What is the purpose of a NAM device in infants with cleft lip/palate?

• A. To gently mold and align the maxillary segments before surgery, reducing tissue tension and improving surgical outcomes.
• B. To permanently close the cleft without surgery.
• C. To replace the need for postoperative orthodontics.
• D. To stimulate early speech development.

Answer: (A)

NAM, or nasoalveolar molding, is a pre-surgical approach used in infants with cleft lip and palate to gently move and shape the gums and nasal cartilage before repair. By applying gradual, calculated forces through a custom intraoral appliance with nasal components, the maxillary (alveolar) segments are guided closer together and the nasal cartilage is molded toward a more normal shape. This reduces the width of the cleft and improves nasal symmetry, which decreases tissue tension during surgery and helps the surgeon achieve a better, more aesthetic and functional repair. It’s a temporary, adjunctive treatment that aids surgical outcomes and later orthodontic care but does not permanently close the cleft and is not intended to replace orthodontics or directly drive speech development. NAM is started soon after birth and requires regular adjustments as the baby grows.