Cleft and Craniofacial Center
Hasbro Children's Hospital

About Nasoalveolar Molding for Cleft Lip

Our specialists may recommend an orthodontic treatment called nasoalveolar molding (NAM) to prepare the baby for surgical repair of the cleft lip.

NAM brings the two sides of the upper lip closer together and changes the shape of the nose, making the surgery easier and provides the best possible result.

NAM procedure
An infant benefits from NAM therapy to treat cleft lip. This process reshapes the gum, lip, and nostrils with special dental molds and tape.

NAM is a special service provided at Hasbro Children’s Hospital. The Cleft Team is one of the few groups to offer this therapy in New England.

How NAM Works

This process reshapes the gum, lip, and nostrils with special dental molds and tape. The goal is to bring the edges of the upper lip and gums closer together, potentially reducing the number of surgeries your child may need for an optimal result.

A dentist will make a mold of your infant’s mouth in our office and create the device, which is similar to a retainer. The device remains in place throughout the day and is only removed for cleaning and periodic adjustments by the orthodontist.

Frequently Asked Questions About NAM

What is Nasoalveolar Molding?

Nasoalveolar molding (NAM) is a special molding technique that is offered at Hasbro Children’s Hospital for our cleft patients. It is performed to decrease the size of the cleft lip and palate and also to mold the nose to a more symmetrical shape. This procedure helps to improve the results of surgery. NAM is only offered at a few specialty centers across the country and is not available in Boston.

Will my child need NAM?

After your child is born, the dental team will meet with you and your child to evaluate the need for NAM and answer any questions you may have. Generally, children with complete cleft lip with or without cleft palate will benefit from NAM. 

How does NAM work?

If NAM is used, a dental impression will be taken on your child at around two weeks of age. A removable intraoral “retainer” is made which is held in place by tape and elastics. The dental team will instruct you on inserting and taping the appliance and answer any questions until you are comfortable before heading home. 

You will return to the dental clinic with your child for weekly adjustments that will gently guide the palate into position. Frequently, a wire “nasal stent” will be added to help mold the nose. The NAM is kept in place 24 hours/day except for cleaning after feeding, and the tapes are changed as needed at home. On the day of the cleft lip surgery, the surgeon will remove the NAM. After surgery, NAM will no longer be needed.

What are the benefits of NAM?

NAM reduces the size of the cleft, improves long-term nasal symmetry, improves future surgical results, minimizes scarring, reduces the need for additional surgeries, and lowers the overall cost of therapy.

NAM device
Each mold is individually created. Nasoalveolar molding makes surgical repair of the cleft lip easier and provides the best possible result.