Nasal Alveolar Molding (NAM)

Prior to surgery to repair a cleft lip, some patients will require orthodontic treatment in order to guide the growth of the mouth in the right direction, eventually aiding in the correction process. This technique is called nasal alveolar molding (NAM), and is usually begun during the first two weeks of a baby’s life and can last up to six months.

The Children’s Center for Craniofacial Disorders was among the first craniofacial centers in the country to offer the NAM device. Children’s installed more than 41 NAMs in 2009, the most in the Southeast.

How does NAM work?

­The child’s first visit to the Children’s Center for Craniofacial Disorders, the Children’s pediatric orthodontist will take a mold of the infant’s mouth.

­The orthodontist will then create a custom-made plastic plate of the child’s mouth, lip and nostrils.

­The child will wear the plate 24 hours a day for approximately six months. The plate is held in the mouth by surgical skin tape that also helps guide the growth of the child’s face. 

­Each week, the orthodontist will reshape the plate, reducing the child’s cleft and reshaping the facial features.

What are the benefits of the NAM technique?

­Typically, children with cleft lip and palate require between five to seven surgeries—sometimes extending into adolescent years. The NAM device reduces the number of surgeries required during a patient’s lifetime, which in turn reduces facial scarring, trauma, inconvenience and cost involved in additional surgeries.

­The NAM device dramatically improves postsurgical results for cleft lip and palate patients. In addition, it also may have a dramatic effect on speech and overall health.

­Because the NAM device covers the roof of the infant’s mouth, the NAM appliance also helps with feeding.

What is the role of the parents?

Parent participation is essential to the success of the NAM appliance. In addition to weekly visits to the Children’s Center for Craniofacial Disorders, parents will be responsible for attaching the tape to their child’s face, which allows the NAM device to stay in place.