title: An access to care study for the pre-surgical nasoalveolar molding and other treatments for cleft lip and palate.
abstract: OBJECTIVE
  This study is designed to ascertain whether a regional bias exists, as well as provide a reference to those seeking the various modalities used in pre-surgical intervention for cleft lip and palate either for their own patients or educational purposes.
  
  
  METHODS
  A survey was constructed using Survey Monkey and distributed via e-mail to American Academy of Pediatric Dentistry members. Approximately 3689 surveys were delivered consisting of 12 questions asking whether they provide pre-surgical intervention to cleft lip and palate patients, and what type of interventions they use.
  
  
  RESULTS
  A total of 572 members responded. Of the respondents, 480 reported they treat children affected by cleft lip and/or cleft palate. Of these, only 102 reported that they provide pre-surgical treatment. Pre-surgical nasoalveolar molding (PNAM) represented 29.2 percent of the interventions used and was most heavily concentrated in Texas. Other modalities used included the Latham appliance, lip adhesion/tacking, the passive appliance, and a category 'other' was included. Those checking 'other' most often described alveolar grafting prior to later surgical procedures than were of interest in this study. The University of Texas Health Science Center San Antonio had the largest number of respondents using the PNAM.
  
  
  CONCLUSIONS
  A very small proportion of pediatric dentists are providing pre-surgical intervention of any kind to patients with cleft lip and palate. However, those that are providing the service are spread around the country enough to consider PNAM as the standard of care for pre-surgical infant cleft treatment.
authors.affiliation: Craniofacial Anomalies Team, Christus Santa Rosa Hospital, Texas, USA.
authors.forename: Carlen P
authors.initials: CP
authors.lastname: Blume
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Henson
mesh_terms: D000328:Adult; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009967:Orthodontic Appliances; D009989:Orthotic Devices / Q000706:statistics & numerical data; D010158:Palatal Obturators / Q000706:statistics & numerical data*; D010347:Patient Care Planning; D010377:Pediatric Dentistry / Q000379:methods / Q000706:statistics & numerical data; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data; D011300:Preoperative Care; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D015625:Tissue Expansion Devices / Q000706:statistics & numerical data