Dr. Pradip Shetye Interview Transcript

Interviewer: Blake Herman
Interviewee: Dr. Pradip Shetye
Topic: Cleft and Craniofacial Orthodontics

Introduction

Blake Herman: Hello everyone. Today, I will be interviewing expert Dr. Pradip Shetye of NYU Langone Health, discussing his background as a craniofacial orthodontist, what inspired him to work with kids who have a cleft, and much more.

Dr. Pradip Shetye: Thank you.

Background and Inspiration

Blake Herman: Maybe you could share a bit about your background and what initially drew you to the field of orthodontics?

Dr. Pradip Shetye: I grew up in India and completed my dental school training. While I was doing my residency training, my uncle, who is also an orthodontist, inspired me to pursue this field. During my residency, I saw adult patients with unoperated cleft lip and palate. That led me to research how these patients’ upper jaws grow when there is no surgical intervention. This ultimately motivated me to specialize in cleft and craniofacial orthodontics.

Defining Moment

Blake Herman: Was there a defining moment that influenced your decision to focus on craniofacial orthodontics?

Dr. Pradip Shetye: Yes, it was when I met a particular adult patient who had never undergone surgery. That experience pushed me to study more cases of individuals who did not have the opportunity to receive surgical intervention. Eventually, I started a Smile Train project to fund surgeries for these patients who couldn’t afford them.

Training and Experience

Blake Herman: How do you think your training and early experiences prepared you for the unique challenges of treating cleft patients?

Dr. Pradip Shetye: After my residency, I completed two advanced fellowship training programs. One was at the University of Illinois, Chicago, where I spent a year studying cleft and craniofacial conditions. The second was at NYU Langone in 2022, where I specialized in pre-surgical infant orthopedics and different treatment modalities for infants born with facial differences.

Unique Challenges in Cleft Care

Blake Herman: When it comes to orthodontic treatment, what are some of the unique challenges that children with cleft lip and palate face?

Dr. Pradip Shetye: Craniofacial orthodontics requires mentorship, and I was fortunate to have Dr. Grayson and Dr. Cutting as mentors. Together, we developed treatment methods that reduce the burden of care on families while improving surgical outcomes with minimal procedures.

Advances in Technology

Blake Herman: In your experience, what recent advances in technology have had the most significant impact on cleft patient treatment?

Dr. Pradip Shetye: One of the most significant innovations has been pre-surgical infant orthopedics. Previously, a technique called nasoalveolar molding (NAM) required weekly visits for adjustments over 5 to 12 months. Now, a newer technique called "Planner" has reduced the treatment time to about three months, requiring only four or five visits.

Another major advancement is the use of CT scans and 3D technology in planning treatments, especially bone grafting and jaw surgery. In the past, we relied on 2D radiographs, but CT scans allow for more precise surgical planning.

3D Printing in Orthodontics

Blake Herman: How have digital imaging and 3D printing influenced the way you plan and execute treatments?

Dr. Pradip Shetye: We now have in-office 3D printing, whereas we previously relied on third-party companies. This allows us to create custom surgical guides and plates for procedures.

Treatment Timeline for Cleft Patients

Blake Herman: Could you walk us through a typical treatment plan for a child with a cleft condition, from infancy through young adulthood?

Dr. Pradip Shetye:

  1. Infancy (0-4 months): Pre-surgical infant orthopedics to reduce cleft severity.

  2. 12 months: Palate surgery.

  3. Ages 1-7: Preventive care with speech therapy and pediatric dental checkups.

  4. Ages 8-9: Bone graft surgery (if needed).

  5. Ages 11-12: Braces and orthodontic preparation.

  6. Ages 17-18: Jaw surgery (if required).

  7. Adulthood: Final touch-ups for lip and nose aesthetics if desired.

Coordinating Care with Other Specialists

Blake Herman: How do you coordinate care with surgeons, speech therapists, and pediatric dentists?

Dr. Pradip Shetye: Cleft care must be managed in a team setting. We work closely with surgeons to determine the best timing for procedures and collaborate with speech therapists to address speech changes after jaw surgeries.

Role of Parents in Treatment Success

Blake Herman: What role do parents play in ensuring the success of treatment?

Dr. Pradip Shetye: Parents are one-third of the success—along with the orthodontist and the surgeon. They play a crucial role in pre-surgical therapy and ensuring their child follows the treatment plan.

Misconceptions About Cleft Orthodontics

Blake Herman: Are there any common misconceptions about orthodontic treatment for cleft patients?

Dr. Pradip Shetye: Yes. Many people don’t realize that every cleft patient grows differently. Unlike general orthodontics, where growth patterns remain stable, cleft patients' growth patterns can change unpredictably, making treatment more complex.

Emotional & Community Support

Blake Herman: How do you address the emotional aspects of treatment for both children and families?

Dr. Pradip Shetye: We prioritize compassion and involving teenage patients in decision-making. Additionally, organizations like MyFace provide support networks for families going through treatment.

Final Advice for Parents & Patients

Blake Herman: What final message would you like to share with families beginning their cleft care journey?

Dr. Pradip Shetye:

  1. Get information from cleft team members, rather than relying on outdated sources.

  2. Connect with families who have recently undergone treatment for real-time insights.

Conclusion

Blake Herman: Thank you so much, Dr. Shetye. I really appreciate your time!

Dr. Pradip Shetye: Absolutely! You’re doing a great job with this project. I’m proud of you.