The NewFace Foundation
A Non-Profit Corporation that Benefits Children Born With Facial Deformities
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The NewFace Foundation A Non-Profit Corporation that Benefits Children Born With Facial Deformities |
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Dr. Ralph Latham The World Famous Latham Device
Dr. Ralph Latham and Foundation Executive Director Pamela Peters Millard Society Meeting November 2001
Orthodontic Appliances for Cleft Palate Infants By Dr. Ralph A. Latham When a baby is born with a cleft that goes through the lip and the gums as well as into the roof of the mouth, parts on either side of the cleft do not match together and are often separated by a wide cleft gap. There is distortion of the parts of the face as well, and that happens after the cleft first forms. So much of what is wrong at birth is caused by lip, gum and nose parts that are out of their normal place. Many clefts do not completely separate the parts of a child's mouth and they are closer to their normal position. Plastic surgeons see their best results in the child with an incomplete cleft. New treatments used before surgery can turn a severe cleft to look like an incomplete one and then the surgeon has the opportunity to accomplish more for the child. Endeavors by dentists to team up with plastic surgeons to provide this treatment started in the 1950's led by Dr. McNeil in Scotland. Under his guidance a second generation pioneer in England, Dr. Bill Burston, expanded the idea of dentists working with the newly born babies. Dr. Burston recruited Dr. Latham fresh out of dental school to make the third generation step. Quite A big step it turned out to be. Dr. Latham eventually joined the team of Dr. Ralph Millard at the University of Miami. Dr. Paul Howard was the senior resident in Plastic Surgery there at that time. As a result of dedication to excellence from the chief down to the residents, cleft infant orthodontic treatment developed into an essential part of the surgeon's treatment plan. Dr. Millard wanted to achieve his result with the fewest number of surgeries, with later growth and development, he looked for a smile that was supported by nice straight teeth. The need for good long term growth has to be factored into the surgical plan for the infant. The part played by an appliance is easily seen in the time leading up to the first surgery, but the opportunity for better surgery that is provided is what is going to matter most of all in long term and cost saving benefits.
Dr. Latham has an orthodontic practice in London, Ontario, Canada, where he is fortunate to have his daughter Emma as an associate orthodontist. He is in touch with many plastic surgeons and dentists in the United States who contact him regarding their new patients with cleft lip and palate.
This is a picture of the Latham Device before it is surgically placed in the patient. Notice at the top of the picture the screw in the area where the cleft is in the maxilla. Over time (approximately 2-3 weeks), the screw is turned 3/4 of a turn everyday until tight. The screw pushes on the back bracket to rotate the two side brackets upward and together. The baby doesn't feel any pain from the Latham device, and can feed as normal. The infant will usually stop gaining weight while the device is in place. After removal of the device and the cleft lip repair, weight gain should return to normal. The advantage of this device is that it helps to to bring the cleft together making the cleft lip repair easier and allows for a more complete nasal repair at the same time. It reduces the need for multiple gum surgeries later in life. Latham Devices are recommended for Complete Cleft Lip and Cleft Palate. There are case where a Latham Device is not recommended such as an Incomplete Cleft Lip.
For more information about Dr. Ralph Latham and his Device, you may contact him at:
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Navigation: ***The NewFace Foundation does not pay for adult cosmetic surgery. This Foundation benefits Children Born With Facial Deformities. Please do not contact us if you are an adult seeking financial assistance for cosmetic surgery. Send mail to
CleftLip@aol.com with
questions or comments about this web site.
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