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Cleft Palate & Craniofacial Disorders

We help children and teens born with cleft palates and other disorders of the face and head.
Our program

We help patients reach their maximum potential. Disorders of the face and head can cause issues with a person’s appearance, speech, hearing, facial function and self-esteem. That’s why we have a team of specialists that work together to make sure patients reach their maximum potential. 

We care for patients from B.C. and the Yukon, providing onogoing specialist assessments, treatment plans, case management and coordination, treatment intervention, and second opinions about managing speech and orthodontic issues. During our weekly clinics, we examine our patients, develop their treatment plans, and set up services for them in their community. 

Please note: a referral from a medical professional is required to request treatment for a patient or consultation.

Our team

Program coordination

Our nurse clinician/coordinator may be the first person you meet on the team. She will provide support and information and will answer your questions about: clefting and craniofacial conditions, feeding your cleft-affected baby, what to expect and watch for, and other areas of concern or questions. She will coordinate your child's team care and guide you through the process.

Nurse clinician/coordinator

Sandra Robertson, RN, BSN
T: 604 875 2345 ext 7057

Program secretaries

Our program secretaries are the first line of communication in our program. They will take your call and answer your questions, or connect you with someone else on the team when needed. They coordinate and book all Cleft Palate/Craniofacial team appointments.

Reymie Krefting (T: 604 875 3146)
Karine Nishimura  (T: 604 875 3146)

Social work

Our social worker assists our patients and their families with the social and emotional impacts of their medical conditions. Social work services may include individual family and group counselling; parent groups; financial/practical assistance, as well as liaison with community resources.

Kathryn Urquhart (T: 604 875 2345, ext 6551)

Pediatrics

Our pediatricians and nurse practitioners specialize in caring for infants, children and teens with cleft and disorders of the face and head. They are involved in treatment from the time a patient is born until the time they are teens.

 

‎Dr. Christine Loock, MD, FRCPC, is a developmental pediatrician at BC Children's Hospital and Sunny Hill Health Centre for Children. She is currently the medical director of the provincial Cleft Palate/Craniofacial Program at BC Children's Hospital and an associate professor in the Department of Pediatrics, Faculty of Medicine at UBC.

 

A graduate of Harvard Medical School, Dr. Loock did her US and Canadian pediatric residency training in Seattle and Vancouver, respectively. For over three decades, her clinical and research work has improved the recognition, treatment and prevention of Fetal Alcohol Spectrum Disorders (FASD).

 

Dr. Loock's current clinical and research work focuses on socially marginalized children and youth, with special focus on those with neurodevelopmental disorders, sleep disorders, birth defects, FASD and other craniofacial conditions including cleft palate and multiple congenital anomalies. In 2010, Dr. Loock and her coworkers developed the first Canadian social pediatrics network with clinical and academic partners across Canada to foster research, training and child and youth health care advocacy.

 

Dr. Loock has been recognized locally, provincially and nationally for her clinical service and academic work in education and research, and for volunteer service and advocacy work in the broader community. In 2012, Dr. Loock was awarded the Queen Elizabeth II Diamond Jubilee Medal for community service by the Governor General of Canada. In 2018, she received the YWCA Women of Distinction Award (health and wellness category) as well as the Janusz Korczak Medal for Child Rights Advocacy. In 2019, Dr. Loock and her team received UBC's John F. McCreary prize for their work on interdisciplinary and intersectoral programs in social pediatrics. 

 
Dr. Collin Yong is a staff pediatrician at BC Children’s Hospital and a faculty member with the Department of Medicine at the University of British Columbia.

Dr. Yong has extensive and varied experience in general and acute pediatrics as well as sub-specialty training in biochemical and kidney diseases. His clinical skills range from newborns to young children.
 
Over the years, Dr. Yong has also provided medical assistance in underserved areas throughout the world. He has worked extensively in Ethiopia, South America, Indian sub-continent, Southeast Asia and China. Dr. Yong also participated as a lead pediatrician for cleft lip and palate surgeries in Africa, South America and southeast Asia. His extensive experience has prepared him to work in the cleft palate team at BC Children's Hospital.
 
With his accumulated international experience, Dr. Yong has affirmed a single theme in the care of children: it starts with the family. He is a firm believer in involving the family in medical decisions for the children. The care of children is not just about a medical condition; it also entails the cultural and social values of the family.


 
Dr. Emily Fisher,  MD, MSc, FRCPC, grew up in Vancouver. She completed her pediatrics residency at the Hospital for Sick Children in Toronto after completing her medical degree at Tel Aviv University School of Medicine in Israel. Prior to entering medicine, Emily completed her Master of Science in medical genetics at the University of British Columbia. 

Emily’s interest in cleft and craniofacial care stems from her genetics background combined with her interest in social justice. During her bachelor’s training at Queen’s University, Emily joined her two older sisters, both physicians, on a surgical mission to rural Guatemala. During this trip, Emily was introduced to developmental differences and how they are accepted and treated differently in different cultures. 

During her master’s, Emily learned the importance of collecting data in order to advocate for services and supports. She was responsible for ascertaining the prevalence of Huntington’s disease in British Columbia and along the way was involved in Huntington’s summer camps and became acquainted with social workers at the Huntington Society of Canada. 

Emily considered a career in social work, but opted for medicine. Emily’s interest in social justice dates back to childhood. Her mother is an appellate court judge and her father worked in east Vancouver for 50 years as a frontline family doctor. Growing up, social justice was a common theme at the dinner table. 

Emily’s master’s thesis project prepared her for more advocacy-based research. During her medical studies in Israel, she connected with a mother of two adopted children later diagnosed with fetal alcohol spectrum disorders (FASD). The two of them worked together to ascertain the prevalence of FASD in a community in Israel. They understood that to fill a service gap, we must understand the population is in need. Their project served as the first ascertainment study of its kind in Israel and helped families advocate for awareness, education and services. 

During her time with the cleft and craniofacial team as a fellow, Emily was involved in a social determinants of health survey study. She also co-authored a chapter in the new cleft and craniofacial text book on the social determinants and barriers to access of cleft care. Emily looks forward to continuing on as a developmental pediatrician on the cleft and craniofacial team. She is most passionate about the human aspects of care and she brings with her strong experience with advocacy and social justice. 




Nurse practitioners

Treatment plans for clefting and craniofacial conditions can be complex. Our nurses are an important part of your team throughout your child’s treatment from birth to “graduation” from our program. They coordinate your child’s care and ease communication among the care team members and with your family. They have a thorough understanding of your child’s condition and can answer questions and offer advice. They teach you about your child’s clefting/craniofacial condition and treatment. Nurses help you prepare for follow-up care at home. You may meet the cleft/craniofacial nurse before your child is even born (if your baby’s cleft or craniofacial condition was picked up on ultrasound before birth). For any questions or concerns about your child or their treatment, call the nurses first. For questions about appointments, call the Program Secretaries first. 

 

Aurélie "Leigh" Houta, MN-NP (F), is a family nurse practitioner with ten years of nursing experience in community, acute and intensive care. She has a strong background in cardiology and cardiac surgery and has spent most of her career in the adult world at Vancouver General Hospital.

 

Observing a lack of primary care services available to her patients has inspired her to broaden her scope and skill set and become a nurse practitioner. After completing the family nurse practitioner master's program at the University of British Columbia, she joined the BC Children's Hospital cardiac surgery team and found a passion for pediatrics.

 

Leigh joined the Cleft Palate and Craniofacial Program team in early 2022 and is enjoying her new role and her new client population. Leigh is passionate about providing excellent care to the pediatric population. She believes strongly in family-centered care and involving the entire family and their cultural and social values in the care, treatment and medical decisions for each child. 


 
Misty Reis has 20+ years of nursing experience and 15 years as a nurse practitioner. Early in her career, Misty focused on neonatal and pediatric critical care, obtaining a neonatal subspecialty certificate.

Following completion of her master’s in nursing, Misty developed the nurse practitioner role and worked in the neonatal neurodevelopmental follow-up clinic in Edmonton, Alberta.

Children with cleft lip and palate are close to Misty’s heart as she has both professional and personal experience related to the program; her niece had a cleft lip and palate.

In her spare time, Misty enjoys being active outside and is an avid sports participant. Her favourite sport is soccer but she plays pretty much everything. She loves golfing and getting out on her paddle board on beautiful Vancouver summer days.


Audiology

Our audiologists assess and treat hearing issues from the time our patients are infants until early childhood.

 

‎Kristina Bingham, MSc, R.Aud, is an experienced pediatric audiologist with an interest in cleft and craniofacial hearing care. After graduating with a master's degree in audiology from the University of British Columbia (2007), Kristina worked at WorkSafe BC and Surrey Memorial Hospital before joining the team at BC Children's Hospital in 2015. 


Kristina is a clinical educator with the University of British Columbia's School of Audiology and Speech Sciences and also provides Diagnostic Auditory Brainstem Response testing through the BC Early Hearing Program.  


In 2018 Kristina travelled to Ho Chi Minh City, Vietnam to participate in a collaborative teaching mission with The National Hospital of Odonto-Stomatology in Vietnam, as they established a comprehensive program for pediatric cleft care. 

 

Speech pathology

Our speech pathologists are involved with treating speech and language issues from the time our patients are toddlers to the time they are pre-teens.

 
‎Lindsay Beveridge, MSc, R-SLP, graduated from the University of British Columbia in 2009 with a master’s degree in speech language pathology. 

Lindsay began her career as a community SLP on Haida Gwaii, and has since worked as a pediatric SLP for BC Children’s Hospital in the following areas: brain injury, alternative and augmentative communication, hearing loss and craniofacial/cleft palate. 

 

‎Katie Kewin, MClSc, R-SLP, graduated from the University of Western Ontario in 2007 with a master’s degree in speech language pathology. 


Katie has experience working in a variety of settings including school districts, child development centres and hospitals. As a pediatric SLP at BC Children’s Hospital, she has worked in mental health and craniofacial/cleft palate. 

 

Sheryl Palm, MCISc, S-LP,  is a registered speech pathologist who joined the cleft palate craniofacial team at BC Children’s Hospital in 2004. She is a clinical faculty member with the University of British Columbia audiology and speech sciences program where she provides regular instruction in the area of cleft palate and craniofacial speech disorders.   


Since graduating from UBC in 1995, Sheryl has worked in a variety of school, preschool and health care settings including Deaf Children’s Society, BC School for the Deaf, Oral Program at Burnaby South, and Sunny Hill Health Centre. She has always had a passion for working on a collaborative, interdisciplinary team and feels fortunate to have learned so much over the years from outstanding colleagues and, importantly, from her amazing patients and families, who are valued members of the team.  

Sheryl is an advisory member of Planet Smile for Kids Society and travelled to Ho Chi Minh City, Vietnam in 2018 and 2019 as part of a collaborative teaching mission with the National Hospital of Odonto-Stomatology as they work to become a centre for comprehensive cleft care.  

Phone: 604-875-2000 ext. 7045

Orthodontics

Our orthodontists treat problems with the position of patients' teeth and jaws. They are often involved in treating newborn patients before they have surgery, and when they reach pre-teen and teen ages.

 

‎Dr. Travis Gibson, DMD, MSc, Dipl(Ortho), is one of our team's Certified Specialists in Orthodontics. He was born and raised in North Vancouver, and attended the University of British Columbia for his Bachelor of Science (BSc), Doctor of Dental Medicine (DMD), Diploma in Orthodontics, and Master of Science (MSc) degrees. 

 
After completing his orthodontic speciality education, Dr. Gibson completed a Fellowship in Craniofacial and Special Care Orthodontics at New York University where he gained extensive experience in the orthodontic management of cleft lip and palate and other congenital facial differences. 

Dr. Gibson believes in the importance of an honest and open partnership between patient, family and doctor. He works hard to ensure each person understands their unique treatment needs and options so that they can make an informed decision on what is best for them.

In addition to being a member of the BC Children’s Hospital cleft and craniofacial team, Dr. Gibson maintains a private practice in Maple Ridge which focuses on comprehensive dental care for children and teens, offering both orthodontic and pediatric dental services. Dr. Gibson is also involved in academic research with both New York University and BC Children’s Hospital, and has published studies in the Cleft Palate-Craniofacial Journal, American Journal of Orthodontics and Dentofacial Orthopedics, Journal of Craniofacial Surgery, and Journal of Plastic and Reconstructive Surgery. 
 
In his free time, Dr. Gibson likes to spend time with his wife and their identical twin boys. They enjoy outdoor activities such as biking and camping, and playing board games.


Phone: 604-349-5430 

Email: info@mapleridgedentistry4kids.com

Website: mapleridgedentistry4kids.com/services/orthodontic-services        

 

‎Dr. Paul Helpard is originally from Welland, Ontario. He attended the University of Western Ontario where he received a Bachelor of Science degree. He then completed dental school at McGill University where he was a gold medal recipient. Following university, Dr. Helpard spent three years with the Canadian military before pursuing orthodontic specialty training at the University of Iowa.


Dr. Helpard is actively involved with the Cleft Palate and Craniofacial Team of B.C. He works at BC Children's Hospital providing consultation services and interdisciplinary treatment planning with numerous medical specialists. 

Dr. Helpard is a member of the Canadian and American Associations of Orthodontics, the British Columbia Society of Orthodontists as well as the Canadian and British Columbia Dental Associations. He is a fellow and examiner of the Royal College of Dentists of Canada and he has completed the multistage examination process to become a diplomate of the American Board of Orthodontics.

Outside of the office, Dr. Helpard likes to spend time with his wife, Christine, and their three beautiful children, Benjamin, Amelia and Sammy. He enjoys participating in many community and athletic activities.


 

Dr. Angie Loo, DMD, MSc, FRCDC, graduated from the Faculty of Dentistry at the University of British Columbia in 1985, after which she completed her general practice residency at the Hospital for Sick Children, Hugh MacMillan and Holland Bloorview Kids Rehabilitation Hospitals in Toronto, Ontario. 

 

Dr. Loo graduated with a combined certification in the specialty of orthodontics and Master of Science in Craniofacial Biology from the University of Manitoba in 1989. Following graduation, Dr. Loo returned home to establish her private practice in Vancouver and subsequently received her orthodontic fellowship in the Royal College of Dentists of Canada. 

 

Dr. Loo is an active orthodontist staff member on the BC Children's Hospital Cleft and Craniofacial Team, an Associate Clinical Professor at the UBC Faculty of Dentistry, and the course coordinator for the UBC graduate orthodontic program in cleft and craniofacial care. She lectures internationally on facial clefting and feels privileged to participate in surgical cleft missions overseas. 

 

Dr. Loo's passion for treating children with cleft and craniofacial differences inspired her to form the Spring for Kids Foundation in 2009, where she currently serves as the foundation's president. Dr. Loo's commitment to the treatment and education of children with cleft and craniofacial differences was recognized with a 2011 certificate of merit from the British Columbia Dental Association, and the American Association of Orthodontists Humanitarian Award in 2022.

 

When not in private practice, Angie enjoys her favourite hobbies including soapstone carving and nature photography,  and venturing the great outdoors sea kayaking with her family.  


Phone: 604-261-8890 

Email:  DrLoo@bracedinbc.com

Website:  bracedinbc.com       

‎

 
I have the best job in the world. I truly love getting up in the morning to come to work!

I am thrilled when I see the improvements we are able to make to someone’s appearance and function, and the enormous effect that can have on the person’s self-esteem and confidence. 

Orthodontics requires science, medicine and art, along with the ability to connect with each patient and understand what will serve them best. It is essential to develop a treatment approach that not only delivers the radiant smile, but also provides stable function so the person is able to enjoy a lifetime of oral health.

I feel very privileged to have the confidence of parents who bring their children to me and equally appreciate the trust of my adult patients. Creating something so personal that will affect the individual’s health and emotional well-being for years to come is a great responsibility.

After 35 years of practice, I take that responsibility as seriously as I did the day I saw my first patient.


 

Dr. Dorothy Sonya, DMD, MSc., Dip. Ortho. RCDC, Dip. ABO, CDSBC, has more than 35 years of experience in dental medicine, orthodontics and radiology.

 

Prior to specializing in orthodontics, Dr. Sonya was a general dentist. This experience enabled her to gain essential insight into the long-term oral health needs of the community, and that insight continues to inform her orthodontic treatment planning. She crafts each patient's treatment approach to address their aesthetic goals as well as lasting function and stability.

 

Dr. Sonya holds a Doctorate of Dental Medicine, a Master of Science and a diploma in orthodontics from the University of Manitoba, as well as a Master of Science in dental and maxillofacial radiology from King's College, London, England, and a corticate of clinical proficiency in radiology from the University of Washington in Seattle.

 

When she's not seeing patients, Dr. Sonya enjoys time with her family, friends and many community activities. 


Phone: 604-535-3028

Email: info@whiterockortho.com

Website: whiterockortho.com

Otolaryngology

Our otolaryngologists treat problems related to the ear, nose and throat. They are involved in treatment from the time patients are infants to the time they are teens/adults.

 
Dr. Neil K. Chadha, MBChB(Hons), MPHe, BSc(Hons), FRCS, completed his medical and otolaryngology training in the United Kingdom and his pediatric otolaryngology fellowship at The Hospital for Sick Children in Toronto, Ontario.
 
Dr. Chadha joined the Division of Pediatric Otolaryngology (ear, nose and throat surgery) at BC Children’s Hospital in July 2010. He has been division head since September 2018. Dr. Chadha is also director of the Pediatric Otolaryngology Fellowship Program, director of pediatric otolaryngology research and a clinical professor in the Faculty of Medicine at the University of British Columbia.
 
His practice is exclusively pediatric, with special interests in open and minimally invasive surgery of the airway, pediatric congenital neck, salivary and thyroid surgery, and endoscopic sinus surgery. 
 
Dr. Chadha has a master’s degree in public health and epidemiology and has published over 100 research articles and seven book chapters. In his spare time, he loves playing and coaching soccer, running, skiing, and more recently woodworking—and he is making sure to be extremely careful with his fingers.

Phone: 604-875-3730

 
Dr. Mark Felton, MD, MBChB, MSc, FCRS, is a consultant pediatric otolaryngologist at BC Children’s Hospital and a clinical assistant professor at the University of British Columbia. Originally from the United Kingdom, Dr. Felton studied at the University of Leeds in England, graduating with an honours degree in anatomy before completing his medical degree. 

Dr. Felton carried out his specialist ENT (ears, nose and throat) training at the University of Manchester. Following this, he undertook a subspecialist pediatric ENT fellowship at BC Children’s Hospital in 2015/2016. After this he spent over three years at the Evelina London Children’s Hospital, United Kingdom, as a consultant otolaryngologist with a subspecialist interest in children’s ear disorders. He rejoined the Division of Pediatric Otolaryngology at BC Children’s Hospital as a consultant in 2019. 
 
Dr. Felton is active in medical teaching having completed a master's degree in medical education. He regularly enjoys teaching trainees, students and allied specialists. He is also active in research and has completed a postgraduate research degree as well as numerous international presentations and peer reviewed publications. His research focuses on ear disorders and outcomes from implantable hearing aids.

Phone: 604-875-2113
Fax: 604-875-2498

 
Dr. Fred Kozak, MD, FRCSC, is the senior pediatric otolaryngologist in the division. He is a graduate of McMaster University Medical School. After completing a rotating internship in Toronto he undertook residency at the University of British Columbia. Following a fellowship in pediatric otolaryngology head and neck surgery at Seattle Children’s Hospital in 1991-1992, he joined the staff at BC Children’s Hospital.

Dr. Kozak’s surgical practice has covered the entire field of pediatric otolaryngology, however over the past 20 years he has focused on the ear as a pediatric otologist and pediatric cochlear implant surgeon.  

Over the past thirty years, Dr. Kozak has served on numerous committees at BCCH including chair of the medical advisory committee and surgical physician admitting officer. He was the division head from 1996-2018. His research area of interest covers the entire field. He has presented his work locally, nationally and internationally and has over 75 publications.

Dr. Kozak is a UBC clinical professor in the Department of Surgery and has been the UBC Otolaryngology Head and Neck Surgery Residency (OtlHNS) program director since 2012. He started the BCCH OtlHNS Fellowship Program in 2002. Dr. Kozak teaches medical students, residents and fellows. He is involved with the Doctors of B.C. and the B.C. Ministry of Health.

In his spare time, he is known to be an on again off again guitar player, a fine baritone singer and a weekend road bike rider. He is also co-founder of a custom colourful sock company: drsox.ca.

 
Dr. Jeffrey Ludemann, MDCM, FRCSC, joined the Division of Pediatric Otolaryngology at BC Children's Hospital in 1999. He is a Clinical Professor of Otolaryngology at the University of British Columbia; and is the Quality of Care Lead for the Division of Otolaryngology at BC Children's Hospital.

Dr. Ludemann is the principal founder of dontchoke.ubc.ca (evidence-based injury prevention education, in eight languages).  Dr. Ludemann was the founder and former chair of the Canadian Society of Otolaryngology Pediatric Study Group. He conceptualized the Storz Vancouver Forceps, which have been used since 2006, by Pediatric Otolaryngologists around the world, for the safe removal of small bronchial foreign bodies.

Dr. Ludemann's hobbies include Tai Chi and Kung Fu, playing guitar, hiking and skiing. He also enjoys biking, especially to fundraise money via the Vancouver Rotary Club for hearing loss research. Dr. Ludemann is married, with three amazing children.

 
Dr. Paul Moxham, MD, FRCSC, is a Pediatric Otolaryngologist. He completed medical school at the University of Alberta in 1992, followed by an internship at Charles Camsell Hospital (1993), a residency in otolaryngology (head and neck surgery) at the University of British Columbia (1998), and finally a fellowship in pediatric otolaryngology at the Royal Children’s Hospital in Melbourne, Australia (1999). 

In his downtime, Dr. Moxham enjoys running, particularly trail running for the past 10 years. He also enjoys cycling with his wife and daughter several days a week. During the winter, Dr. Moxham loves downhill skiing, trying new hills or his old favorites in B.C. and Alberta. 

Dr. Moxham was born in London, Ontario and has lived all across Canada (Toronto, Calgary, Edmonton and Vancouver) as well as in Melbourne, Australia. He has called Vancouver home for 26 of the past 27 years. 


Phone: 604-875-2113
 

 
Dr. Ronak Rahmanian, MD, FRCSC, completed her undergraduate education in microbiology and immunology at the University of British Columbia, during which time she worked at the British Columbia Center for Disease Control as well as the Protiva Biotherapeutic Company performing basic science research. 

She then earned her medical degree and completed her residency at the University of British Columbia. She pursued a fellowship in otology and neurotology at the St. Paul’s Hospital Rotary Hearing Clinic & Vancouver Hospital Neurotology Services. She completed a second fellowship in pediatric otolaryngology at Rady Children’s Hospital and worked as an assistant clinical professor at the University of California San Diego (UCSD) – Rady Children’s Hospital as a full-time pediatric otolaryngologist prior to joining the pediatric otolaryngology team at BC Children’s Hospital. 
 
Although Dr. Rahmanian enjoys all aspects of clinical pediatric otolaryngology, she has a special interest in pediatric ear surgery and cochlear implants. 
 
Dr. Rahmanian was raised in Vancouver. During her spare time she enjoys the outdoors, playing tennis, skiing, learning to surf and spending time with her friends and family.
 
Plastic surgery

Our oral and plastic surgeons perform operations to repair/improve the function and appearance of a patient's face and head. They are involved in treatment from the time patients are infants to the time they are teens/adults.

 
Dr. Jugpal S. Arneja,  MD, MBA, FAAP, FRCSC, received his Doctor of Medicine and completed his plastic surgery residency training from the University of Manitoba. He also completed a fellowship in craniofacial/pediatrics from the Medical College of Wisconsin and received his Masters of Business Administration from  the University of British Columbia's Sauder School of Business.

He is currently a clinical professor in the Department of Surgery, Division of Plastic Surgery at the University of British Columbia and an associate member of the Sauder School of Business and attending clinical staff at BC Children's Hospital. He is actively involved in teaching and conducting research at UBC, as well as serving as the editor-in-chief of the journal Plastic Surgery, the official journal of the Canadian Society of Plastic Surgeons.

In addition, he has participated with Smile Train as a plastic surgeon and educator as well collaborating in plastic surgery research overseas.
 

 
Dr. Douglas Courtemanche, MD, MS, FRCSC, is a plastic surgeon with a special interest in cleft and craniofacial surgery. 

A graduate of the University of British Columbia's medical school (1983) he interned at Memorial University in Newfoundland and Labrador, and returned to British Columbia for his residency in plastic surgery. He also completed a craniofacial fellowship at the Royal Children’s Hospital in Melbourne as well as a Master of Surgery at the University of Melbourne. 

Having started in practice in Vancouver in 1991, he brings a little over 30 years of clinical and academic experience to the care of his patients and the support of his excellent colleagues as one of the surgeon leaders on the team. 

Dr. Courtemanche is a clinical professor of surgery at UBC. He has also worked to support system improvements to enable the cleft team to meet its mandate to provide care at the standards set by the ACPA. In addition, he manages a diverse pediatric and adult practice focused on craniofacial conditions (including trauma) and vascular anomalies where he is the director of the Vascular Anomalies Clinic at BC Children’s Hospital.

Outside of medicine Dr. Courtemanche enjoys cycling, gardening, spend time with family and, of course, his dog. His other major passion is his work with Doctors for Planetary Health - West Coast, working for social and environmental justice and challenging colonial structures to make the necessary changes in the face of the global climate emergency.
 

 
Dr. Erika Henkelman, MD, BMSc, is a pediatric plastic and craniofacial surgeon. She completed medical school at the University of Toronto and a plastic and reconstructive surgery residency at Southern Illinois University. 

She has done fellowships in pediatric plastic surgery at Sick Kids Hospital (Toronto, Ontario), craniofacial surgery at Victoria Hospital (London, Ontario), and pediatric complex craniofacial surgery at Lurie Children’s Hospital (Chicago, Illinois). 

Dr. Henkleman is board-certified in plastic surgery in Canada and the United States. She has subspecialty interests in head shape, cleft and craniofacial differences, and facial paralysis. 
 
Phone: 604-875-2008
Fax: 604-875-2749

 
Dr. Sally Hynes, MD, FRCSC, is a pediatric plastic surgeon with a focus on cleft lip and palate, congenital hand differences and burns. 

Dr. Hynes completed medical school at Queen’s University in 2007, followed by a plastic surgery residency at the University of British Columbia in 2012. She completed a fellowship in pediatric plastic surgery at Sick Kids in Toronto, followed by further fellowship training in cleft lip and palate in Zurich, Switzerland. 

Before returning to British Columbia, Dr. Hynes worked at the University Children’s Hospital in Zurich as a clinical research physician and plastic surgeon, investigating a novel bioengineered skin substitute for burn patients.  

Phone: 604-875-3748
Fax: 604-875-2749


Dr. Saoussen Salhi, MDCM, MSc, FRCSC,  attended medical school at McGill University in Montreal, Quebec. She then entered the Plastic and Reconstructive Surgery residency program at the University of Montreal where she simultaneously completed both her clinical training and her master's degree in biomedical sciences.

She then completed a one-year fellowship in craniofacial and pediatric plastic surgery at Nicklaus Children's Hospital in Miami, Florida under the mentorship of Dr. Anthony S. Wolfe.

She subsequently worked as a pediatric plastic surgeon at Nicklaus Children's Hospital in Miami, Florida and at Health Sciences Center in Winnipeg, Manitoba with a practice focused on craniofacial surgery, cleft lip and palate surgery, ear reconstruction, facial reanimation, vascular anomalies and breast surgery.

Dr. Salhi is board-certified in plastic and reconstructive surgery by the Royal College of Physicians and Surgeons of Canada and by the American Board of Plastic Surgery.

Phone: 604-875-3758
Fax: 604-875-2749

Maxillofacial surgery

 
Dr. Graham Grabowski completed his Bachelor of Science and Doctor of Dental Medicine at the University of British Columbia. He continued his training at Yale-New Haven Hospital in Connecticut where he completed his residency in oral and maxillofacial surgery. Following this, he completed the National Dental Specialty Examination of the Royal College of Dentists of Canada and is recognized as a certified specialist in oral and maxillofacial surgery.

In addition to his work at BC Children’s Hospital, Dr. Grabowski is an assistant clinical professor at UBC’s Faculty of Dentistry. He is involved in the undergraduate oral surgery program as well as the graduate pediatric dentistry and orthodontics programs.

Outside of work, Dr. Grabowski enjoys spending time with his wife, daughter and two dogs. He stays active skiing and biking, and when possible, travelling. To relax, he enjoys cooking and gardening. 
 
Dr. Grabowski enjoys working with patients, and other care providers, to ensure patients understand their treatment options and select treatments that achieve their objectives.

 
Dr. Chris Olynik, DMD, attended the University of British Columbia and obtained his Bachelor of Science degree in animal physiology in 2004. He received his Doctor of Dental Medicine (DMD) degree from the University of British Columbia in 2008.

Dr. Olynik then moved to Houston, Texas to complete a residency in oral and maxillofacial surgery at hospitals affiliated with University of Texas Health Science Center at Houston and Baylor College of Medicine. He obtained his fellowship with the Royal College of Dentists of Canada in 2012 as a certified specialist in oral and maxillofacial surgery.

After completing residency, Dr. Olynik joined the Department of Oral and Maxillofacial Surgery at the University of Texas Health Science Center at Houston in the Texas Medical Center as an assistant clinical professor.

Dr. Olynik is a diplomate of the American Board of Oral and Maxillofacial Surgery (ABOMS) and has active memberships with the Canadian Association of Oral and Maxillofacial Surgeons (CAOMS), the British Columbia Association of Oral and Maxillofacial Surgeons, the American Association of Oral and Maxillofacial Surgeons (AAOMS), the American Cleft Palate and Craniofacial Association, and the Academy of Osseointegration.

In addition to his work as a surgeon with BC Children's Hospital, Dr. Olynik is affiliated with Nanaimo Regional General Hospital and BC Cancer.

Dental

 
Dr. Jennifer Park, DMD, FRCD(C), MSc, BA, is a certified specialist in pediatric dentistry. She is committed to providing comprehensive dental care for infants, children, adolescents and those with special needs. She is passionate about preventing disease and restoring/maintaining great oral health.

Dr. Park received her Doctor of Dental Medicine (DMD) in 2008 from the University of Saskatchewan, where she also obtained her Bachelor of Arts in psychology (2004). Dr. Park also completed a Pediatric General Practice Residency (GPR) at the IWK Health Centre and Dalhousie University in Halifax. She went on to practice as a general dentist for three years in Saskatoon, Vancouver and the Kivalliq region of Nunavut. Her passion to use her skills to serve the underprivileged led her on medical/dental mission trips to Haiti and Nicaragua.

Throughout the years, Dr. Park was particularly drawn to pediatrics, which led her to pursue specialty training in pediatric dentistry at the University of British Columbia where she also obtained a master's in craniofacial science. Dr. Park is extensively trained in providing comprehensive dental care for healthy, medically compromised and special needs children using a wide variety of modalities, including behavior management and oral sedation. She is particularly interested and experienced in dental trauma care.

Dr. Park is a pediatric dentistry fellow of the Royal College of Dentists of Canada, a member of the Canadian Academy of Pediatric Dentistry, American Academy of Pediatric Dentistry, British Columbia Society of Pediatric Dentistry and the British Columbia Dental Association. Dr. Park is committed to teaching and training future dentists and specialists and is a Clinical Assistant Professor at the University of British Columbia and the Chief of Dentistry at the BC Children’s Hospital.

Phone: 604-875-2114 (Department of Dentistry)

 
Alice Mak is a local British Columbian, born and raised in Vancouver. She has 25 years of experience working as a certified dental assistant (CDA), and has worked in a variety of private dental offices from non-profit  to pediatric. Since completing the certified dental assistant program at Vancouver Community College, she continues to develop professionally through conferences, courses and study clubs. She also volunteers in the community, educating children and their families in inner city schools about the importance of oral health.

Alice joined BC Children’s Hospital in 2010 and has developed a passion in working with children and their families, hoping to make a life a little easier and sunnier. She loves what she does in supporting the cleft palate program and the Department of Dentistry.
 
Alice and her husband also run a busy household along with their three children, all in different stages of life. She volunteers at her children's school and serves on the Parent Advisory Council committee. In her spare time, she enjoys running, scrapbooking and loves to explore any new local cafes in town. 

Your visit

On your first visit, you’ll meet with several members of our team, which may include the following people: audiologist, orthodontist, nurse, plastic surgeon and speech and language pathologist.

Each specialist will meet with you and your child individually to review your child's medical history and perform physical exams.

Indigenous Supports

We advocate for and provide help to Indigenous families who are visiting the hospital.

 

Indigenous Patient Navigators offer in-hospital assistance to improve the quality of health care delivery to Indigenous patients through direct patient support and staff education. This includes:


  • Cultural support and comfort to Indigenous patients and families
  • Access to traditional cultural medicines
  • Connection to an elder for spiritual and emotional support
  • Care packages and help with emergency clothing 
  • Information about the First Nations Health Benefits Program
  • Assistance with complaints
  • Connection to Indigenous community resources
  • Attending medical appointments with Indigenous patients and families while on site at BC Children's or Sunny Hill
  • Liaison with the on-site health care team (nurses, doctors, other health care professionals)




Frequently asked questions






Resources

There are hunderds of rare syndromes associated with cleft and craniofacial conditions. If your/your child's condition is not listed here, please be assured that the team at BC Children's Hospital will be able to provide you with information, a diagnosis and care for the condition.

If you are a health care professional seeking resources, please visit our clinical resources section.

Conditions & Resources

Cleft Lip & Palate Conditions & Resources

 

About 

A cleft lip is a condition where there is an opening (cleft) in the lip. It is one of the most common craniofacial disorders.



Incomplete unilateral cleft

When one side of the lip has a gap, we call it a unilateral cleft lip.
If the unilateral cleft does not go all the way to the nose, it's called it an incomplete uniltaral cleft lip.


Complete unilateral cleft

If the cleft is one side of the lip and goes all the way to the base of the nose, it's called it a complete unilateral cleft lip.


Bilateral cleft

When both sides of the lip have a gap that goes all the way to the nose, we call it a complete bilateral cleft lip.

Causes

Each year, 1 in 700 newborns is born with a cleft lip. A cleft lip occurs when the parts that form the mouth don't join together properly: this happens very early in the pregnancy, within the first 4-12 weeks. Cleft lips can be caused by both genetic and environmental factors.


Impact on a child

We use our lips to do many things, from eating and drinking to speaking. Patients with cleft lips may have issues related to their:

  • Appearance
  • Speech
  • Feeding
  • Growth/development
  • Dental health

Treatment

Yes, cleft lips can be successfully treated with surgery. Our team's plastic surgeons and orthodontists work with our patients' parents to choose the best timing for surgery. In most cases, a baby's cleft lip will be repaired within the first 3 months after birth. The actually timing of the surgery depends on the patient's general health and the nature of the cleft lip. 


Typical treatment and follow-up plans are outlined below:


At Birth: Newborn Nursing Consultation & Follow-up

The treatment process starts with a nursing consultation for new parents to learn about and get support for diagnosis, feeding and treatment plans.


First 2 Weeks: Orthodontic Evaluation

Our orthodontists assess the cleft, and if needed, fit the baby with an orthodontic appliance that may help to narrow the gap between the lips and gums, improve the symmetry of the nose and minimize the amount of scaring from the surgery. For babies with "bilateral cleft" (a gap on both sides of the lip) the appliance may also bring back the small central portion of the lip and gum in a controlled fashion. Because the lip and gum are in a better position, it simplifies the surgical repair.


4-6 Weeks: Plastic Surgery Consultation

Our surgeons assess the cleft and begin planning for surgery.


4 Weeks Before Surgery: Pre-admission Clinic Consultation

Our anesthetist and nurse ensure that our patient is ready to have anesthetic and surgery.


3-4 Months: Cleft Lip Surgery

Our surgeons repair the cleft in the lip.


6 Weeks After Surgery: Plastic Surgery Follow-up Appointment

Our patient is assessed by either our team, or by specialists in our patient's community.


3 Years: Cleft Lip Team Assessment

Our patient is assessed by the entire team over the course of a 1-2 day out-patient visit.


Before School: Cleft Lip & Nose Revision Surgery

If appropriate our patient undergoes lip and nose revision surgery.


5 Years: Cleft Lip Team Assessment

If appropriate, our patient is assessed by the plastic surgery and orthodontics over the course of a 1-2 day out-patient visit.


Resources

 

About

The palate is the roof of your mouth, and it's made of two pieces:


  • The hard palate, which is the part right behind the teeth; you can feel it with your tongue
  • The soft palate, which is at the very back of the mouth, near the throat
A cleft is an opening or a gap, so a cleft palate is condition where there is a gap in the roof of your mouth. Types of cleft palates include:

  • When the gap is only in the soft palate, we call it an incomplete/partial cleft palate
  • When there is a gap in the both the hard and soft palate, we call it a complete cleft palate.
  • A complete cleft can occur in one or both sides. If it's on one side, we call it unilateral cleft. If the cleft occurs on both sides, we call it bilateral cleft.

Causes

A cleft palate occurs when the parts that form the palate don't join together properly: this happens very early in the pregnancy, within the first 6-8 weeks. Cleft palates can be caused by both genetic and environmental factors.


Impact

The palate separates the mouth from the nose. We use it when we eat, drink and speak. A cleft palate may impact a child's:


  • Appearance
  • Speech
  • Hearing
  • Dental health
  • Feeding
  • Growth/development

Treatment

Cleft palates can be successfully corrected with surgery. Our team works with our patients' parents to choose the best time for surgery. In most cases, a baby's cleft palate should be repaired by the time the baby reaches the age of 9 months. Determining when to have surgery will depend on the patient's general health and the nature of the cleft palate. 


The typical treatment and follow-up plans are outlined below:


At Birth: Newborn Nursing Consultation & Follow-up

The treatment process starts with a nursing consultation for new parents to learn about and get support for diagnosis, feeding and treatment plans.


First 2 Weeks: Orthodontic Evaluation

Our orthodontists assess the cleft, and if needed, fit the baby with an orthodontic appliance that may help to narrow the cleft.


4-6 Weeks: Plastic Surgery Consultation

Our surgeons assess the cleft and begin planning for surgery.


8-9 Months: Cleft Palate Team Assessment

Our entire team assesses our patient's cleft over the course of a 2 day out patient visit to complete the surgical plan.


8-9 Months: Pre-admission Clinic Consultation

Our anesthetist and nurse ensure that our patient is ready to have anesthetic and surgery.


9-12 Months: Cleft Palate and Middle Ear Tube Surgery

Our surgeons repair the cleft in the palate, and if necessary, insert middle ear tubes.


6-8 Weeks After Surgery: Plastic Surgery, Audiology & Otolaryngology Recheck

Our patient is assessed by either our team, or by specialists in our patient's community.


18 Months: Cleft Palate Team Assessment

Our patient is assessed by the entire team over the course of a 2 day out-patient visit.


Resources

Conditions associated with cleft lip & palate


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‎About

CHARGE syndrome is condition that occurs when different types of tissue do not develop completely. This happens very early in pregnancy, within the first 3-4 weeks. Children born with CHARGE syndrome often have multiple serious medical conditions that affect many different systems in their bodies. The diagnosis of CHARGE syndrome is based on a combination of major and minor characteristics. 


The word CHARGE is based on the major symptoms of the condition, and stands for:


  • C- Coloboma of the eye (a hole in one of the structures of the eye)
  • H- Heart defects
  • A- Atresia of the choanae (narrow or blocked nasal cavities)
  • R- Retardation of growth and/or development
  • G- Genital and/or urinary abnormalities
  • E- Ear abnormalities and deafness

Causes

CHARGE syndrome occurs in 1 in 8,500 to 10,000 births (1). It’s a genetic disorder, which means it's caused by changes (mutations) in a gene(s). Genes, which are passed from parents to children, determine a person's traits, including appearance and growth. Mutated genes can be inherited from a parent, caused by environmental factors or occur randomly. In most cases, CHARGE syndrome is caused by a random (new) mutation in a gene.


(1) National Library of Medicine's Genetics Home Reference


Impact on a child

Children with CHARGE syndrome have many serious, potentially life-threatening medical challenges. Due to the range of symptoms, each child is impacted differently. Symptoms may include (but are not limited to):


  • Impairment or loss of vision
  • Heart abnormalities
  • Cleft Lip and/or palate
  • Narrowing or blockage of the nasal cavities (atresia of the choanae)
  • Impaired growth and/or development
  • Genital and/or urinary abnormalities
  • Ear abnormalities and hearing loss

Treatment

Due to the range and severity symptoms, each child’s treatment is unique. Our team works with our patients and their families to develop a treatment plan that address each patient’s specific needs.


Resources


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Craniofacial Conditions & Resources

 

About

Craniosynostosis is a condition that affects the shape of the head and face. It occurs when the bones of the skull close too early, before the brain has finished growing. A newborn's skull has seven bones, which are separated by spaces called sutures. As an infant's brain grows, it pushes the bones of the skull outward.


Craniosynostosis prevents the brain from growing normally, so the head becomes mishapen. Because there are multiple sutures that can fuse, there a several different types of craniosynostosis:


  • Sagittal synostosis occurs when the suture at the top of the head (the sagittal suture) closes too early, forcing the head to grow long and narrow, instead of wide.
  • Coronal synostosis (anterior plagiocephaly) occurs when one of the sutures that runs from the ear to the top of head (a coronal suture) closes too early, forcing the head to flatten on the fused side.
  • Bicoronal synostosis (brachycephaly) occurs when both of the sutures that run from the ear to the top of head (the coronal sutures) close too early, forcing the forehead and brow to become flat and elevated.
  • Metopic synostosis (trigonocephaly) occurs when suture that runs from the nose to the top of the head (the metopic suture) closes too early, forcing the top of the head to have a triangular shape.
  • Lambdoid synostosis (posterior plagiocephaly) occurs when the suture at the back of the head closes too early (lambdoid suture), forcing the head to flatten on the fused side.

Causes 

Craniosynostosis occurs in 1 in 2,500 births (1). When cause of craniosynostosis is unknown, it's classified as non-syndromatic. When craniosynostosis is a symptom of a medical condition, it's classified as syndromatic. Craniosynostosis is often a symptom of Apert, Pfeiffer and Crouzon syndromes.


(1) Slater BJ, Lenton KA, Kwan MD, Gupta DM, Wan DC, Longaker MT (April 2008). "Cranial sutures: a brief review". Plast. Reconstr. Surg. 121 (4): 170e–8e.


Impact on a child

Because Craniosynostosis affects the growth of the head and face there are a range of symptoms, which may include (but are not limited to):


  • Missing "soft spot" (fontanelle) on the newborn's skull
  • A raised hard ridge along the affected sutures
  • Irregular head and face shape
  • Impaired head growth
  • Increased intracranial pressure
  • Dental malformations

Treatment

Treating craniosynostosis usually involves surgery to separate the fused bones. Our team works with our patients and their families to develop a treatment plan that address each patient's specific needs.


Resources

Conditions associated with syndromic craniosynostosis

 

About


Apert syndrome is a condition that causes abnormal growth of the head, face, hands and feet. During pregnancy, the skull bones join together too early, which prevents them from growing normally. As a result, the area between the bottom of the eyes and jaw are often underdeveloped, making the eyes appear more prominent. Webbed fingers and toes are also common in children born with Apert syndrome.


Causes

1 in 65,000 to 88,000 children are born with Apert syndrome(1). Apert syndrome is a genetic disorder, which means it's caused by changes (mutations) in a gene(s). Genes, which are passed from parents to children, determine a person's traits, including appearance and growth. Mutated genes can be inherited from a parent, caused by environmental factors or occur randomly.


(1) National Library of Medicine's Genetics Home Reference

Impact on a child

Because Apert syndrome affects the growth of the head, face, hands and feet, there are a range of symptoms, which may include (but are not limited to):

  • Underdevelopment of the mid-face
  • Protruding eyes
  • Webbed or fused fingers and toes (syndactyly)
  • Extra fingers or toes (polydactyl)
  • Cleft palate (palatoschisis)
  • Ear infections
  • Hearing loss
  • Impaired vision
  • Increased sweating (hyperhidrosis)
  • Intellectual disability (ranging from normal to moderately severe)

Treatment

Many of the symptoms of Apert syndrome can be treated. Our team works with our patients and their families to a develop treatment plan that address each patient’s specific needs. Treatment plans for patients with Apert syndrome often include surgeries to correct the shape of the head and face, as well as the webbing/fusion of the fingers and toes.

Resources

 

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Conditions associated with non-syndromic craniosynostosis

 

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Conditions associated mandibular differences

Dental Conditions & Resources

 

About

Ectodermal Dysplasia Syndromes (EDS) is a group of related conditions that causes the abnormal development of some combination of teeth, hair, nails, sweat glands and parts of the eye and ear during pregnancy. More than 150 conditions have been identified, and each syndrome usually involves a different combination of symptoms. EDS is diagnosed when a patient has 2 or more EDS symptoms.


Causes

EDS is a genetic disorder, which means it's caused by changes (mutations) in a gene(s). Genes, which are passed from parents to children, determine a person's traits, including appearance and growth. Mutated genes can be inherited from a parent, caused by environmental factors, or occur randomly.


EDS is caused by mutations to genes that control the ectoderm, the cells that eventually develop into skin, hair, nails, teeth, nerve cells, sweat glands, parts of the eye and ear, and parts of some other organs during pregnancy.


Impact

Because the ectoderm plays a role in development of so many body parts, patients with EDS may have a broad variety of symptoms, which range in severity. Symptoms often include:


  • Missing or sparse hair growth (hypotrichosis)
  • Missing or malformed of teeth (hypodontia)
  • Inability to sweat (hypohidrosis), which causes overheating (hyperthermia)
  • Weakened or loss of hearing or vision
  • Missing or malformed fingers or toes
  • Cleft lip and/or palate
  • Irregular skin colour
  • Challenges breathing

Treatment

Many of the symptoms of EDS can be treated. Our team works with our patients and their families to develop a treatment plan that addresses each patient's specific needs.

It is common for patients with EDS and EEC (Ectodermal-Ectodactyl Clefting Syndrome) to undergo significant dental treatment, including orthodontic, oral surgery and prosthetic services.


To learn more, please read about the Orthodontic Program for Children with Cleft Lip and Palate & Syndromic Craniofacial Anomalies and the  Dental Program for Ectodermal-Ectodactyl Clefting Syndrome


Resources



Ear Conditions & Resources

 

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SOURCE: Cleft Palate & Craniofacial Disorders ( )
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