Frequently Asked Qustions

GENERAL QUESTIONS

1. How do I choose the right doctor?
- This is a very stressful time for most parents, and choosing a doctor to care for your child is an important decision. The doctors training and experience, your ability to communicate and ask questions, and the quality of the providers on the craniofacial team are important considerations. Dr. Ricalde takes pride in the fact that she is one of very few craniofacial surgeons in the country with both a dental and a medical degree, as well as a fellowship certificate with world renowned Dr. Jeffrey Posnick. Her team was carefully selected to ensure each member has both the technical skills and compassion to care for challenging patients.

INSURANCE QUESTIONS

1. I don’t see Dr. Ricalde in my insurance book as a contracted provider. Will she take my insurance?
- Because Dr. Ricalde is a “sub specialist”, most insurance companies don’t have a special section in which to include her. However, she takes most insurance plans. Even if she is not “contracted” with your insurance company, her staff will be happy to call them and make special arrangements for your child, to minimize any out-of-pocket expenses.

2. My insurance company tells me that my/ my child’s surgery is considered “cosmetic”, and it isn’t a covered benefit. How can that be?
- Dr. Ricalde doesn’t perform general cosmetic surgery – she is a facial reconstructive surgeon. And that is how she will relate to your insurance company. There are laws in Florida to try and protect you from unnecessary insurance denials, as well as avenues for appealing an insurance company’s decision, let our staff assist you.

CLEFT LIP AND PALATE

1. How do I feed my baby with a cleft palate?
- Every baby is unique, but most babies with a cleft palate will require a specialized bottle/ nipple system to make feeding easier. We don’t necessarily advocate the use of any one particular system – but can work with you and your baby to find one that is comfortable for you both.

2. I’ve heard that my baby with a cleft should see a cleft team. Do you work with one?
- Yes. Dr. Ricalde is the Director of the Cleft and Craniofacial Team in Tampa, and is also a member of teams in Ft. Meyers and Orlando. See our links page for more information.

3. Do you use NAM (naso-alveolar molding)?
- NAM is an intraoral appliance that can be used to reshape the lips/ nose/ gumline prior to the lip repair. We will be happy to talk with you about the advantages and disadvantages of these appliances, and certainly can provide them for your baby if you are interested!

PLAGIOCEPHALY

1. My baby has a flat spot on the back of their head that is not getting better. Is there something wrong?
- First, it is important to make a diagnosis. Your baby should be examined to rule out a skull malformation (craniosynostosis), which would require surgery. Also, torticollis (tight neck muscle) creates limitation in neck movement, which can lead to a flat spot. If these are negative, then your baby may have deformational molding, which usually responds to repositioning techniques (RPT).

2. I’ve been using Repositioning Techniques for without improvement. What else can I do?
- Depending on the age of your baby and the size of the soft spot, custom helmet therapy is another way to treat deformational plagiocephaly. We will be happy to talk with you about the advantages and disadvantages of these therapies, and will assist you in making a comfortable decision for your baby! For best results, have your baby examined by Dr. Ricalde before the age of 6 months.

ORTHOGNATHIC SURGERY

1. I need jaw surgery but am over the age of 40. Is it too late? Will surgery be more difficult for me?
- Dr. Ricalde will be happy to discuss jaw surgery with you! There are certain medical conditions (including cigarette smoking) that may make you ineligible for surgery. For the most part, patients with dentofacial disorders can benefit from correction at almost any age, especially if you snore or have sleep apnea.

2. I know I need jaw surgery, but I don’t have an orthodontist. Can I go to anyone?
- Orthognathic surgery is accomplished by Dr. Ricalde working closely with your orthodontist. Dr. Ricalde is happy to refer you to an orthodontist with training and experience in managing problems like yours. If you already have an orthodontist you like, be sure they are comfortable and knowledgeable in orthognathic surgery, and feel free to call our staff for assistance!

3. I’ve been in braces for years and my orthodontist can’t seem to fix my bite. They are now talking about surgery, but I don’t want aggressive treatment. Is there a conservative approach?
- You may have a skeletal (jaw growth) problem that is making it difficult for your orthodontist to fix your bite. Unfortunately, prolonged orthodontic treatment is not healthy for your teeth and bones, and surgery may in fact be the more conservative treatment. Dr. Ricalde will be happy to review your records and give you a second opinion.