Manitoba Centre for Craniofacial Difference

About the Manitoba Centre for Craniofacial Difference (MCCD)

The Manitoba Centre for Craniofacial Difference was established in 2003 by plastic surgeon, Dr. Lonny Ross to serve children born with facial issues such as cleft palate, Synostosis, Pierre Robin sequence and Treacher-Collins Syndrome. He now partners with Dr. J McGregor. Both are Craniofacial fellowship trained Pediatric Plastic surgeons.

The centre provides comprehensive, cradle-to-adulthood care from a range of health-care providers. In addition to Ross and McGregor, MCCD team members include an orthodontist, oral maxilla-facial surgeon, pediatric dentist, dietician, lactation consultants, occupational therapist, physiotherapists, pediatric anesthetists, geneticist, opthamologist, child development specialists, audiologist, speech and language pathologist, prosthodontist, psychosocial professionals, as well as many support health professionals. 

Heading up one of only five centres of its kind in Canada, Ross and McGregor have been working to enhance the MCCD's expertise. The team is accredited by the American Cleft Palate - Craniofacial Association. This accreditation is designed to ensure MCCD continues to operate at the highest professional level.

Manitoba Cleft Lip and Palate / Dysplasia Dental Benefit Program

In 1980, Manitoba Health assumed the responsibility for the dental treatment of Manitoba residents born with a cleft lip and/or palate. This came about at a time when Manitoba, as well as other western provinces, were increasing spending and expanding dental programs for children. However, although public funding for children’s dental programs has been greatly scaled-back since the mid-1980’s, the province has always recognized that children born with congenital conditions affecting the dentition should be afforded more rather than less. In 1995, at the government’s request, the program was extended to include children with significant oral facial dysplasia and other anomalies that affect the dentition. As the primary insurer, the program covers 100% of the cost of almost all dental treatment (certain prosthodontic procedures may have limited funding). A commitment was made to be the payer of first resort because dental care for children with oral clefts can quickly exhaust family benefits under private insurance plans, which can lead to less funding available to other family members and/or children with cleft palate not obtaining required treatment. Therefore, being the payer of first resort ensures that patients are getting all the treatment that is required and also serves as a source of information for tracking completed dental services. This is because all dental claims must go through the Children’s Hospital clinic claims manager prior to being forwarded to Manitoba Health. In 2007, coverage was broadened to include dental implants and prolong eligibility past the age of 18, or until the treatment plan is deemed completed by the Cleft Lip and palate/Craniofacial (CLP/C)Team. Due to the financial investment that is made on the care for patients with oral clefts, it is a requirement under the program that patients undergo annual dental check-up examinations and maintain an acceptable level of oral hygiene in order to retain enrolment.

Eligibility: To be eligible for benefits, a patient must be a Manitoba resident, under the age of 18, registered with the cleft palate team and have a valid MHSC number. Manitoba residents over the age of 18 years may be considered for benefits on review by the CLP/C Team. Furthermore, the team makes it a requirement that patients undergo annual dental check-up examinations and maintain an acceptable level of oral hygiene in order to retain enrolment under the plan.

Services: As a payer of first resort the plan covers 100% of the cost of all dental treatment. This includes annual dental examinations, preventive, restorative, endodontic, periodontic, orthodontic and prosthodontic treatment.

Service Provision: Under the plan any dentist may provide treatment, however orthodontic, periodontic and prosthodontic treatment must be provided by a dental specialist. Preapproval is required for treatment over $500.00. Dental implants require further preapproval through the Manitoba Health Implant Committee.

Children’s Hospital of Winnipeg Cleft Lip and Palate/Craniofacial Clinic

After receiving referrals from the Fetal Assessment Unit or Geneticist, the Nurse Clinician will meet with families prenatally to answer questions and offer program information and support. All newborns will attend an appointment with the Nurse Clinician within the first month following birth in order to address feeding concerns and to be assessed for pre-surgical treatment. Initial consultation with the Plastic Surgeon and paediatric dentist will occur by 2 months of age and lip repair surgery is planned for 3-4 months of age. The Otolaryngologist coordinates any required surgical intervention with lip & palate repair surgery when at all possible. Speech and Genetics will see families within the first 6 months of life. Palate repairs take place at approximately 9-12 months of age. All team players are responsible for their own guidelines and protocols for follow up and ongoing care. Appointments for treatment and services are coordinated, by the Nurse Clinician, so as to minimize unnecessary travel and disruption to the families.

Patients must be registered into the program prior to their 18th birthday. Dental coverage for patients past 18 years of age is client specific as determined by the CLP/C team. Often times due to skeletal growth, the treatment cannot be concluded prior to 18 years of age and patients remain eligible for dental benefits until their treatment plan is deemed complete.

Once the treatment plan has been completed the patient receives a “cut-off” of dental benefits letter. Patients can still be followed in adulthood. The team plastic surgeon has an adult clinic on site and the oral surgeon and prosthodontist have associated adult practices. In some situations adult patients require further treatment for recurring cleft related issues. Under such circumstances dental benefits may be temporarily reinstated at the discretion of the dental director through an application to a committee.

Medical Travel Assistance

Manitoba Health’s Northern Patient Transportation Program (NPTP) provides financial travel assistance for Manitoba residents in the North that require medical treatment , diagnostic services, qualifying therapeutic services, or medical consultation services that are not available in their home community.

Eligibility under the program is limited to Manitoba residents residing north of the 53 parallel from the Saskatchewan boundary to Lake Winnipeg, and North of the 51 parallel from the Ontario boundary to Lake Winnipeg.

The program subsidizes the cost of transportation for the patient. Under circumstances where a companion or a parent is required to escort the patient, the Program includes provisions that subsidize the companions cost of travel, one night stay in a hotel and meals.

Information regarding the Program can be obtained from the NPTP office in Thompson.

Thompson NPTP office

c/o Thompson General Hospital

871 Thompson Drive South

Thompson, MB

R8N 0C8

1 800 290-1098