skeptical inquiry, part 2: epigenetic orthodontics

Standard

I took some time to look through the literature cited on the “DNA Appliance” Web site. As a non-scientist, this is what I could glean from the articles:

– There are orthotics that can help change the alignment of the jaw and other structural parts of the head and face.
– These are most effective when used in children, when they can help “guide the growth” of the mouth and face.
– With children, you might be able make a case for an orthotic affecting gene expression over time, but I don’t have the expertise to know whether that’s a  valid claim.

Suspicions are raised by the following:

I didn’t see anything in PubMed about somehow using or taking advantage of epigenetics for treating adult mouth and airway problems. If you read the Web site referenced above, you’ll notice carefully worded statements about the efficacy and nature of the treatment. Examples (the italics are mine):

“Dr. Singh believes that (his orthotics) are capable of modulating genetic pathways…”
“…appliances, which may invoke natural developmental processes…”
“…the human genome is implicated during…airway treatments…”

Dr. Singh wrote a textbook with a co-author that costs $294.00 and there is no indication of who published it or who, if anyone, reviewed it.

I also found something on a list of SMILE Foundation seminars. Dr. Singh is giving a lot of seminars on epigenetic orthodontics this year. Yes, the course is expensive, but please go to the bottom of the listing. This is copied straight from the Web site:
_______________

INSTRUCTOR
Dr. Dave Singh

REGISTRATION INFO
Course Number: Singh1
Course Fee: $ 1995
Early Bird Fee: $ 1995
Early Bird Deadline: 11/20/2010
Additional Details: Staff: $195

*FREE DVD “Epigenetic Orthodontics in Adults” featuring Dr Jim Krumholtz and Dr Dave Singh

*FREE textbook “Epigenetic Orthodontics in Adults” by Dr Dave Singh and Dr Jim Krumholtz

*FREE Diagnostic support (first case)

*21 CE credits

*All lunches and refreshments

SEMINAR DESCRIPTION
Advances in technology and molecular genetics have provided new approaches to orthodontic care in the 21st century. The aim of this course is to provide new perspectives on the provision of orthodontic care for both adults and children. One of the most important aspects of orthodontic treatment is diagnosis. This course will help improve your diagnostic skills to help identify and expand your practice of orthodontics. Specific topics will be discussed including the growth and development of the face. In addition, diagnostic clinical facial features will be highlighted with a view of mid facial development. These principles will be tied together under the new concept of ” Foundational correction which takes facial growth and genetics into account for stable functional corrections associated with craniofacial homeostasis.

SEMINAR HIGHLIGHTS
The epigenetic orthodontic technique will:

1. Improve tooth alignment

2. Enhance facial esthetics

3. Decrease TMD issues

4. Correct obstructive sleep apnea.

Using this technique, treating 2 patients a month can increase your practice by $100,00 a year.

___________________

The boldface and italics are mine. I suspect there’s a typo and it should read $100,000 per year. That comes to more than $4,000 per month for each patient. I couldn’t find any other seminar that was so blatant about the cash involved.

This, of course, does not invalidate the concept of adult epigenetic orthodontics. It does add some fuel to the fire. Unsubstantiated claims (in the case of adults), plus a big dollar reward–make of that what you will. I’ll leave it there until I can find a medical professional to weigh in on this.

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82 thoughts on “skeptical inquiry, part 2: epigenetic orthodontics

  1. I am currently using the DNA Appliance and have been for six months. My upper jaw expansion has just hit the 5mm mark and there is a huge difference in my teeth.

    I’m hugely impressed..straighter teeth already (and only part way through the treatment).

  2. Jennifer

    There is very little evidenced based dental/orthodontic science ANYWHERE. It is very discouraging to be suffering the ill effects from the radical 1970’s orthodonture, toxic products used in the mouth and hasty dentistry incurring malocclusions and poor bites.

    • dangblog

      Thank you. I did a bit of searching and it looks like there *is* a desire out there for more evidence-based research. I hope that research is happening and I hope this “epigenetic” technique gets a rigorous appraisal along with everything else.

    • It’s true that there is very little evidence/based research, although our specialty speaks much about it and is trying hard to obtain some. The lack of such evidence is one of the reasons that patients get so many different opinions when they visit different orthodontists. We lack solid evidence for several reasons: Making accurate measurements on people’s heads and teeth is inherently difficult. Further, obtaining control groups is also often difficult (who wants their child not to recieve what the doctor thinks is the best treatment).

      Jennifer, what toxic product was used in your mouth? In many ways, orthodontics is very similar today to how it was in the 70’s.

  3. I recently received an advertisement to one of Dr. Singh’s classes. This advertisement is directed at general dentists, not orthodontic specialists.

    I searched for “epigenetic orthodontics” in both the American Journal of Orthodontics and the European Journal of Orthodontics. There are zero articles published in these most prestigious journals. I also read the description of this technique on Dr. Singh’s website. On his webite, Dr. Singh states that the “entire human genome has now been sequenced”, implying that this work is somehow related to his “new” and “different” technique. Epigenetics is when a cell’s dna expresses itself in a different manner without a change in the original dna. This means that a different protein is produced. If Dr. Singh could name a single protein which is being changed as a result of his efforts, and which is different which conventional appliances produce, he might begin to have some credibility. I would be surprised if he could find actual genes which his technique is affecting. This might give some “real world” basis for the name of his technique.

    It appears that his technique involves orthotic type appliances which change the way the patient postures his jaw and sometimes positions his tongue. The cheek positioning can also be affected. I would be extremely surprised if any of his appliances do anything that could be shown to be even moderately different than the huge array of functional type appliances which have been employed by orthodontists over the past century.

    Dr. Singh may have something which is an improvement, but the name of his technique appears to be throwing unsubstantiated hype at what he is doing, something done by snake oil salesmen.

  4. One more thing…the publications he has listed under his name on his website are not from bona fide journals. The top two appear to be from a book he is publishing. The third one is from a group which puts on seminars. The fourth one I am not familiar with, but the title tells me that it is not about his appliances or epigenetics, and the last three relate to well known theories on human facial growth, where genetic and epigenetic roles are being hypothesized.

  5. dangblog

    Thanks for your comments, Dr. Nisson. The epigenetic claims did seem to me like double-talk or at least a misleading bit of hype. It’s good to know that someone who practices orthodontics (and dentistry) feels the same way. Much appreciated.

    I suspect the lack of evidence-based research could make orthodontics a fertile field for exploitation.

  6. yacman

    If Dr. Singh’s dental practice is not based on evidence-based science, then I wonder if his methods should be brought to the attention of some sort of state medical or dental authority. My heart goes out to the potential “patients” of Dr. Singh who might pay thousands of dollars not knowing that his techniques are not substantiated. Dr Nisson, do you happen to know others in the dental or orthodontia community who might wish to look into this?

    L. Scot Bastian Ph. D.

    • Dr. Singh’s techniques I am sure are completely above board, and I am sure that he is making a lot of people happy. What I don’t like is that he is putting a new name on something that has been around already for a long time, and plays this up with flowery and meaningless language. The other thing people should be aware of is that it appears to me that the majority of his students, at least in the U.S., are not specialists in orthodontics.

      • Sara

        I started using the DNA appliance over a year ago since that time I have had two episodes where I have had an erosion on my upper pallet resulting in exposed bone in an area of about a dimes circumfrence. I had had to have oral surgery to remove the bone, bone grafts, extreme pain, not to mention the financial burden. In addition, I have also suffered abscesses underneath three teeth that have had root canal performed in the past. I ended up having to have one tooth pulled because, despite immediate attention and action to save the tooth, the damage was so extensive that nothing else could be done. I dentist recommended the DNA appliance to help treat mild sleep disturbance. My dentist assures me that all my dental problems are not a result of the appliance, however, they all took place after I began wearing the DNA. In fact, I had stopprd wearing the appliance for four months, wore it two days and immediately had exposed bone. I have seen two oral surgeons and two endodontist who are very skeptical. To recap the appliance cost me over 6000 dollars, the fist exposed bone episode ran me about 2000, the three abscesses teeth about 5000, the second exposed bone about 2500, and I still have additional treatments. I am disgusted. My teeth were perfect prior to this treatment. Now, I am just hoping to save them.

    • Dr. Basitan sounds like the typical paid-for special interest Gestapo. I’m just an educated layman, a 43 yo military veteran, a skeptic, yet my intellect has yet to be corrupted by an advanced degree like Dr. Bastian.

      I suggest you get out from behind your computer and correspond with Dr. Singh personally to validate your intellectual fears and prejudices. I’ve used a derivative of the DNA appliance and have experienced upper palate expansion, although to a lesser degree.

      Dr. Basitan, would my experience be a product of self-delusion ?

      Regards,

      Jay Polatnick
      Odenton, MD

      • dangblog

        Congratulations, Jay! You are the first poster to invoke Godwin’s Law (look it up if you have never heard of it) and thereby automatically lose your argument.

      • Samuel J. Higdon, DDS

        The path between open mindedness and healthy skepticism is a very narrow, treacherous path that is difficult for anyone to walk. Carl Sagan stated, “Skeptical scrutiny is the means, in both science and religion, by which deep insights can be winnowed from deep nonsense”. He also said that extraordinary claims require extraordinary evidence. With regard to Dr. Singh’s claims, both of these need to be considered. Dr. Singh is certainly making extraordinary claims. We should all ask how good his evidence is. As to your personal experience, in science it would be considered anecdotal — not to be ignored but certainly not proof of anything.

        Sam Higdon, DDS
        Portland, OR

  7. It appears to me that Dr. Singh is what has been termed for decades as a “functional orthodontist”. He has given it a new name. Functional orthodontics typically involves intraoral orthotic type appliances which effect changes. These types of appliances have been in widespread use for over 100 years and they can be remarkably varied in both their design and implementation. I believe that their use is much more widespread in Europe than they are in the U.S. The use of them has dropped off significantly to my knowledge when a Kevin O’Brien, in Britain, someone who had been a staunch proponent of the appliances, did a prospective randomized controlled clinical trial (a very well designed study). His study found that use of the Twin Block appliance (an appliance to treat overbite’s by forcing a forward posture of the lower jaw) did not produce any significant change in the underlying skeleton, which is what functional orthodontists claim. His studies concluded that the appliance tended to result in increased length of treatment and increase in cost, without any increase in benefit when the treatment was followed by braces, which is typically done.

    I have used functional appliances. I stopped when a teacher told me that children who have these appliances tend to shut down in class. In other words, they can be difficult for the child to live with.

  8. EpigeneticsGenomicsGirl

    We went to our dentist with the kids to get a teeth cleaning and some advice if my daughter may need a brace in the future (she is 7). The doctor then started to recommend this ‘great new approach’ (which only would cost us $8,000!), called ‘DNA appliance’ and went on with some gibberish about ‘epigenetic orthodontics’ and how it would change her genes and improve the immune system of the child. Now it happens that I am a scientist who is a geneticist (with a PhD) and works in the field of ‘epigenetics’ and ‘genomics’. I could not believe the utter nonsense I was hearing and the utmost ignorance of any scientific background of the doctor who tried to sell us this stuff. A few probing questions and a look into medline and Dr. Singh’s website made clear that this is fiction. If it were not so serious that this is a shrewd way of trying to rip off people I could laugh at this nonsense. There is NO scientific basis WHATSOEVER in the claims Dr. Singh et al. are making. I’m glad the human genome has been sequenced and the field of ‘epigenetics’ has indeed seen a tremendous increase in research and publications in recent years but there is no connection between epigenetics, gene expression, the immune system and braces or orthodontics whatsoever!!! I am appalled and angry by their attempt of a clear money making scheme and that some non-scientist individuals will be ripped of to buying something at a premium that has been around for ages and will be impressed by this pseudo-scientific nonsense!! Be warned – don’t believe in their snake oil!!!

    • Maya

      Since your daughter is only 7 – well 8 by now, she could still benefit from nutritional therapy if she needs braces. Look into the work of a dentist called Weston Price. He was basically studying epigenetics before it was termed.

      • Maya

        I was aware of Barrett’s view on Price’s work, though I hadn’t looked much into Price’s theory on root canals – which is what I gather you’re referring to. It was his connection between nutrition and cranial facial development to which I was drawing attention.

        I am not looking to convince anyone of anything, but I feel it is only fair to post the rebuttal to Barrett’s article so that readers can view both and decide for themselves.
        http://www.westonaprice.org/basics/the-right-price
        (Scroll down to “Quackwatch on Dr. Price)

      • dangblog

        Thanks for the link, Maya. So are you saying that if a 7-year-old needs braces, she may be able to straighten her teeth through nutrition? Do you have any references other than Price?

    • Sara

      I was suckered into this. Not only did I suffer the cost of the appliance, but I have he’d a whole host of issues including tooth loss, bone loss, and money loss…..but I do appreciate the brand new state of the art office my dentist just built.

  9. Dr Erik Reukers

    With great interest I have read the discussion above. Dr Singh will give a lecture for the Academy for Sports Dentistry in June 2011 about Epigenetic Orthodontics. When I read the summary it looked as if it was to good to believe and now I am convinced that it is.
    Functional orthodontics works fine in growing children. I advise my patients to wear the appliance 12 hours each day. This means taht they do not wear it during school or when playing. From 7 pm until 7 am is enough to solve overjets of 10 mm and more without using extractions or headgear.
    I agree that in orthodontics Evidence Based treatments are rare. Companies selling appliances make claims that are misleading patients and doctor. I wrote a PhD thesis about the Straight Wire Treatment (Straight Wire Appliance versus Conventional Full Edgewise. A prospective clinical trial 1997). I showed that all the claims the companies made lacked evidence and that there was nearly any difference. Ik think that if a clinical trial is done comparing epigentic orthodontics and funtional orthodontics, no differences will be found.

    • Elizabeth Bollmer

      I’m not sure what to think & do for my lower jaw after reading about Epigenetic Orthodontics (EGO). As a child I had buck teeth and an extreme overbite. The solution in the 1970’s was braces & head gear that pulled the teeth and jaw back into alignment. (my 1st set of braces) I was 12 and in the 6th grade.

      And from that point on I have had severe head/jaw/neck pain over the last 35+ yrs. This has caused asymmetry to my face, swelling and inflammation, displacement of the lower right jaw, locking of the jaw, difficulty chewing, eating etc.

      I have been to an oral surgeon who wanted to give me trigger point injections into the TMJ area that had risks of nerve damage & possible vision problems in my right eye. I passed on that treatment and dentist.

      My family dentist, who mainly treats adults, has twice fitted me for braces to expand the upper jaw to correct what the 1st set of braces did to me in the 70’s. That was in the mid 2000’s. I had the third set of braces about a year & 1/2 after the 2nd set when the retainer I wore to bed broke due to the muscles pulling and my jaw clenching in my sleep.

      The 3rd attempt seemed o.k until early 2009. My face and jaw swelled up and Ii couldn’t chew, bite, etc., without biting the inside of my mouth. I felt I was back to where I started.

      I was tested for trigeminal neuralgia- negative. solution- I was told to open my mouth more- I couldn’t. So I went back to my dentist. This time I had an orthodic splint made that I wore 24/7 even when I ate. it gave some relief. That was in April 2010. Near the end of 2010 there was nothing more the dentist could do. She added acrylic fillers onto the orthotic to get the lower jaw to keep moving forward and to keep the left side of my jaw from continuing to pull the right lower jaw off center,keeping the right lower tm joint dislocated and out of alignment.

      I’ve worked w/ physical therapists & well trained, knowledgeable massage therapist to help release my right lower jaw. Only once the right jaw released. That involved intense, painful intercranial trigger point/muscle work inside of my mouth. I was pain free for 2 hrs and then everything shifted back.

      Then my dentist told me about Epigenetic Orthodontics. She is training w/ a specialist (don’t know name) and said “she will call me” when she’s ready to do this treatment correctly. She was using my case specifically to train w/ the specialist.

      Now I am confused & frightened by what I am reading here. My massage therapist said she can give me some relief but structurally I need some type of treatment/surgery to correct my problem. I can’t sit for more than 15 min. w/out head & neck & jaw pain. When I’m upright and moving I feel off balance, stumble around and have actually fallen a few times.

      Doing all my own online research on this and then finding this review blog; Well – I’m flabbergasted. Who & what do I believe now? If this EGO does work how much does it cost? I don’t have dental insurance. To me this should be a major medical situation. It’s in my jaw. My teeth are fine. My head always hurts. This has severely impacted my life, my body.

      Any feedback, help, would be greatly appreciated. Thank you for posting this blog.

      • mk

        I don’t know if this will reach you, but I have been reading up on all this business because I’m interested in fixing bad orthodontic work of my childhood as well. I cannot recommend this because I haven’t researched it well enough, but just to let you know it exists, there is a treatment called “neuro cranial restructuring”. Some of the claims are very good, but some of the skeptics also say it could be dangerous because people have suffered when they put this balloon in you nasal passage. Either way, it might be worthwhile looking up.

      • You need to call a dentist by the name of Bill Dickerson in Las Vegas Nevada. If he can’t help you I would be surprised. He is one of the best dentists of our generation and is probably the most experienced dentist I know for treating what you describe. Give him a call and see what you think. I think you will be happy.
        Sincerely,
        David S. Peterson DDS, FAGD, FICOI, Misch Fellow

      • Alex Mangan

        Hello Elizabeth,

        I too have suffered constant 24/7 head, ear and facial pain…for the last 14 years and strongly believe it’s my jaw position (from ’70’s braces) that is perpetuating the pain. Yes, it does affect your whole body. Dry needling into the pteregoids muscles and trigger point injections into the occipital muscles has lessened the pain.

        Please keep in touch as I’m interested in the DNA appliance. If it works, it could be a godsend.

        Thank you.

  10. Lisa

    Hi. I’ve just got my DNA Appliance. I’ve been using it for 3 nights without any problems except for the horrible excessive drooling. I came across the comments here when I was trying to find out why one is only supposed to use the DNA Appliance in the evenings and at night.

    Interestingly, almost all of the articles I’ve found online related to the DNA Appliance are either from the Appliance website or copied and pasted from the website and there is no proper explanation of “why” only in the evenings and at night. Could it be to do with melatonin production? I’ve not been able to confirm any information and it’s very frustrating.

    Is Dr Singh “overpromising” the benefits of the device? I don’t know but I will keep this site updated as my treatment progresses.

    My dentist recommended the DNA Appliance because I grind my teeth at night. I also clench my jaws in my sleep. I know because I’ve woken up from the pain from the pressure of the clenching – it felt as though my teeth were about to shatter. I also snore badly, have sleep apnea, severe sinusitis, migraines….. basically I have nothing to lose by trying out the DNA Appliance.

    Since using the DNA Appliance I’ve not snored at night nor ground my teeth. Those are already two benefits. The bonus is, apparently, that my teeth will be straightened – a bug bear since I was a teenager. I couldn’t have braces done then because I could not have regular access to an orthodontist to monitor the treatment. I did see a dentist every 6 to 8 months and most said that my irregular teeth were mostly cosmetic than a serious orthodontic issue.

    Then, when I was older, I was not a candidate for adult braces because I have veneers on my front teeth. I am 41 and had the veneers done about 18 years ago. Braces were not recommended before the veneers were done because my bite is apparently very good (class 1 occlusion, I think is the term the dentist used) but now that I grind my teeth, the situation with my bite has changed.

    I will definitely keep you updated on my progress with my DNA Appliance and check back from time to time to find out how others may be doing with their DNA Appliances. I admit all the info comes from Dr Singh alone and there are a lot of unanswered questions. Also, the emphasis on on profitability of DNA Appliances is really tacky but the key thing is still, does it work after all that???

    • Elizabeth Bollmer

      Hi Lisa,
      What I found out about the appliance is it is to be worn early evening and overnight. The overnight is crucial because that is when we produce human growth hormone (hgh) and as we sleep hgh stimulates growth, cell reproduction and regeneration. So the DNA- Day Night Appliance along w/ restorative sleep is supposed to allow the treatment to work cooperatively with the body, not harshly as braces or even jaw surgery would do. This to me seems like an innovation in how to treat various jaw disorders. My dentist said it would cost me $3600, that she would not charge me for her time, especially since the braces didn’t work for me. So I can only think that she does want to help me and not make money off of me. I will post my progress after I begin this treatment. And I say progress because I am hopeful this will work.

  11. dangblog

    Thanks everyone, for your comments.

    Elizabeth I’m sorry to read about all your troubles. You might try calling the office of Dr. Nisson (who posted above) and see if you can get a referral for someone in your area. Definitely get more opinions.

    Yes, the treatment might help some people, but I personally wouldn’t put my trust or money into something that talks about DNA and epigenetics, but as far as anyone can tell has *nothing* to do with either of these things. Honesty is the best policy, especially for medical professionals.

    • Elizabeth Bollmer

      Hi, hopefully you will read my reply to Lisa. DNA stands for Day Night Appliance, not DNA of our genetic make up. I talked w/ my dentist at length to try and understand how this works. That is also in my reply to Lisa. I am wondering about how human growth hormone effects the use of the orthotic. I do know my dentist Dr. Munowitz, here in West Chester OH, has always been holistic in her approach to dentistry and is very involved in how her patients respond to treatments. So I am putting my faith in her hands that she will do right by me.

  12. dangblog

    Hi Elizabeth. Thanks for your post. I did read your reply, and I did realize that DNA means “day-night appliance.” However, I believe Dr. Singh intentionally uses “DNA” to reinforce his message that some sort of genetic change is happening, That’s what he claims. “DNA” was a convenient shorthand.

    This is my primary complaint about the doctor – I believe his marketing is deceptive. He has zero evidence that his treatment has anything to do with epigenetics, yet that is how he promotes it. This is hype, and I’m suspicious of medical practitioners who use grandiose claims for costly treatments, especially without evidence.

    His expensive treatment may very well work for some people. Is it more successful, or really different than traditional orthodontics? There is no reason to think so.

    In the meantime, I sincerely hope that it happens to be a good treatment for you.

  13. Charli

    The treatment is not that expensive at all. Obviously it depends on your dentist, but I only paid $4000 in total – not $4,000 per month. I’ve had no problems with it so far (it has been a few days) and it’s a great investment to treat the problems in my mouth and in particular, my very narrow jaw.

    It’s meant to be worn at night, like another poster before me has suggested, because that’s when the growth hormones are released.

    Here’s a blog I’ve just found of a patient that has been using the device for the past 6 months – http://epiorthodontics.blogspot.com/. The alignment of his teeth over the past 6 months (and in particular, the past 2 months as seen with two of his photos) is quite noticeable.

    My dentist calls the field ‘dentofacial orthopaedics.” If it works, which it does, then I’m not personally skeptical by what Dr Singh may or may not be calling it.

    • Oh Charli……It was nice to see a picture of this DNA appliance. What you have recieved on the upper is nothing more than a standard upper active plate with a “triple screw” and a bunch of Rube Goldbergess finger springs to push your front teeth forward. The triple screw pushes the molars and bicuspids to the side and it pushes the anterior teeth forward. I am currently looking at a picture of this appliance in a book published in 1966 and written by a dentist named Schwarz. Your upper appliance is a combination of a Schwarz plate and a Sagittal Plate. Similar constructs were being used in the 1800’s. The improvement in alignment results from tipping all of your teeth outwards. This is a very simple thing to accomplish (if the patient can actually wear the thing, many won’t tolerate these…..unless you pay $4000 for it….then you will wear it.) and it has as much to do with an alteration in your jaw bone gene expression as it does to the alteration in my brain’s gene expression when I have now come to fully realize what a load of bologna this whole idea is. Sure, when I start getting my dander up my brain gene’s change their expression. The same thing happens when you get punched in the face, when you watch television, when you pay your taxes….

      The lower appliance is nothing more than a “spring aligner”. In my practice, I would charge you about $250 for the lower spring aligner and (if I used them, there are better alternatives) I would charge you about $450 for the triple screw apliance. Unfortunately, I can tell you that there has been no change in the transverse dimension of your maxilla. Zero studies show long-term stability of non-surgical palatal expansion in adults. If you stop wearing a retainer, your teeth will go right back to where they started, with the possible side-effect that your bite will be worse. This is the risk of tipping teeth outwards with removeable appliances. A few months of braces could accomplish the same thing and obtain an identical result, except the teeth would be straighter because there is more control. It would also have been a lot more comfortable than those things. I suspect that the reason you are asked to wear them part time is to get more patients to accept the treatment. The notion that increased growth factors during the evenings makes them work better is laughable at best. If you wear them full time they will do what they are going to do faster….no question.

      Regarding Joel’s reply to Charli: Joel believes that epigenetics is using stimulation rather than mechanical force, and that stem cells in the periodontal “suture” recieve “signals”. This is Orthodontics 101. The mechanical force is the stimulus which recruits osteoblasts and osteoclasts from within the periodontal suture which makes tooth movement possible. Clearly, the appliances shown by Charli are producing a mechanical force resulting in the stimulus to the pdl (periodontal ligament) just like those rough old traditional orthodontic forces. I can tell you that the forces produced by today’s braces are much much much much lighter than the forces which would be produced by Charli’s active plate’s. Joel, please name one developmental mechanism which is influenced by this appliance.
      There is nothing different, therefore no new name is deserved.

      Robert Nisson

      • I checked the article written by Dr. Singh in the link that joel left in the peer-reviewed Journal of the American Orthodontic Society. Firstly, let me say that there is peer review and there is peer review. There can be a huge difference in what that means from one journal to the next. This article does not provide evidence for Dr. Singh’s claims. It is a treatise, or an opinion piece. I read the one reference which pertains to alterations in gene expression and functional appliances. This was a very cool article where rats had their jaws pushed to one side with some type of device cemented onto their teeth. Their messenger RNA for several general growth factors were separated, isolated and quantified 3 days and 7 days after the appliances were placed. This shows that these gene’s do change their expression when condylar cartilage is submitted to these types of traumatic forces. No surprise there……everything we do results in changes in gene expression.

        Dr. Singh suggests that this evidence for the Spatial Matrix Hypothesis, which is just a new name for Moss’s Functional Matrix Hypothesis which was posited decades ago. He further states that “this is evidence for a change in jaw relations producing a skeletal correction”.

        While the technology in this study is impressive, we are light-years away from being able to say that this change in the amounts of certain growth factors produced leads to any kind of long-term change in any skeletal structure. For that matter, we do not even know what types of changes these factors are eliciting within the cells from which they were obtained. We only know that they are likely to be involved somehow in the gross morphological changes which were observed in the rat condyle (swollen cargtilage).

        The way to see if a skeletal structure is changing is to measure the skeletal structure. I am not going look up the references but suffice it to say that I learned in a lecture from James McNamara (Professor in Orthodontics in Ann Arbor and who used functional appliances for many years) that his studies led him to conclude that correcting overbite’s with this method led to what appeared to be a temporary increase in the size of the mandible. Over time (when the patient was full grown) the increase in size is no longer apparent. Many orthodontists are convinced that even this temporary increase in size is not real, but it results from a reposturing of the mandible.

        Robert Nisson

      • Charli

        Dr Nisson, thank you for your response. I was never personally under the impression that the DNA Appliance was anything new. I know the issue for many on this blog was that it is marketing itself as something different and something to do with genetics (which I understand you have a problem with too. For me, this is a non-issue). But, regardless of what it is called (and for the purposes of my question, let’s throw out anything relating to ‘DNA’ and ‘genes’), does it work? It was just recommended to me as something that would be beneficial due to my exceedingly narrow upper jaw, and that Invisalign would not be suitable for my complicated case without either jaw surgery, or a jaw expander like the DNA Appliance or the Homeoblock first (these devices are, essentially, the same thing – http://www.facialdevelopment.com/). For point of reference, at its narrowest point, my upper jaw is the width of my thumb (and I have small thumbs!). My orthodontist did explain to me that many dentists and orthodontists do not believe in expanding the jaw in adults – that it was a ‘matter of divided opinion.’ However, he was adamant that it does indeed encourage jaw growth and not does not just tip the teeth outwards. Many orthodontists I’ve spoken to (and have seen post online) have said that typically, a jaw expander before braces or Invisalign is a combination that produces the most attractive, widest smiles.

        I have been wearing my upper appliance for over 2 months now with little pain and no problems. I do suspect that wearing it during the evening hours has much to do with the fact that you can’t talk properly with the appliance in. My speech is horrendous while wearing it (I probably would have avoided it if I’d have known this, as I am a shift worker). However, that’s my only complaint. My jaw is now wider (if it does indeed encourage growth) and my teeth are a little straighter, and it’s only been 9 weeks.

      • Charli, I am assuming you are an adult and that you are finished growing. In addition, the suture between your right and left maxillary bones has been fused for many years. Here is the abstract I found from the only article I found in the the American Journal of Orthodontics regarding maxillary expansion:
        ______________________________________________
        Introduction
        The purpose of this retrospective study was to evaluate the dentoskeletal changes after slow maxillary expansion in adults.

        Methods
        Three kinds of maxillary expanders (Haas [Dyna Flex, Laboratory, St Louis, Mo], MAX-2000 [Dyna Flex], and DMAX-2000 [Dyna Flex]) were used randomly in 3 study groups of 65 adults treated with nonsurgical slow maxillary expansion, followed by full straight-wire appliance therapy. A control group of 22 adults, meeting the same inclusion criteria, were treated only with full straight-wire appliance therapy without expansion. Posteroanterior and lateral cephalometric records were taken before the start of treatment (T1) and after fixed orthodontic treatment (T2). The data were analyzed statistically by using paired t tests and Kruskal-Wallis H tests.

        Results
        From T1 to T2, there was no significant change in nasal width, maxillary width, and mandibular width in the 3 groups. The sella-nasion-mandibular plane angle increased 0.97° (P <0.05) in the DMAX-2000 group. The mandibular incisor-mandibular place angle in the Haas, MAX-2000, DMAX-2000, and control groups had mean increases of 4.90°, 4.42°, 4.55°, and 5.20° (P <0.05 for each), respectively. The maxillary incisor-nasion-A-point angle increased 3.04° (P = 0.05), and the distal root of the maxillary first molar-nasion perpendicular decreased 1.48 mm (P <0.05) in the control group. The distal facet of the maxillary first molar-nasion perpendicular decreased 3.57 mm (P <0.05), and the distal root of the maxillary first molar-nasion perpendicular decreased 2.50 mm (P <0.05) in the MAX-2000 group.

        Conclusions
        After expansion treatment, there were no evident transverse or significant sagittal and vertical skeletal maxillary changes in the 3 groups.

        ________________________________________

        I suspect this is the only article in this journal because it is a technique that doesn't work well on adults. Nonetheless, many orthodontists, like myself will try it, then don't do it ever again.

        Ask your dentist if he can show you a journal article showing long-term or even short-term skeletal expansion in adults.

        Robert Nisson

  14. dangblog

    Consider this: suppose a cardiologist implanted a pacemaker in your heart and said it’s powered by “quantum cold fusion energy.” You could say, “I don’t care what he calls it as long as it works.” Personally, I’d want to know what I was actually getting; not some double-talk.

    Dr. Singh has zero evidence that his treatment has anything to do with epigenetics, yet that is how he promotes it. It’s plain old functional orthodontics, which has been around for decades.

    • Goodguy

      I concur with dangblog on several of his/her points. I believe it likely works but I dislike people using misleading terms, or bombastic words to hype things. If it works, that is its own testimony.

      I agree that DNA seems aimed at misleading because in the official website, the company logo is a representation of the DNA. I am also wondering why Dr Singh is not selling his technology to orthodontists but targets the ordinary dentists…

      That said, I would like to hear testimonies of those ho have gone through it for a year or at last six months. Melanie (Oct 21, 2010) never posted again.

  15. Robert V.

    I have severe obstructive sleep apnea and to make things worse my case is difficulty to treat with CPAP.

    This device seems to have two significant advantages over traditional devices for my case. The first advantage is it is a day/night appliance and has the convenience of not having to be worn for 8 to 12 hours per day.

    The second advantage is that it has a tongue retainer wire. If my OSA is significantly affected by tongue collapse (it seems to be), the tongue retainer wire might offer immediate benefits that could range from a total preventive to a lower effective CPAP pressure. I will make my hopes for a lower pressure and if it happens to be a total preventive what a bonus that will be.

    Similarly for the long term (after use of device is ended), expectations would be a wider palate and fuller mandible and maxilla would achieve something ranging from a lower CPAP pressure to the ultimate bonus – a total cure.

    The side benefits of straighter teeth and better profile are secondary but not insignificant.

    BTW, I have no problem with the marketing of the product or the pursuit for profit. If good new products are not marketed aggressively they may well fail and millions of potential customers will miss their wonderful benefits. Also, the pursuit of profits is a key part of the capitalist system which has brought us so many wonderful, even lifechanging, products to enrich the lives of everyone. There is no good alternative to the profit motive and enlightened self interest.

    Let me say, I appreciate the skeptic and like to carry a healthy dose of skepticism surging in my veins throughout life. However, I am not overly concerned about the lack of published efficacy studies. As I said at the outset, I have a severe problem that is difficult to treat. The potential benefit of DNA is very high and that makes the risk (loss of some thousands of dollars) a good risk to take.

    The next step for me is to have a consultation with a DNA practitioner. The problem is the roundtrip driving distance to the nearest one is burdensome. However, three practitioners in my state have signed on in the last year and I have high hopes than one near to me will sign on soon.

    Most comments will be appreciated.

  16. atr

    Robert, you say – ‘The first advantage is it is a day/night appliance and has the convenience of not having to be worn for 8 to 12 hours per day.” Not having to be worn? It has to be worn for a 15-16 hours per day. From roughly 5pm to 9am. I’ve had it for a month and I’m still lisping like there’s no tomorrow, so that is something to consider if you’re active during the evenings.

    It is completely painless too, which is a bonus. Robert, I don’t have the tongue retainer wire at the back (that looks like it presses down on the tongue?) but this is perhaps specific to one’s individual case.

  17. joel

    Looking for journal articles?
    Here is one from 2011 July’s “Dentistry Today”: http://www.dentistrytoday.com/dental-medicine/dental-sleep-medicine/5674-midfacial-development-in-adult-obstructive-sleep-apnea
    He was also published in the Journal of the American Orthodontic Society, Nov-Dec 2010 issue. Also go to scholar.google.com and search “G. Dave Singh” and you’ll see many. His website might not be ideal, but he is definitely the real deal. The DNA appliance approach is fairly new and in the near future, I believe you will see more positive research being published and widely available.
    I’m in the dental field and know many dentists who are beginning to see very positve results.
    Couple things to note: Because the appliance works through light stimulation, not force, there is very little risk of causing any harm. It is non-invasive.
    What causes harm? When an orthodontists chooses to remove a bi-cuspid to gain space.

    • dangblog

      Thank you, Joel! I’m about to go out of town for a week but hope to take a closer look. I did some initial searching and did not find any peer-reviewed research involving epigenetics by Dr. Singh, but I may have missed it and you can point it out for me. Epigenetics is how he promotes it and that’s the key issue here.

      Is it functional orthodontics with a fancy and unsupported claim for epigentics attached, or is what he claims? I hope it is what he claims. Just want some evidence.

      • joel

        You could say that epigenetic orthodontics is a new technique and approach of functional orthodontics. The major difference from conventional functional orthodontics, is that epigenetics uses stimulation rather than mechanical force. Rather than forcefully moving teeth, it “signals” developmental stem cells, located in our periodontial suture, to remodel bone. In other words, the appliance itself did not change the bone, osteoclasts and osteoblasts are responsible for that. The appliance works by influencing developmental mechanisms – that’s why the name “epigenetic” fits.
        If you have something to offer that is very different, wouldn’t you give it a new name?
        That ortho article I mentioned is peer-reviewed and it is titled “Epigenetic Orthodontics: Developmental Mechanisms for Functional (Formational) appliances” You can see it here: http://www.mydigitalpublication.com/publication/?i=53014

      • Sorry, I put this in the wrong place above…(and now I’m adding to it).

        Joel believes that epigenetics is using stimulation rather than mechanical force, and that stem cells in the periodontal “suture” recieve “signals”. This is Orthodontics 101. The mechanical force IS the stimulus which recruits osteoblasts and osteoclasts from within the periodontal suture which makes tooth movement possible. Clearly, the appliances shown by Charli are producing a mechanical force resulting in the stimulus to the periodontal suture just like those rough old traditional orthodontic forces. I honestly was expecting something much more elegant than what Charli found a photo of above. I suspect that Dr. Singh uses an ordinary array of removable orthodontic appliances and tells people that they are causing an alteration in gene expression or some other nonsense as described above by epigeneticsgenomicsgirl. While what he is saying is true, it is completely and utterly irrelevant. Someone please correct me if I am wrong, but my understanding is that everytime our cells are stimulated to produce proteins, this is gene expression. Everything we do from blinking our eyes to singing a song changes our protein production.

        Let me be clear. All orthodontic and functional appliances lead to a stimulus and a recruitment of stem cells into osteoblasts and osteoclasts. This happens either directly with force against the teeth, or indirectly, by changing a tooth’s environment. To me a Functional appliance generally changes the mandibular posture which can affect the airway. Some dentists call removable expanders or active plate’s a functional appliance. I never understood this. To me, a functional appliance effects the posture of the jaw in a direct manner. This is more or less semantics. The real crux of the matter is can you help someone with the given appliance, and does this happen in the most efficient and cost-effective manner. I can tell you that the forces produced by today’s braces are much much much much lighter than the forces which would be produced by Charli’s active plate’s. Further, as I mentioned back in April above, functional appliances followed by braces in a double-blind randomized clinical trial were found to be no more effective than braces alone. This gives credence to my stance that there are more efficient and cost-effective mechanisms for many, if not most situations.

        Joel, please name one developmental mechanism which is influenced by the DNA appliance in a manner which is different from a “conventional functional appliance”.

        Robert Nisson

    • DD

      “What causes harm? When an orthodontists chooses to remove a bi-cuspid to gain space” I agree with you but your a little off – everyone in orthodontics knows/understands that removing bicuspids doesnt gain space, it actually decreases it, (it just kind of removes the “problem”) thus allowing the teeth to align; however, this causes a whole bunch of other “problems” such as being mid face deficient, sleep apnea and chronc TMJ pain and many other problems I wont mention, Im a non extraction kind of person myself, but when your remove bi’s and do space closure, retraction happens; hence decreasing space, expanding the arch is a better way to go, “make room”.

  18. dangblog

    Thanks everyone for continuing this interesting discussion. We’re currently waiting for a response to this request:

    “…please name one developmental mechanism which is influenced by the DNA appliance in a manner which is different from a ‘conventional functional appliance.'”

    A clear, concise answer could shed some much needed light on this subject.

  19. Ann

    There are a few people in Malaysia using this Dr Singh’s methods and I am assessing it. So far, I am sceptical, and I dislike misleading information. The thing is Dr Singh is targetting the sale of his methods at non-orthodontists, rather than orthodontists. I find this interesting.

  20. Janice

    I am participating in this treatment at the moment and am a 55 year old female. My dentist is in class with Dr. Singh and I am my dentist’s student patient, and yes, he is giving me a break on the cost. I believe he will charge around $5,000 for this treatment once he is fully trained, similar to the cost of orthodontics these days. He, himself, is also a student patient to one of the other dentists in the class. My treatment began in January 2011 and is supposed to be finished around June 2012 (18 mos). Soon after beginning the treatment, I began to sleep better as it began to open up my airway, and my sleep hypopnea (mild apnea) has been alleviated. I am not awakening several times a night with no memories of dreaming any more. I now am sleeping much longer periods and remember dreams. This was the main reason I participated in the treatment, but in addition, my upper palate and bottom jaw has expaned to the point of allowing some crowded teeth on the bottom to straighten and my jaw has come forward a bit, improving my profile. It was a bit recessed prior to treatment, I believe, from many years of thumb sucking as a child. I had braces as a teenager where they pulled 4 teeth and the space that was made was filled by all my wisdom teeth. I have had no pain in my jaws. The only discomfort has been: 1) after expansion of the bottom appliance, it has occasionally rubbed on my bottom gums. My dentist just shaves down the area of the appliance that is rubbing to solve this, and 2) when my bottom teeth were being moved to be straightened. No serious pain. I am very happy with the results so far.

    • Janice….many of the comments that I have made previously do not relate to patients who are being treated for sleep apnea. However….$5,000 is a heck of a lot for removable acrylic expanders. The laboratory cost to construct of one these appliances would be less than $100.

      The claim is made that these appliances are changing not just the teeth, but the underlying skeletal structures. I have done a fair amount of research since my first post and I find no measurement, pre and post treastment, in any publication done in a clinical study or even in a case study which supports the notion of anything other than dentoalveolar expansion for dna appliances. No change in the basal bone (the bone underlying and supporting the teeth) has been shown through published measurement to occur. The publications I have found are only case studies and treatises.

      R. Nisson

  21. T

    Well, it’s been 3 1/2 months for me and my jaw has expanded 4 mm (it was so, so narrow before!). My teeth have definitely straightened up quite a lot (still a way to go though) and many friends have noticed the difference. Very impressed so far.

  22. T

    Interestingly, since my last post I’ve noticed a difference in my facial structure. My face isn’t very symmetrical and I’ve had uneven eyes my whole life – one of my eyes never opened as much as the other. My dentist did notice this and put it down to my jaw being underdeveloped and said the DNA appliance could help that (however, I didn’t think so as I thought it was hereditary – my father’s eyes were like that and mine were like that since I was a young child if my pre-school photos are anything to go by!). In recent photos of myself my eyes are the same size and my face is much more symmetrical! I’ve taken a lot of photos of the journey with the DNA appliance and in none of the 30 photos I took today and yesterday do my eyes look uneven. This is the first time this has ever happened and unless there’s another explanation, I’m fairly certain it has something to do with this device.

  23. Dear Dr. Nisson,

    I wonder how you will change your obvious dislike of the DNA technique when critical mass (within our industry) changes towards more non-invasive homeopathic treatment of malocclusion.

    Similar effect occurred with LANAP technique and periodontists. At first specialists were rejecting the tx, but now there are more periodontists getting certified.

    DNA is a catchy marketing concept and it’s just play on words.

    So, relax.

    Dr. Benjamin

  24. yacman

    Wow, it has been a long time since I visited this thread. I’m fascinated to find out that I precipitated a “Godwin’s Law” event. Maybe I’ll be called a more creative name than “Gestapo” if I state the obvious that there is no validity whatsoever to homeopathic treatments of anything. L. Scot Bastian Ph.D.

  25. Guts

    I just read this whole thread. It is very entertaining. Good info and bad info to be sure, but overall just a good time. I mean I kind of sense mass hysteria about to happen over this and all because we just don’t understand it yet. We dont understand it yet because all of the necessary studies have not been done. But that doesn’t mean it doesn’t work! There are a million things that are true and have not been proven. If that means you don’t want to try it that is totally fine and is your choice of course, but seeing as I have met and talked to people who have had positive experiences (and seen the comments on this blog) and barely any negative ones, I believe in it.

    I am probably going to try it and if I do I’ll leave some updates. I have TMJ, narrow jaw, pain, mild sleep apnea, deviated septum. Like other people have said, I don’t care that much about the claims and the science behind it as long as it works and that information is forthcoming. I came to this website just looking for other people who are using it and how their experience is going. This PARTICULAR device is still very new and that is why there aren’t as many studies as you’d like (although my dentist did point me towards some). It is low risk though, and the results seem worth it. Why are people shocked that DNA sequencing and genes are being referenced like that is some sort of crazy talk? We are human beings who are made up of cells and DNA and all that crap and it makes sense that something you are doing with your body might involve some of those things. Its not magic.

    The skepticism on this page is insane. It is healthy to a degree but I think this is going overboard, especially Dr. Nisson. It almost sounds defensive to me, like it is some sort of inner industry rivalry.
    The dentist I have seen– I have looked in the eyes and talked to and she gave me her full attention and yes, I trust her. I still have that ability, to trust people. She had her secretary come in and show me her device and tell me about it since she was just beginning treatment. This woman took her time and was honest and open and answered all of my questions. She has seen it work and has not seen any disasters. She charges 6000 for full treatment, bottom and top.

    There have been a lot of studies done on a lot of things that are total crap–point being, I don’t trust all studies or Dr. recommendations. Remember how they have been telling us to eat 9-11 servings of bread and pasta for years? Recommending high doses of Calcium without Magnesium? Just saying, there are lots of things Dr.’s and scientists are doing wrong so you kind of have to go with your OWN research and your own gut to a point. People trust studies and stuff to a FAULT– go with what people have done for centuries that worked. Go with what makes sense, not with a fad. I especially believe that when it comes to diet. And yes I agree that Weston A Price’s work is very important in this whole debate. If you read his work and then research this it all makes a lot more sense, I can’t explain it here, it took me months of researching to even understand myself.
    It was cute when that person referenced wikipedia when trying to debunk Price’s ideas. I think we all know that you can’t use wikipedia in a debate about anything.
    I would ask Dr. Nisson, if he thinks this is such a huge waste of money and a scam, what treatment do you recommend that is non-invasive and not braces for people with these issues? Any ideas and anything cheaper? Maybe you can get some new clients this way.

    Oh ps that Dr I saw strongly believes in a few years this will be very mainstream and much more available, she says her an her colleagues are asking for more studies because they want what they have SEEN to be documented and proven to make it more substantiated. There is the demand and I am sure we shall receive. If anyone finds any other good websites talking about this let us know! Thanks for having this discussion!

    • dangblog

      Thanks for your response, Guts. I’m enjoying this discussion as well. I think there are two items that ought to addressed, and they are neither hysterical nor insane.
      1. Do the DNA appliances perform any better than traditional orthodontics? Until such evidence exists, one can only, like you, look into the eyes of a dentist or get anecdotal reports. While you personally may not care about research to back up the claims, many consumers will justifiably want that before paying large sums of money.
      2. Does epigenetic orthodontics actually create a result based on epigenetics – or more to the point – does it have any more do with epigenetics than any other orthodontic treatment? If not, why is it called epigenetic orthodontics? I understand that you don’t care what it’s called, but others justifiably see value in honest labeling.

      Please note that I’m not saying the treatment doesn’t do anything. I’m just asking what I think are reasonable questions.

  26. tina

    I have been using the appliance for two weeks. They said its made from acrylic isn’t that bad for my health? I have a sore starting on the roof of my mouth th taste is very bad from the appliance aswell. Getting used to the invasive appliance my, time wearing it. Any info is helpful. Never new about exercises to follow after wearing appliance either. Thanks Tina

    • Dr E

      I’m a provider who have seen it work in my patients and I also want more studies to substantiate the results. I would like to write a long blog about my experience with my patients over my last 3 years of experience. However due to my time constraints at this moment I will hold off for now. I want to address Sara and now to Tina who talked about soreness to the palate (roof of the mouth). As soon as any soreness occurs, please get back to your practitioner as soon as you can to have the appliance trimmed down. The palate is either remodeling in shape or position and/or the appliance has changed position due to advancing the screw. Any excess pressure against soft tissues need to be relieved. If it isn’t done and the appliance is still being worn then you are subjecting yourself to unnecessary and undue trauma. I believe Sara who wrote on July 14, 2012 went through the sequelae of events unnecessarily due to delay in immediate treatment to address the discomfort and to excessive force placed on the palate and teeth. The appliance is not meant to be used with a lot of force and is not supposed to be invasive. Tina, please contact your dentist right away if you haven’t done so already. Additionally, the appliance is not supposed to taste bad. Again, contact your dentist about that also.

      I will be back soon with my experience as a clinician. I have good and bad news to report. I will not post my full name because I don’t want to be accused of loitering with intent to garner future DNA appliance patients. Ciao for now.

  27. Donna

    Interesting to read all these comments.

    Working in the industry I have attended many presentations on many systems and appliances etc…
    Something you may not know is that Dr. Singh designed this with another doctor. Their falling out resulted in them splitting their finding. This other doctor, Dr. Theodore Belfor, in my opinion presents the same technology (different name) in a much better manner.

    I personally have had my Homeoblock/DNA appliance for 6 months now and I absolutely LOVE IT. It changed my jaw after only having it for a week and it just keeps doing good things for me.

    At first it was awkward and I drooled a lot ( it helped that my husband and I got ours at the same time :P). Now I can talk (fairly) normal with it. I found that wearing it with my night guard helped a lot in terms of comfort.

    My husband hasn’t snored since he got his, and his front teeth are all straight now.

    I’ve worked in a dental clinic for over 10 years and in my experience we’ve had a lot of success with this!

    I can’t comment on the terms Dr Singh uses while explaining the DNA appliance cause I don’t have the right educations to make any claims about that kind of stuff.

    What I can say is that My husband and I, as well as dozens of other patients have had great results and increased confidence(my whole face has changed!) and who really cares what words the dude used to write up a blurb he uses to get DENTISTS to prescribe it?

    • Donna

      And here’s a link to Dr. Theodore Belfors website to check out the Homeoblock (sorry I forgot it in the last post)

      http://www.facialdevelopment.com/about.php

      Be sure to check out the clip on the right side of the page to see the Homeoblock in action.

      And again, these doctors worked together to design this appliance. They are essentially the exact same thing.

  28. Kristen

    I am not sure it makes much difference in anyone’s opinion, but I think the cost is about $7500 all inclusive for a patients case with this, some say $8000. There are at least five blogs I’ve found with people showing their pictures as they go along and all of em I’ve found seem happy. There’s also a similar appliance called the homeoblock and there are some people with blogs tracking their experience on that one too. I think the palate expansion seems to makes sense but seems like nutrition would be real important plus I’d want to go to a really experienced person and not someone who’s just done a few. I’d also want to get cramps actual treatments along the way or maybe st johns neuromuscular work to make sure the rest of my structure was accommodating optimally to head shape changes and how it effects posture and balance and such. Anyways, interesting topic!

  29. Dana

    Myy mother is currently using the DNA appliance with great results. She has regained use of her jaw (was in so much pain she was unable to chew– she is now happily eating solid foods again) and it has made a difference in her sleep/energy. So far very happy.

      • --

        Hey Jennie,
        Sorry for the late reply.
        We’re seeing Dr. Pavlenko in Edmonton, Alberta.
        My mom is doing great! It lifted a little of her fatigue, but didn’t completely fix it as originally hoped. Crooked teeth she’s had her whole life have comfortably and painlessly straightened out, and her palette/jaw look better on the whole (it’s a subtle yet noticeable change). Admittedly, some of these conversations turned me off and made me nervous, but, she’s happy and hasn’t had any issues so far.

        I also got an appliance for different reasons. I haven’t noticed anything negative (aside from minor spaces in my teeth when before they were essentially perfect) but the positive has been a huge relief in neck and facial pain that wasn’t relieved by previous treatments (I’m thinking this is the neuro-muscular balancing of the appliance) As well as an instant and dramatic affect on my sleep quality to the point where I get anxiety if I don’t have my appliance with me because I know I’ll wake up feeling crappy. This could be due to the support of my upper palette/opening of the airways while I sleep that I’m sure could have been achieved with some other device/appliance but nothing I’d tried before had ever worked.

  30. Kerbox

    Interesting discussion here, I have read it all and at the end of the day still am not sure what to do. I am another perfect example for one of these devices (not that I would use the DNA because of price), I was born with very bad asthma so was basically mouth breathing coming out of the womb and henceforth leading to narrow palate, narrow profile and now in my early 30’s TMJ problems, due to how my jaw, palate and teeth have developed, seriously restricting my life. I have remedied some of these problems through diet and getting fit, I have forced nose breathing during exercising and training myself to do this throughout the whole day

    Just seems so many positive testimonials for devices like the homeoblock or ALF (Advanced Lightweight Functional), at least for those who obviously need it; occasionally I have read the odd person who likely does not have an overly narrow palate, thinking it will improve their facial structure which is very naive and blow thousands of dollars for nothing.

    When I hear of people sleeping better within weeks, their breathing improving and more prominence in some of their facial features it is just impossible for someone like me to ignore.

    What I find frustrating about all this is orthodontists complete ignorance, or avoidance to see how nutrition, soft process foods or repository problems can clearly lead to poorly developed jaws and teeth. Is not much different from mainstream medicine really regarding nutrition, they are happy to work on and come up with expensive methods to cure problems but not bother pushing and championing preventative methods. Some of Weston Price’s ideas may be a little off but he pointing out the impact of nutritionally rich diets over nutritionally poor, soft food diets many decades ago and we still mostly ignore the dramatic implications.

  31. dangblog

    Once in a while the dangblog owner (me) likes to poke my nose into this thread and repeat some still unanswered questions:

    1. Do the DNA appliances perform any better than traditional orthodontics? Many consumers will justifiably want evidence for this before paying large sums of money.

    2. Does epigenetic orthodontics really have anything to do with epigenetics? I mean more than any other orthodontic treatment? If not, why is it called epigenetic orthodontics? Many people justifiably see value in honest labeling.

    • Kerbox

      Dan I will give you my opinion after much more reading and after getting several opinions from orthodontists, the truth I believe, as already stated by other comments, is once you are an adult it is simply not possible to permanently change the jaw and palate without surgery.

      Yes they can still expand the palate but so can many other devices, but as an adult you will need a retainer for life to maintain the shape. I will be looking at a permanent bonded retainer, at least for the lower for convenience.

      I also think ‘traditional’ orthodontics is maybe becoming a thing of the past, because with much improved braces, like Damon combined with things like Suresmile it is a much more refined, convenient and shortened process; I have also read several orthodontists state that even Damon can also do exactly the same thing as palate expansion devices, it likely just depends on what goals your orthodontist has.

      Orthodontics, or more so the development of the mouth and jaw obviously has clear links to epigenetic’s which all orthodontists need to be more aware of, opposed to simple cosmetics, but as you question the use of the term for the DNA device seems a bit frivolous since they do not appear to do anything special. Ironically though at the end of the day it is probably not actual dishonesty because it appears to have merit, it is just mainstream orthodontists simply just still overlook facial structure, overlook how this can impact health and well being and overlook all these factors relating to epigenetic’s; this product is simply taking advantage of it.

      From my personal experience my poorly development mouth and jaw has had a dramatic impact on my health and life, I believe earlier in life it made me more prone to asthma, anxiety and even athletic limitations. Narrow mouth = narrower nose cavity = inefficient oxygen intact = prone to exhaustion easier = leads back to mouth breathing = vicious cycle.

      I ended up dealing with my anxiety and mental health issues in my early 20’s becoming a fitness nut, burnt myself into the ground which lead to 6+ years of chronic fatigue syndrome, which is basically an auto-immune disorder. I have no doubt at all now that this has all been heavily influenced by my underdeveloped jaw mouth, especially my inability to adapt to stress properly; how can you when your mouth and TMJ issues endlessly makes you prone to tension? Of course I realised all this when the tension became permanent (TMJ) in my late 20’s. Technically I do not know how all that relates to epigenetic’s but obviously it relates the how the whole biological system is functioning.

      Sounds a little ridiculous? I wish I had a reference but I believe there is some ortho’s that believe many athletes and people use adrenalin/exercise to compensate for their mal positioned/underdeveloped jaws, just as I was in my early 20’s which ended up ruining me; this would be a prime example of gene expression (or should be say suppresion?) and compensation at work from poor development.

      To end this, for anyone who may be reading this, the palate can be permanently expanded in early childhood, around 4-6 years of age I believe, it is just a matter of finding the right functional ortho. At least for any child who is clearly developing a narrow mouth/palate or has bad malpositioning a simple expansion device is likely a much better option than traditional braces, can even prevent further orthodontics and dental work so many end up having in adolescents and adulthood.

      Just another 2 cents.

  32. Kelly

    I have a DNA appliance to correct my jaw and NEVER snored prior to wearing it, after only a few months of wearing it I now snore so much that my partner can no longer sleep in the same room as me and the more I expand it the worse it gets! My orthodontist doesnt know what to do and is now contemplating reversing what has been done which will no doubt mess up my teeth (that were perfect beforehand) and I will require braces. DO NOT get a DNA device I really dont think there is enough evidence to prove that it does what it claims to do.

  33. T W

    I am a board eligible orthodontist having a masters degree and certificate in orthodontics and dentofacial orthopedics both of which are beyond the four years required to become a general dentist. This is a spin on traditional removable appliances in name only. Oh wait, the other big difference is that people who are paying more than several hundred dollars are getting taken to the cleaners.

    The sources cited, as other have alluded to are laughable. “Dentistry Today”? Give me a break. The phrase “Junk Journal” comes to mind. Until “epigenetics” becomes a mentionable topic in a reputable publication (Such as The American Journal of Orthodontics and Dentofacial Orthopedics or perhaps the Angle Orthodontist) I don’t think I’ll take it seriously.

    Think about this: If it were possible to change the DNA to expand the jaws without surgery, wouldn’t the same principle apply to say, stretching your leg bones? Sweet! I’d like to add 2 inches to my height. Where do I sign up?

    As others have mentioned, an acrylic expander is nothing different than what has been used forever. Not any different than the force vectors braces or invisalign place on the dentition or jaws. The beauty of this for those practicing it is that it takes no effort whatsoever to use. Just take a mold of the teeth, slap the appliance in, then go to the bank. Diagnosis seems pretty easy too .

    There is nothing new here. Move along.

  34. Lynn_M

    I have looked at 5 blogs and photos of patients that are in the process of or recently finished epigenetic orthodontics, as well as Dr. Singh’s case photos. All of these cases seem to have had very positive results, with sometimes dramatic positive changes in appearance accompanying the mm changes in palate width. So based on looking at these photos, it looks to me like epigenetic orthodontia works. I’m told one must wear a retainer for life to maintain the changes, though.

    I would be more reassured to hear about the long-term results, and I would also like to know about people such as Kelly that have had negative results.

    I would like to hear from the orthodontists on here, such as Dr. Nisson, what techniques today’s orthodontia uses to expand the palate. In the olden days, it seemed what was important was to straighten teeth, usually involving placing a wire and pulling the teeth back in order to do so. Which makes the oral cavity smaller. What would you do for me if I came to you now? If DNA Appliances are nothing new, what else is there that’s comparable that’s being recommended? As far as cost, is conventional orthodontia priced any more reasonably?

    I had conventional braces when I was 16, which including having 4 bicuspids extracted to “make room” for my teeth. Now, 50 years later, that orthodontia has relapsed, with my bottom incisors again crowded together and twisted. Otherwise my teeth are straight, although the molars are tilted inwards. I have extensive gum recession now, some bifurcation and abfraction, and my new dentist tells me my rear teeth look about 30 years older than my actual age due to excessive wear. My tongue has scalloping – evidence that it is too big for the space between my teeth. My mouth looks small in photos, and my middle face is a bit recessed. I have no problem with sleep apnea or snoring. None of the dentists I’ve seen in the last 50 years told me that my tongue-tie had grown back, which may have caused some of my dental problems but which will be lasered away shortly. My dentist has recommended a DNA appliance for me, so I’m researching them now.

  35. Lynn_M

    After my prior post, I researched the Damon and SureSmile orthodontic techniques that Kerbox mentioned. Thank you Kerbox. Based on the photos I’ve seen of the wonderful results achieved, everyone’s crowded and overlapping teeth in the before pictures seem to fit in well when these treatments are ended. But since teeth aren’t extracted, how is space created to make this possible? Are the wires able to pull the teeth outwards and/or move the maxilla and mandible anteriorly?

    When I started researching this, I thought the unique positive aspect distinguishing epigenetic and Homeoblock/Bioblock/functional orthodontics from conventional was the ability to expand the palate, thus creating room for the teeth, moving the maxilla and mandible anteriorly, and developing the mid-facial area. And I thought conventional straight-wire orthodontics pulled backwards and retracted teeth. Is this thinking wrong?

    Dangblog, I appreciate the opportunity you’ve provided here to discuss the merits of epigenetics orthodontia. I too would like to hear the answers to your two questions. I’ve also thought the name was bogus. I think the naysayers such as Dr. Nisson and TW raise legitimate concerns, much to my initial annoyance when I was more gung-ho about pursuing epigenetic orthodontics, and I thank them for their contributions here.

    Now I’m thinking Suresmile may be the way to go. I would like more information about how it works in developing the mid-face and eliminates those small black triangles on the side of the teeth when smiling. It seems like Suresmile has overcome the difficulty Dr. Nisson mentioned as preventing good orthodontic research, that of obtaining accurate measurements of people’s head and teeth.

  36. I have stayed away from this blog for a long time. I am only goinjg to reply to Lynn-M. I haven’t read most of the posts subsequent to my last post. You asked what techniques are used by orthodontists today to expand the palate. There is a myriad of different appliances used today. They all do the same thing and they are all basically the same as what we used 50 and more years ago. They attach to the teeth and the push outwards in a lateral direction. The ability to actually expand the palate depends on the patency of the suture. In individuals whose suture is closed you can still make the dental arch wider. This is not stable and has risks associated with it. These risks include gingival recession and dental tipping which means an opening of the mandibular plane angle (bad). Dr. Singh proposes that his appliance does something that all that have come before do not. His appliance is not worn full time and he combines it with some type of muscular exercise. He recently sent to me an article he published which shows an increase in bone volume and he uses cone beam computed tomography which demonstrates this. What he does not include is a comparison with a matched sample which uses traditional methods. I still contend that there would not be a difference except for the exorbitant price differential.

    Regarding your comments about traditional orthodontics being retractive vs suresmile and Damon being expansive. Let me give you a bit of history here:

    Around the turn of the 20th century, Edward Angle developed the edgewise appliance. This is basically the appliance most orthodontists still use today (there are significant improvements which makes things much easier for the patient and the orthodontist). Angle maintained that teeths should not be extracted, ever. Many of his students experienced poor results with Angle’s method and realized that some people needed to have teeth removed. This gained more and more acceptance until the mid-century or so the opposite situation was occuring than occurred with Angle, that is that some patients had teeth extracted that shouldn’t have. (Sometimes it can be ok either way). Now the pendulum for some orthodontists has swung back to where it was with Angle.

    When you tell a patient that you don’t have to extract teeth it makes it much easier to sell the case. Most orthodontists I know realize that some patients are better off if teeth are removed. This does not mean that things are retracted and there are many studies to show that well treated extraction cases do not retract teeth and many samples still end up with more forward positions of incisors. What is important are the goals. First you identify where you want the teeth to end up. Then you decide how to get there. If that means extracting teeth, then you extract teeth.

    With regards to Suresmile and Damon. These are just braces and techniques. Any particular orthodontist can use these braces and decide to expand or extract or strip or whatever. WHen you have someone pushing the fact that there treatment involves non-extraction, that’s where I would worry that someone is trying to sell you on this fact alone, and not what the best position of your teeth will be.

    Dr. Nisson

  37. dr. mick…..randomly found this blog. fascinating thread..i looked at singh’s cbct study after i called him out personally about the claims. my practice is all tmd/sleep and ortho, with a fair amount of orthognathics. i asked him specifically to show how the palate is expanded. this is fairly easy to do if you have a good tech to manipulate cbct data. i am blessed to have some of the best in the business close by and we have worked together on thousands of cases. my biggest population of patients (thousands) have degenerative joint disease, as young as 8…so i am always looking for an edge to make them better. bottom line the data that he demonstrates may show changes in molar intercuspal position, however there is no change in the palatal suture…it would be so easy to see with cbct. splitting a palate surgically is a bear…these appliances are just tipping teeth. i have been invited to take the class for free. just not worth the effort until some real evidence has been produced. there is enough critical mass out there. i get a cbct on all of my patients pretx. make that the standard, look at a few hundred, have a qualified radiologist or two evaluate…easy study, but the results may discredit the technique. thx for the entertaining read. caveat emptor, tm

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