Clinician’s Corner: To Mold or Not to Mold?

ACPAACPA News, Clinician's Corner

Pat Ricalde, DDS, MD

To mold or not to mold? That is the question.

Presurgical molding tapes and appliances have been around for many years. And yet, the issue remains incredibly controversial, divisive, and confusing (to say the least) for families. At my institution we offer several options. We offer the option to do presurgical molding via taping or naso-alveolar molding, as well as the option of no presurgical molding. The only device we do not advocate is the Latham appliance. One thing I’ve learned over the years is that it’s nice to have a bag of tools in your armamentarium.

Not all options are best suited for every patient and family. Some parents love presurgical molding, and they can see changes daily and follow the instructions for care diligently.  Sometimes the child’s skin is just too oily, or too sensitive, for taping. Some babies do not tolerate molding appliances. Some parents do not have easy transportation to appointments, and might have other financial barriers.  And some parents are perfectly happy kissing a face without any appliances until the day of surgery. Let’s not judge them, or judge each other. Let’s continuously strive to provide individual treatment plans and allow outcome studies to guide our conversations.

DISCLAIMER: This segment is meant to tap an invited expert to provide a perspective on a clinical topic. It is not a definitive statement on behalf of ACPA, rather it is intended to be a forum for various viewpoints. This is meant to present one clinician’s approach, stimulate member interest and provide something to spark discussion among your team members and professional colleagues. If you think that you have a topic that would lend itself to this format, please feel free to email it to us. Ideally, articles should be 350 words or less and include no more than four photos, images or diagrams to illustrate the content. A poll could be included, and results can appear in the next Member Monthly Digest.