Children with craniofacial deformities and special needs require highly trained specialists, including orthodontists, to manage their sensitivities and specific set of treatment needs. Dr. Efstathios (Steve) Giannoutsos (Dr. G) received additional orthodontic training specifically to work with special needs patients, and the word has spread. After establishing his Georgetown Orthodontics practice in Georgetown just a few years ago, he opened another office last year in Norwalk, and he plans to expand his practice to accommodate this influx of patients.
Giannoutsos trained for the subspecialty of Craniofacial, Cleft and Special Needs Orthodontics under a renowned reconstructive plastic surgeon, Dr. Joseph G. McCarthy, as well as with another esteemed orthodontist, Dr. Barry Grayson. Both men are recognized as the premier specialists for craniofacial deformities and have both developed innovative techniques for improving craniofacial care.
Since opening his orthodontic practices in Connecticut, Dr. G has treated several patients with cleft palate and craniofacial issues. The course of treatment begins with each patient taking a tour of the office and meeting Giannoutsos, as well as the various staff team members, before beginning treatment. Dr. G speaks with each patient and his family to learn what their behaviors and concerns are and so that he can tailor his orthodontic work to their individual needs.
“I work as a therapist and an orthodontist with these patients. It takes tremendous understanding of their particular issues, as well as trial and error to determine the best procedure that works for a given patient on a given day. However, it is rewarding when severe facial or dental abnormalities are corrected. The child looks and feels great when treatment is completed and so do I. The parents are also elated,” he says, adding,”This experience enhances my work as well as provides me with a tremendous feeling of professional satisfaction.”
For example, many children on the autism spectrum have oral aversion, and what can helps is for Dr. G to apply pressure on the mouth continually while the work is being performed. Transitions (both acutely during treatment as well as between various stages) are also a real challenge for some of these patients, so it can take longer for them to become comfortable with the process. Dr. G and his assistants can distract children by engaging them with conversation, music and video to helps calm them.
Taking impressions is one of the first steps before putting braces on the teeth and while it’s usually a relatively simple procedure, it can be very difficult for patients with sensory issues to tolerate. Dr. G makes the process easier even though sometimes one child may require ten appointments before she will allow an impression to be taken. Patients can often be desensitized through simulating the process—perhaps by using a fluoride tray, which is similar to an impression tray, at home with parents and siblings, to help make the office experience a more familiar one. Simulation can also help before putting braces on the teeth of patients with taste aversions; Dr. G. practices several times with them to allow them to become comfortable with the treatment plan.
Dr. G constantly evaluates new ways to make progress in the delivery of care to the patients who need it most. He recently purchased a new machine, called an intra-oral scanner, which eliminates the need to take conventional impressions. It uses revolutionary digital camera technology to capture a highly accurate record of the teeth and surrounding structures, eliminating the need for using messy impression materials.
The practice has grown so rapidly that last year he hired a part-time associate, Ankush Khanna, DMD MBE to work with him. Khanna shares Dr. G’s passion for orthodontics. He was the chief resident at New York University, teaches at night at New York Methodist Hospital, and recently opened his own practice in Park Slope, Brooklyn. He is also a member of the Spear Study Club, which has a select group of dental practitioners who meets regularly to improve patient care.
“I have been passionate about this work since I was in high school. And working with Dr. G is a great experience, while the patients make each day challenging and rewarding,” Khanna says.
Dr. Giannoutsos’s offices are located at 73 Redding Rd. in Georgetown, and 10 Mott Ave., in Norwalk. The hours vary based on location. Both offices can be reached at 203.544.9338.