, and jaw position — preparing a patient for surgery at the right moment, and then guiding teeth and bone into their final positions after surgical correction. Timing is central to this process. Orthodontic work is often staged across childhood and adolescence, coordinated carefully around growth milestones and surgical procedures.

What to Expect During Treatment

Craniofacial orthodontic treatment tends to unfold over several years rather than months. Early interventions may begin in infancy in some cases — for example, pre-surgical nasoalveolar molding (NAM) for cleft lip and palate patients — though the orthodontic phase involving braces or other appliances typically begins as the permanent teeth come in during the mixed dentition stage.

A typical appointment during the active orthodontic phase looks similar to a conventional orthodontic visit: the provider checks appliances, adjusts wires or devices, and monitors how teeth and bone are tracking against the treatment plan. What differs is the frequency and depth of coordination with the surgical team, and the need to plan around procedures that may temporarily change the position of bone or soft tissue.

Patients in Los Alamitos and the surrounding area who are navigating craniofacial treatment benefit from working with an orthodontist who understands both the clinical detail of these conditions and how to communicate across a multidisciplinary team.

Why Advanced Training Matters Here

Standard orthodontic training prepares a clinician to straighten teeth and correct bites in patients whose underlying anatomy is typical. Craniofacial conditions require a deeper understanding of facial growth, bone biology, and how surgical changes to hard and soft tissue interact with orthodontic mechanics. A graduate-level background in craniofacial biology — the kind Dr. Chang and Dr. Chung hold — provides the foundational science that supports clinical decision-making in this more complex population.

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Frequently Asked Questions

**At what age does craniofacial orthodontic treatment start?** It depends on the condition. For cleft lip and palate, some interventions begin in the first weeks of life. Active orthodontic treatment with braces or expanders typically begins around age 7–10, when permanent teeth start emerging.

**Will my child need surgery as part of treatment?** Many craniofacial conditions do require surgical correction — orthodontics alone cannot reposition bone. Your orthodontist and surgeon will plan the timing of each together.

**How long does craniofacial orthodontic treatment last?** Treatment commonly spans several years, with different phases corresponding to growth stages and any planned surgical procedures.

**Does craniofacial orthodontics only treat cleft lip and palate?** No. While cleft lip and palate is the most common diagnosis, other craniofacial syndromes affecting jaw and tooth development may also require this level of specialized care.

**How is a craniofacial orthodontist different from a general orthodontist?** A craniofacial orthodontist has training beyond standard orthodontic residency in the biology and treatment of facial birth differences, and typically works as part of a surgical team rather than independently.