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Permalink Reply by Anonymous on November 14, 2011 at 3:54pm

I am an orthodontist and I'd like to clear up a multitude of misconceptions I'm reading here.  I recently recieved what dental professionals call "junk journals", ie ones that are in the business of looking like an actual medical journals but being nothing more than a series of adverstisements that look like articles.  It was called "aesthetics" or something along those lines and the cover caught my interest because it said "botox, face lift and orthdontics with one simple appliance".  Obviously this claim is ludicrous so I read the article to find that this "dentist" is marketing this new "revolutionary" system that can do orthodontics, dentofacial orthopedics, cure sleep apnea, perform face lifts and make non-growing adults jaws all of a sudden magically grow. 

First, there were no pictures of the appliance included in the article, which raised suspicion so I finally found some pictures on this thread.  Essentially he designed something that has been around forever.  Orthodontists and dentists have used functional appliances to aid in dental expansion or postion the lower jaw to increase the airway in cases of sleep apnea for decades and this one is not that different.  The little springs are essentially a very old school way of aligning the anterior teeth and it is actually pretty crude.  These types of retainers were developed to at least improve anterior alignment back when braces were more expensive and exclusive than today.  The wires in the middle of the appliance look adjustable so you could get some dental expansion of the arch, but don't believe for one second that you would see skeletal expansion in an adult whose palatal suture is fused.  Also, if a dentist were to expand the upper posterior teeth but do nothing with the lower teeth, I'd love to hear the complaints patients would have about their bite changing and not feeling right.  The bottom line is that this is just another form of an expander/active retainer that orthodontists routinely use in 7-11 year old children who can easily be expanded skeletally.  Adults simply do not all of a sudden magically start growing.  Please review growth and development if you are a dentist and think they do.  Orthodontists have tried every trick in the book for the last century to make the mandible or lower jaw grow in adults and it simply does not happen.  The same can be said of the maxilla and surgical correction is the only way to predictably alter bone structure.

I will say that the extension of the wire into the oropharynx is somewhat unique but I have heard of appliances that include that also.  There is no question that this can help keep the airway open while sleeping, but the comfort of the appliance may be an issue.

I also have some major issues with some of the comments by Dr. Eng.  She says, "It's safe to say that we are stunted if teeth were taken out during our youth for braces and or our third molars (wisdom teeth) didn't have room to come in straight if at all. The DNA appliance is innovative in that it has the design mechanism to wake up this growing process in adults."  I would like Dr. Eng to show me articles in well respected medical or dental journals that indicate there is a "growing process" in adults that can be "woken up".  Also, to say that people are "stunted" if teeth were taken out is a blatantly ignorant statement.  Orthodontic patients have pre-molar teeth removed at times because you simply cannot expand the dental arch sufficiently to align the teeth without putting the supporting structures of the teeth at risk by literally moving the roots of the teeth out of the bone.  We also have to remove pre-molars at times if patients decline surgical options, which is often the case.  Imagine that if an orthodontist saw every child at 6 or 7 years old then the incidence of pre-molar extractions would be much lower because we could catch those with constricted maxillas due to airway problems, but we unfortunately don't see most patients until age 12 or later when our options to modify skeletal structures become more limited.  That said orthodontists are extracting teeth in only about 10-15% of all cases these days.  Dr. Eng's claim about being "stunted" if you 3rd molars or wisdom teeth can't come in is also ridiculous because human's used to have 4th molars and we know from anthropology that jaw sizes have been decreasing over time theoretically due to dietary changes (cooked vs raw foods, etc.).  The DNA appliance would certainly have no effect on room for the 3rd molars to erupt so I don't know why she even brought that up in the first place. 

 

The bottom line is that this appliance could certainly help with sleep apnea in some cases, attempt to align some anterior teeth, and possibly allow improved growth in growing children with airway issues but all the other claims have no basis in medical science.  If you are experiencing sleep apnea issues the medical professionals to truly turn to are ENTs, oral surgeons and/or dentists who do a lot of work with sleep disturbed patients.  Orthodontists can help normalize jaw structure in growing children and that is where we are called in.  We don't simply use one appliance of course, we have been trained in a multitude of options.  Look up appliances like Frankel, RPE, etc. and you'll see that this DNA appliance is simply a tweak of available treatment options being marketed to general dentists to make a few bucks.

 

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Permalink Reply by Banyon on November 14, 2011 at 10:23pm

My brother and I have spent some time over the last year looking into appliances for jaw expansion in adults over 40. We read a lot, talked to a lot of people, and brother had a consultation with a trusted orthodontist.

We have recently dropped the idea because we came to conclusions similar to what the anonymous orthodontist posted above.

The DNA appliance no longer is of interest to either of us.

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Permalink Reply by Mary Z on November 15, 2011 at 12:05pm

Thanks for posting Anonymous and Banyon.  This is some good information.

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Permalink Reply by Jackie Chan on February 20, 2012 at 7:25pm

Does this mean an orthodontist can help an adult with widening the jaw?

 

Will this help with sleep apnea?

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Permalink Reply by Bryan Harris on February 20, 2012 at 7:36pm

As I am not an orthodontist nor an expert the only comment I can share is that I've been wearing the DNA appliance for sevral months now both upper and lower, the above picture doesn't look like either of the devices I wear. The dental office I go to offers oral surgery, general and cosmetic dentistry invisalign braces etc... I do use a CPAP so I don't know if it helps with the apnea yet or not. According to the measurements my dentist has taken it seems to be working but you do have to wear the appliances 12 hours a day which can be difficult at times.  

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Permalink Reply by Mary Z on February 20, 2012 at 8:08pm

I think it means the opposite, we have stopped growing. Dental devices can help with sleep apnea, but to what extent for each individual  would have to eventually be tested in the sleep lab to determine its effectiveness.

Jackie Chan said:

Does this mean an orthodontist can help an adult with widening the jaw?

 

Will this help with sleep apnea?

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Permalink Reply by Mary Z on February 20, 2012 at 8:30pm

Thanks.

Anonymous said:

I am an orthodontist and I'd like to clear up a ....

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Permalink Reply by david urban on May 12, 2012 at 2:06pm

As a dentist who has been practicing for 31 years I would tell you that the tongue increases or decreases in size on a regular basis.  A major problem for us is making dentures for a patient who has been mising teeth for a long time.  Their tongues are 20 percent larger than those with teeth.  Tongues get smaller when there are teeth in place and the tongue will shrink when dentures have been regularly used.  we also see these things in people that are missing a small number of teeth.  The tongue shrinks with the placement of teeth.  It takes some time though.

Mike said:

shocking the claim that the tongue shrinks to fit the size of a mouth !  wonder what he makes of scalloped tongues.  anyway, the DNA appliance is compelling if it works.  interesting the suggestion that other forms of orthodontics do the same thing.  Dr. park is doing one of his expert interviews with the DNA Appliance founder Dr. Singh: http://www.sleepguide.com/forum/topics/expert-interview-epigenetic  Someone should ask him whether other orthodontics do the same thing and see how he responds.

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Permalink Reply by Bryan Harris on May 12, 2012 at 9:37pm

I wear both the upper and lower DNA appliance, keep in mind I'm only a patient and not a dentist. The devices seem to be working. My teeth are straighter, it's much easier to floss, and crowding is diminishing. I have severe obstructive sleep apnea, I'm a 5'8" 180lb male, when I was in the Army and wieghed 140lbs I still snored like a buzz saw so wieght isn't the issue. I will always wear a CPAP however if I'm away from my CPAP and take a nap I find my throat doesn't hurt like it use too in the past. I'm still under treatment and have only been wearing the lower device about 6 months now and do not regret  the purchase. Take from this post what you will, if you do decide to go foward with the DNA device report any discomfort promptly to your dentist, mine required a little adjustment a few time as it was expanded.  

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