Nasoalveolar molding (NAM)
Nasoalveolar molding (NAM) is an orthopedic appliance used to actively mold and reposition nose and mouth tissues before surgery. We perform this procedure in the Cleft and Craniofacial Program at Children's Hospital.
Benefits of NAM
- Molding the gums and bone into a better position that makes surgery easier and quicker
- Helping the child have better, healthier teeth as he or she grows
- Easing feeding and breathing
- Becoming something like a pacifier, meaning children tend to adapt well to the procedure
Cleft types that benefit from NAM
- Unilateral, complete and incomplete
- Bilateral, complete and incomplete
We don't recommend NAM if your baby only has cleft palate, due to the normal lip and alveolar formation (the bony ridge that contains the sockets where teeth are rooted).
What can we expect during the NAM process?
You will first have a prenatal consultation with Dr. Maclin and the dental team before your baby is born to review and discuss treatment options. This is to ensure you have time to ask all your questions and get to know the team before your baby is born. This will give us the best possible outcome for your family.
We will perform an initial scan of your newborn baby with digital or traditional equipment depending on your child’s specific needs. We will need to do this as soon as possible, ideally before one week of age. Your baby's NAM appliance will be ready about one week later after the scan.
Your baby will need to wear the appliance for about 23 hours per day so it can work as effectively as possible. This includes while sleeping, eating and playing.
We will make weekly adjustments of the appliance in very small (1 millimeter) increments to better position the two gum pads with nose and lip tissues. We add nasal stents when the distance between the two gum pads is 5 millimeters or smaller. You will continue with weekly visits to our office so we can make adjustments to both the plate and the nasal stents until the lip repair surgery.
Your baby will go through this process of wearing the appliance and visiting us for adjustments for about 12 weeks.
After we perform the surgery, your baby will no longer need the NAM appliance.