Nasoalveolar Molding (NAM)

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Depiction of cleft lip and cleft Palate

Nasoalveolar molding (NAM) is used to treat cleft lips (Picture 1) and cleft palates (Picture 2). Naso means nose, alveolar refers to the gum line, and molding means something that changes and holds a shape. NAM slowly moves the gums closer together and helps close the gap (cleft) in the palate and the lip. Treatment should start 1 to 2 weeks after birth. Your child may not need as many surgeries if NAM is used to reshape the gums and nose.

How It Works

  • A nasoalveolar mold (NAM) is a plate made of acrylic dental material that is placed in the top (roof) of a baby’s mouth by a dentist or orthodontist.
  • The NAM fits on the roof of your baby’s mouth. It is attached with small rubber bands that are taped to your baby’s face. Each week, the orthodontist changes the shape of the NAM to guide your baby’s gums as they grow.
  • Small acrylic pads, or nasal stents, are used to reshape the nose. If your baby has a 2-sided (bilateral) cleft, the nasal stents will be used along with tape that is placed on the upper lip. This will help lengthen the bridge of skin between the 2 nostrils, called the columella.
  • Once the cleft in the gums has closed enough, a post is attached to the molding plate and placed in the nostril. This post is then slowly adjusted each week to lift the nose and reshape the nostril.

Before Treatment

After your baby is born, your doctor will refer you to a cleft lip and palate specialist at Nationwide Children’s Hospital. They will discuss your baby’s needs and the benefits of NAM treatment with you so you can start treatment as soon as possible.

Making the NAM

To make the NAM, your baby’s orthodontist will:

  • Take pictures of their cleft lip or palate.
  • Do a full clinical exam.
  • Make a mold (impression) of your baby’s upper jaw with soft, medical-grade silicone. This is not painful.
    • Your baby will need to stop feeding 2 to 3 hours before the impression is made.
    • Your baby may be upset while the impression is made but will calm down soon after
      it’s over.
    • You will get a custom molding plate 1 to 2 weeks after the impressions are made. This will look like an orthodontic retainer.

During Treatment

Your baby may be upset that there is now something in their mouth all the time. It is normal for them to cry until they get used to this new feeling.

  • Your baby will wear the NAM all the time (seven days a week, 24 hours a day), even while eating. After the first few days, they should get used to it.
  • It may take some time for your baby to get used to the NAM. They may have trouble feeding at first.
  • Your baby may cry when the tape is put on their face or when the NAM is placed in their mouth. They will calm down soon after.

How to Care for the NAM

  • Take the NAM out of your baby’s mouth and clean it one time each day. Use warm water, a toothbrush, and dish soap.
  • Before placing the NAM back in your baby’s mouth, look for rough spots, breaks, or changes on it. These may bother their tongue or gums. Call us right away if something is different.
  • Do not boil the NAM. It will melt.
  • Do not put the NAM in the microwave.

Follow-up Visits

You must go to the scheduled weekly visits with the orthodontist. This is the only way your baby’s treatment will work. Appointment times depend on the type of cleft your baby has.

  • 1-sided (unilateral) clefts: You will go to clinic visits each week for 3 to 4 months, depending on the severity of the cleft.
  • 2-sided (bilateral) clefts: You will go to clinic visits each week for 5 to 6 months, depending on the severity of the cleft.

It’s important to feel comfortable with your baby’s NAM. Call the cleft lip and palate team for any questions or concerns at (614) 722-5602.


Nasoalveolar Molding (NAM) PDF, Somali (PDF), Spanish (PDF)

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