Cleft Lip and Palate

Craniofacial orthodontics is a sub-specialty of orthodontics that focuses on the treatment of patients with birth defects such as cleft lip and palate. The orthodontist will work with a team comprised of speech pathologists, oral surgeons, and craniofacial plastic surgeons in planning treatment to correct cleft lip and palate, as well as other jaw and face abnormalities. As a member of a craniofacial team, a craniofacial orthodontist evaluates tooth and jaw development and growth. He or she takes care of the non-surgical treatment of the position of the jaws, and is also responsible for the pre- and post-operative treatment of jaw surgery, monitoring growth by means of X-rays and models.

If you have questions or need craniofacial care for cleft lip or palate, please contact our office today. Dr. Ambre Kragor is also affiliated with Children’s Healthcare of Atlanta on the craniofacial team. Our team members can help assist if care is required in the hospital setting our can be performed with an outside orthodontist.

Surgical Orthodontics

For some adults, orthodontic treatment alone cannot fully correct their orthodontic problem. They may also need surgery in combination with orthodontic treatment to achieve a functional, healthy bite. Surgical orthodontics, also called orthognathic surgery, is corrective jaw surgery performed to remedy skeletal problems that affect the ability to bite, chew and speak.

Orthodontic treatment is done before and after surgery so that upper and lower teeth meet appropriately, and the individual is able to more effectively bite, chew, and speak. Surgical orthodontics may be necessary for someone whose upper and lower jaws, which hold the teeth, are out of position. Consequently, the upper and lower teeth don’t fit, impairing the ability to bite, chew or speak. Our board-certified orthodontists will work in conjunction with an oral and maxillofacial surgeon to position your jaws and teeth for optimal function.

Please contact our board-certified orthodontists today if you are interested in surgical orthodontics.

Nasoalveolar Molding Device

Nasoalveolar molding (NAM) is a nonsurgical way to reshape the gums, lip and nostrils with a plastic acrylic plate before cleft lip and palate surgery. Pre-surgery molding may decrease the number of surgeries your child needs because it makes the cleft less severe.

  • It reduces the cleft inside the mouth
  • It reduces the gap in the upper lip
  • It lifts and narrows the nose

Surgery is done after the molding is complete, when your child is around age 3 to 6 months. NAM is used mainly for children with large or wide clefts, and has greatly changed cleft repair. In the past, a child with a large cleft needed many surgeries between birth and age 18, putting the child at risk for psychological and social challenges. The first surgery pulled the lip together, the second improved the position of the lip, 2 more would shape the nose, then another — often including a bone graft — would close the palate, and so on.
With NAM, an orthodontist can reduce a large cleft in the months before surgery. NAM also improves the shape and position of the lip and nose. With a smaller cleft, there is less tension when the surgeon closes the cleft. Molding the lip and nose in advance can mean less reshaping is needed during surgery. With a better result from the first surgery, your child may need fewer surgeries later in childhood.
Dr. Ambre Kragor performs the NAM treatment at Children’s Hospital of Atlanta. Please contact our office or Children’s Healthcare of Atlanta for more information.