Treatment can remove a child's cleft lip

A cleft palate can interfere with a child's breathing, eating, and speech. One in every 600 babies will be born with this defect. It's a separation between the nose, lip, and the roof of the mouth. Now dentists are using a unique therapy to prepare their tiny patients for successful surgery.

Jason Paternoster is one tough toddler. His mom, Tiffany, is thankful his only visible facial scar resulted from a recent tumble. You'd never guess the three-year-old was born with a severe cleft lip and palate.

Doctors spotted the cleft during Tiffany's routine, prenatal ultrasound. Three days after he was born, Jason began a unique treatment called nasoalveolar molding (NAM).

"Babies are very moldable after birth because of the increased level of maternal estrogen," said craniofacial orthodontist Dr. Lisa Vecchione.

With NAM, orthodontists take a dental impression of a newborn's mouth in order to create a mold, similar to a small denture. The baby wears it around the clock, guiding the mouth and lip into place.

"I make small adjustments where I add denture liner to push the gum ridge in the position I want it to be in, and I relieve areas of the denture where I want the tissue to grow into," said Dr. Vecchione.

Doctors examined Jason weekly, adding nasal stents to help shape his face. After five months, plastic surgeons repaired the cleft nose and lip.

"It really sets the stage to make surgery much easier," pediatric plastic surgeon Dr. Joseph Losee.

These days, Jason has a smile that lights up a room. Tiffany credits the surgical team and nasoalveolar molding.

"It's the most wonderful thing we could have been introduced to for Jason," said Tiffany.

This procedure is being performed at Children's Hospital in Pittsburgh. There are a wide variety of techniques currently used before cleft surgery, including lip taping and a mouthpiece that is attached to the mouth with screws. Surgeons say NAM is painless, but it can be time-consuming for the family, since it requires a weekly doctor's visit to adjust the appliance.

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