Dental management of CCD has undergone somewhat of a metamorphosis from a "wait and see" approach to more sophisticated and expensive methods combining orthodontics and surgery ( Smylski et al, 1974; Hall and Hyland 1978; Becker et al 1997; Daskalogiannakis et al, 2006; Dental management planning and treatment goals in CCD vary between individuals and depend primarily on the patient's needs, age at diagnosis, and social and economic circumstances. The main management objectives of affected individuals remain the restoration of function and aesthetics. D'Alessndro et al, 2010 classified the clinical features relevant to this article into two main categories: craniofacial and dental. While there is a wide range of management options, there is general consensus that the best outcomes are achieved if the condition is diagnosed and treatment is started at an early age. Management Options: The most popular orthodontic-surgical approaches include:1. The Toronto-Melbourne approach2. The Belfast-Hamburg approach3. The Jerusalem approachThe Toronto-Melbourne approach is based on the timed and serial extraction of deciduous teeth and depends on the degree of development of the roots of the permanent teeth. During each operation, which is performed under general anesthesia, the supernumerary teeth are removed along with the bone covering the underlying permanent teeth. The rationale is to facilitate the spontaneous eruption of unerupted permanent teeth. Orthodontic procedures are used to achieve treatment goals (Smylski et al, 1974; Hall and Hyland 1978). Unlike the Toronto-Melbourne approach, the Belfast-Hamburg approach, to...... half of the paper .... ..D, submitted to the University of the Western Cape, Faculty of Dentistry for management. In addition to CCD's orodental characteristics, he also had poor oral hygiene, multiple decayed teeth, and was believed to have mild intellectual disability. However, upon further clinical investigation, it emerged that he was a regular user of methamphetamine or “tik”, as it is called in South Africa. His poor oral health and mental capacity were therefore the result of drug abuse and perhaps poor socioeconomic status. After careful management planning, the young man absconded from treatment. Therefore the management of complicated orofacial disorders can be extremely complicated in a country like South Africa. Aside from poverty, lack of education, drug abuse and HIV, the cost of treatment is beyond what the average person can afford.: