Nasoalveolar Molding (NAM)

Nasoalveolar molding (NAM) is a non-surgical procedure used to shape your baby’s gums, lips, and nose prior to surgical repair of the cleft lip and palate. This helps lessen the size of the cleft and improve the position of the nose and lips for a better surgical and esthetic result. A better outcome with the initial surgeries often means fewer surgeries and other procedures later in childhood.

The NAM appliance looks similar to a retainer worn after braces and gently directs the growth of the gums and soft tissues during baby’s first few months of life. Every one to two weeks, the doctor will make small adjustments to the NAM appliance. It is held in place by elastics taped to the baby’s cheeks which is changed daily by the baby’s parents. The appliance is worn 24/7 including during eating and sleeping and is removed only to be cleaned. Treatment time can vary between 3 to 6 months.

Timing of NAM is critical. Ideally, treatment is started as soon as possible and as early as your baby’s first week of life. At birth there is a high level of hyaluronic acid present in the baby which makes it easier to mold the tissues, bone and cartilage. This level drastically decreases after two months of age so we like to see the babies early to take advantage of this critical time window.


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Feeding Appliance

In cases where a baby is not a candidate for NAM due to the nature of the cleft, the baby may still benefit from a feeding appliance. This appliance looks similar to a NAM appliance but functions simply as a “cover” for the cleft palate. This helps prevent fluids from coming out of the nose making feedings easier for both the parents and baby. It also protects the delicate tissues around the cleft from sores and ulcers which often develop as a result of the baby bottle rubbing against them.

Treatment for Older Children, Teenagers, and Adults

Patients with cleft palates are often missing teeth in the area of the cleft. As prosthodontists, the prosthetic replacement of missing teeth is our specialty! From implants to bridges to removable prostheses, we will work with you, your general dentist, and other specialists to determine the best treatment options. While we need to wait until a child/teenager has completed growing prior to permanently replacing these missing teeth, we like to plan early whenever possible and work closely with the child’s pediatric or general dentist and orthodontists.

If you would like to learn more about nasoalveolar molding or other treatments for cleft lip and palate, call or email to schedule a consulation. We’re happy to work with your regular dentist, pediatrician, surgeon and other members of you or your child’s medical team to determine what treatment option is best. Please call our Reno office at 775-323-3574 or email andresendds@gmail.com

New Patients & Emergency Appointments Welcome!

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