By School of Dentistry - November 11, 2014

LLU School of Dentistry celebrated five years of cleft lip and palate corrections with an October 24, 2014, reunion of the preschoolers who have benefited by the procedure known as Pre-surgical Nasal Alveolar Molding (PNAM).

It was a gathering of alumni, five years old and younger, at Loma Linda University Health’s Centennial Center, surrounded by their loved ones and members of the LLU School of Dentistry Department of Pediatric Dentistry and the Loma Linda University Children’s Hospital Craniofacial team that is enabling these children to mature without the stigma of a facial deformity.



PNAM alumni and parents

Led by the School of Dentistry’s Jung-Wei Chen, DDS, MS, PhD, Professor and Program Director, Advanced Specialty Education Program in Pediatric Dentistry, they assembled to celebrate the success of 84 PNAM-augmented unilateral and bilateral cleft lip and palate repairs with nearly half of the young patient alumni who received the treatment.





Dr. Chen with PNAM alumnus Chassity Carreno

PNAM (Pre-surgical Nasal Alveolar Molding) is an advanced pre-surgical orthopedic treatment that employs an orthodontic-retainer-like device to enhance the effectiveness of surgery and reduce the number of surgeries required to achieve a functionally and cosmetically satisfying correction.





PNAM retainer

The festive three-hour reunion brought together parents and children who have surmounted the disabling birth defect of a cleft palate and cleft lip that unrepaired leaves the victim badly disfigured, unable to nurse normally, with badly impaired speech potential, and particularly susceptible to infections of the ear, nose, and throat.





Taciturn PNAM alum Isaq Akhlaghi with his proud parents




Jude Morales and brother share their father’s arms.

To see these children toddling around having their faces painted, throwing bean bags for prizes, decorating pumpkins, enjoying healthy snacks, and towing balloons, it would require a forewarned observer to realize these children were anything but a typical group of preschoolers.




Jesus "Panchito" Loustanau fronts oversized dentures with pediatric resident Ava Chung, DDS, in the background.
Face painting fun
Bat girl Donata Cullari and her mother the referee

The first two hours were devoted to fun and informal visits between parents who have been through the similarly disheartening trauma of seeing their newborns appear significantly disfigured. There were also reunions between the parents and the pediatric dentistry and craniofacial team members who have supported them through the extended PNAM process and surgeries that have restored their children to normal function and appearance.




Pediatric dentistry residents (L-R): Minh-Ky Young, DDS; Pooyan Nasibi, DDS; Ryan Baker, DMD, MPH; and Xuan Lam, DMD

At 11:00 a.m., the adults were seated and welcomed formally by LLUH President Richard Hart, MD, and School of Dentistry Dean Ron Dailey, PhD. Dr. Chen then hosted the opportunity for several of the families to take the microphone and share their emotions of disappointment and ultimate elation, as their babies have blossomed under the restorative procedures and emotionally supportive care of the Pediatric Dentistry contingent and Craniofacial team. Among those who spoke so eloquently were Margaret Thronson, mother of Noah Thronson; Melissa Vega, mother of Aubryana Vega; Caasi Lee Bartle, mother of Micaela Drury Bartle; Melissa Ann Youkhanna, mother of Jacob Youkhanna; Nancy Lombera, mother of Andrew Granda. Martha Flores, mother of Logan Flores.




President Hart visits with Noah Thronson.

Maria Ramos, mother of Shawnee Ramos, was the last parent to speak. She and her husband, Tommy, founders of Shawnee’s Smiles, provided each PNAM alumnus a sturdy canvas tote bag that contained a three-ringed binder with dividers devoted to various records and appointments with all craniofacial specialists, a stuffed bear, and several other essential items. Since its founding in 2008, Shawnee’s Smile has sponsored many families in the Inland Empire that could not afford the specialized bottles and feeding systems essential to feeding their babies born with cleft lip and palate.





Maria Ramos watches as Dean Ron Dailey prsents her daughter, Shawnee, an award.

And Kate Yist, mother of Jake Yist and founder in 2010 of Tiny Wide Smiles – Doll Clinic, donated seven gift dolls with craniofacial anomalies for the winners of the PNAM alumni drawing.





A basket of Tiny Wide Smile dolls

Annie Wallace contributed generously to the Loma Linda Craniofacial Team Center providing specialized bottles and feeding systems for cleft lip and palate babies and other valuable resources.

School of Dentistry clinicians and administrators hope to create a PNAM alumni support group for cleft lip and cleft palate patients and their families. In the meantime, Friday’s reunion photos taken of the young alumni with their families have been posted on the Internet.





PNAM alumnus Esmerelda Sotelo in the arms of her mother

The School of Dentistry’s Department of Pediatric Dentistry is one of only three providers in Southern California (and the only one in the Inland Empire) that offers the greatly reduced number of surgeries and improved esthetic outcomes that PNAM makes possible.

Cleft lip and cleft palate are among the most common birth defects in the United States, with approximately 4,440 cleft-lip babies born in the United State each year with or without a cleft palate. Pre-surgical orthopedic treatment of the cleft lip and palate has become the treatment of choice for a growing number of craniofacial teams that have seen the benefits of using a nasal alveolar molding appliance prior to surgical lip repair. The PNAM appliance not only molds the affected intra-oral and extra-oral structures, but also provides nasal support to mold the infant’s collapsed nostrils.

Additional information about PNAM may be obtained by calling the LLU School of Dentistry’s Department of Pediatric Dentistry at (909) 558-4689, by emailing, and by reading online an article by Dr. Chen detailing the PNAM procedure.