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DNA Appliance Journey  

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MarylandIsSouthern
New Member

Not sure if I’m posting in the right place or with the right format but I’m am a 19 year old male, about to start vivos DNA appliance treatment. For context I sucked my thumb and completely F’ed up my teeth when I was little so I had to go through orthodontic treatments, herbst appliance and then Invisalign to straighten my teeth. I don’t have a majorly recessed lower jaw and I’m not extremely messed up like some people have but my bite is uneven, my left side touches first, I suffer from chronic neck and back pain as well as tinnitus in my ears. I also suspect, as well as my dentist, that the current state of my jaw and subsequent tongue position has diminished my quality of sleep. I am interested in the health benefits and equally the aesthetic benefits of  expansion of the maxilla and movement and potential expansion of the lower jaw. I don’t have recession as bad as some people I’ve seen who have gotten the device so I’m curious to see if the aesthetic changes will be more noticeable. I have been mewing or practicing proper tongue posture for about a year mostly consistently and have already seen a great change in my lower jawline.
For more context I take an assortment of daily vitamins, as well as a growth hormone secretagogue (MK677), I work out intensely almost daily and will most likely begin to take more supplements that promote bone growth. 

Edit: Forgot to mention that I just had a frenectomy to remove my tongue tie as well. 

I will come back to this forum registry and update you guys if you are interested. 

Thanks for the useful info this forum provides. 

 

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Posted : 22/12/2020 11:08 pm
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Deebob
New Member

At your age I would strongly advise you do MSE instead. You will get much more lateral, skeletal expansion and it will fix your crossbite. It will also improve your upper airway by increasing the size of your nasal cavity, which will allow for a greater volume of airflow that will also cause your pharangyeal airway to expand.

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Posted : 23/12/2020 2:55 pm
MarylandIsSouthern
New Member

@deebob appreciate the feedback but I think DNA is best for my preferences as I’d like to not be wearing a device 24/7. 

 

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Posted : 23/12/2020 10:45 pm
Deebob
New Member

@marylandissouthern

 

Well you're going to have to wear the DNA like 16 hours a day....and it won't do as much for you.  Would you rather wear something 16 hours a day for 18+ months that probably won't do much but move your teeth?  Or wear something 24/7 for less than 6 months that will 100% widen your maxilla and nasal cavity. At your age MSE is guaranteed to work beautifully. You really should re-consider. 

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Posted : 28/12/2020 4:16 pm
toomer
Estimable Member
Posted by: @deebob

won't do much but move your teeth 

That's really not accurate.  You sound like you just watched every one of Ronald's JawHacks videos and are just repeating what you heard.

The inventor has published research showing just the maxilla itself isolated on CBCT before and after treatment ... the alveolar structures and teeth were excluded.  They showed that on average, the maxilla had 10% more volume after treatment ... about 2 cubic centimeters of new bone overall.

There are other studies showing increased sinus cavity volume.  Sinuses are bony structures, how do those get larger without formation of new bone?  And there are other studies showing increased nasal cavity volume - maybe not as much as MSE or EASE, but definitely showing increases.

There's far more to how DNA works than just applying force to the crowns of the teeth and hoping for the best.  But people who haven't spent any time looking into it end up repeating the same thing over and over again.

I think @MarylandIsSouthern has considered all of his/her options available and made a reasonable choice.  You should respect him/her for that.

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Posted : 29/12/2020 10:36 am
MarylandIsSouthern
New Member
Posted by: @deebob

@marylandissouthern

 

Well you're going to have to wear the DNA like 16 hours a day....and it won't do as much for you.  Would you rather wear something 16 hours a day for 18+ months that probably won't do much but move your teeth?  Or wear something 24/7 for less than 6 months that will 100% widen your maxilla and nasal cavity. At your age MSE is guaranteed to work beautifully. You really should re-consider. 

Not to be rude but a lot of this is objectively inaccurate. I won’t speak on the effectiveness of MSE I know for a fact that it’s an effective route but I cant compare it to other appliances. But DNA does not simply move teeth and most people I’ve seen share their stories about DNA are considerably older than me. I don’t think my only option is MSE. 

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Posted : 31/12/2020 5:24 pm
Deebob
New Member

@toomer @MarylandIsSouthern

Actually I'm getting my information from the fact that I did DNA and experienced no improvement in nasal breathing and saw no noticeable skeletal change. If you ever wear a DNA appliance yourself, you will feel how the appliance is applying pressure to your teeth. I don't see how that is going to change the higher parts of the skull, and widen the nasal cavity.  And I'm not interested in what Dr. Singh has to say about it, there are zero studies or evidence put forward from anyone but Dr. Singh, and every single reputable orthodontist says it's only causing dental alveolar expansion. It should be a red flag that most Vivos providers are "holistic" dentists who aren't particularly knowledgeable about orthodontics/orthopaedics, and defer to Vivos throughout most of the process, versus orthodontists that do MSE who are hands-on and can oversee your case themselves.

And even if by some miracle an acrylic expander pushing on the teeth is capable of expanding the skull, a 19 year old should just go with the method that is guaranteed to produce significant skeletal change, and not gamble on something that might work but is yet to show any positive results except for anecdotal success stories from Facebook moms with zero knowledge about how any of this works and are likely experiencing placebo, or dental changes.  MSE is also less expensive, and will produce results in less than half the time.

 

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Posted : 02/01/2021 5:27 pm
Sergio-OMS
Trusted Member
Posted by: @deebob

@toomer @MarylandIsSouthern

Actually I'm getting my information from the fact that I did DNA and experienced no improvement in nasal breathing and saw no noticeable skeletal change. If you ever wear a DNA appliance yourself, you will feel how the appliance is applying pressure to your teeth. I don't see how that is going to change the higher parts of the skull, and widen the nasal cavity.  And I'm not interested in what Dr. Singh has to say about it, there are zero studies or evidence put forward from anyone but Dr. Singh, and every single reputable orthodontist says it's only causing dental alveolar expansion. It should be a red flag that most Vivos providers are "holistic" dentists who aren't particularly knowledgeable about orthodontics/orthopaedics, and defer to Vivos throughout most of the process, versus orthodontists that do MSE who are hands-on and can oversee your case themselves.

And even if by some miracle an acrylic expander pushing on the teeth is capable of expanding the skull, a 19 year old should just go with the method that is guaranteed to produce significant skeletal change, and not gamble on something that might work but is yet to show any positive results except for anecdotal success stories from Facebook moms with zero knowledge about how any of this works and are likely experiencing placebo, or dental changes.  MSE is also less expensive, and will produce results in less than half the time.

 

👏🏻👏🏻👏🏻

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Posted : 02/01/2021 5:35 pm
toomer
Estimable Member
Posted by: @deebob

Actually I'm getting my information from the fact that I did DNA and experienced no improvement in nasal breathing and saw no noticeable skeletal change.

And how long did you go through treatment?  Were you provided a Vivos airway intelligence report at the various CBCT checkpoints throughout your treatment, and if so what did those measurements say?  How much did some of the Sassouni measurements included in the airway intelligence reports you got change - and in which direction, better or worse?  Would you be able to share some pages out of that report so that we can see that you didn't experience any changes?

It's unfortunate that you did not achieve a clinical benefit (a "failed case"), assuming you saw the protocol all the way through to completion.  That does seem to happen sometimes.  However, it's important to not allow "sample bias" to cloud judgement.  For example, it's snowing outside my window right now.  It would be incorrect for me to assume that therefore, it must be snowing everywhere else in the world right now.

I believe that treatment protocols (including MSE) can have three likely outcomes:

1) Works every time, for every patient (basically, nothing really exists here - not even jaw surgery)

2) Works some of the times, for some patient depending on their condition (which makes case diagnosis critical)

3) Doesn't ever work for anyone, ever

I believe that DNA and MSE are both in camp #2.  You seem to think DNA is in #3, but I disagree.

My provider, for example, won't treat smokers - because he says that smoking inhibits bone growth, he just doesn't see a positive response in those cases, so he has stopped taking on those patients.

I don't see how that is going to change the higher parts of the skull, and widen the nasal cavity.  And I'm not interested in what Dr. Singh has to say about it, there are zero studies or evidence put forward from anyone but Dr. Singh, and every single reputable orthodontist says it's only causing dental alveolar expansion.

And yet, Vivos is - in their airway reports - tracking things like changes in intercanthal angle in patients.  I've seen the reports myself, from the "Facebook moms" you deride in your choice of language.  Tell me - how are the angulations of patient's eyes changing, if all we're doing is moving teeth?

Here's a study that one of Dr. Singh's treating dentists performed, showing about 2.4 cubic centimeters of additional sinus cavity area volume post-treatment.  Sinuses are bony cavities ... how are those getting larger, if we're not creating new bone?  

https://www.sciencedirect.com/science/article/pii/S2095881120301360

Yes, Dr. Singh is listed in the lead author spot.  But the work was done by one of his dentists all the way over in Korea, just the same way that I see some of Dr. Moon's clinical evidence is provided by his treating orthodontist partners - like in the talk he gave recently.  So sure, maybe they're all just fabricating all of this evidence everywhere and getting them into peer-reviewed journals?  I'm doubtful, though.  Again, you - as an individual - might "fail" as a case, but just like my "snowing" analogy earlier - that does automatically mean the appliance and treatment protocol fails in all cases.

And since you probably won't seem to believe anything that has Dr. Singh's name anywhere near it, here's a different study with a different type of "functional" maxillary acrylic appliance.  This was - as far as I can tell - very well run ... a dozen patients, all adults, "blinded" the radiologist as to which image was which patient, and which was before and after, and did the ceph traces twice.  It was a short treatment time averaging 5 months, but post-treatment they measured 1.41mm increase in "facial width" as measured at the outermost tip of the zygomatic arches.  Can you tell me how on earth the ends of the zygomatic bones are getting further apart from each other in space, if all an appliance like that could possibly do is "push teeth"?

https://www.sciencedirect.com/science/article/pii/S1808869415300513

I'm being serious about this.  Your core point is that an acrylic appliance in the maxilla can't ever cause changes in bones higher in the face.  Yet in this study, that's exactly what happened.

It should be a red flag that most Vivos providers are "holistic" dentists who aren't particularly knowledgeable about orthodontics/orthopaedics, and defer to Vivos throughout most of the process, versus orthodontists that do MSE who are hands-on and can oversee your case themselves.

So, a whole bunch of things IMO which are wrong here ... and some I don't quite understand your logical arguments.  Most Vivos providers today are traditional dentists who are doing crowns, bridges, whitening, cavities, cleanings, etc.  Some of the very early ones who got on board early with Dr. Singh were the more "holistic" ones, I would agree.  But I would say it's not a fair statement to make today.

But does that somehow make it better or worse?  They're licensed dentists either way?  Honestly, that whole line of yours sounds like it's straight out of a Ron Ead / Dr. Ting JawHacks video.

And your last part - "deferring to Vivos", how is that bad ... especially as a dentist gets started?  Putting it another way, would you feel more comfortable if your local Orthodontist who just went to a week of training on MSE and has never done a case before you sit in their chair ... just tried to "wing it" alone with your case, or would you feel better if Dr. Moon was perhaps consulting with that ortho during treatment and helping them along?  Because that's what Vivos does to try to help.  It's not a crutch, it's a sound clinical strategy.  Besides, I have personally talked with one Orthodontist in my neighborhood ... and guess what? She is in regular contact with Dr. Moon about cases.

Most Vivos-trained providers, after a few years of cases, don't need the support system any longer.  My provider got trained about 7-8 years ago.  He doesn't pay any more to be a "Vivos Integrated Practice" because he's done hundreds of cases and has seen all the ways it can go.

And even if by some miracle an acrylic expander pushing on the teeth is capable of expanding the skull, a 19 year old should just go with the method that is guaranteed to produce significant skeletal change

Yeah?  And how about for us 50 year olds, eh?  Maybe think a bit more about people in a condition in life which perhaps does not closely match your own?

is yet to show any positive results except for anecdotal success stories

Sorry, but this is utter horse [Rude Language or Insults are not tolerated].  There have been countless cases of cured sleep apnea - validated with real, neutral, 3rd party sleep tests - that the company has documented, and patients themselves have reported.  I already know of two people who cured their sleep apnea.  That's a "positive result" in my books.  Even if it's all dental, as long as it's safe, if that meant I had to wear a Vivos appliance at night for the rest of my life, I'd happily do so ... because it's much more manageable than my CPAP.

Dr. Moon recently gave a talk where he discussed interesting changes and expansion in the pharyngeal airway, post-MSE treatment.  MSE expanded the nasal airway, but then the throat got larger.  He pondered why that was, because it wasn't something they were expecting ... and now he apparently wants to start running studies on sleep apnea (which is good, I commend him for that).  

He actually printed a 3D model of the airway before treatment and afterwards.

But guess what?  Dr. Singh and one of those "holistic" dentists you deride ... had done the same thing ten years ago:

https://imgur.com/a/GNmO6P3

So if Dr. Moon can show changes in the pharyngeal airway after MSE and that's an amazing thing which proves an improved/increased airway ... why do we deride Dr. Singh's technique, which was demonstrating the same pharyngeal changes a decade ago?

 

 

 

 

ReplyQuote
Posted : 03/01/2021 11:36 am
toomer
Estimable Member
Posted by: @sergio-oms
 
👏🏻👏🏻👏🏻

No ... 

👎👎👎

Does "OMS" in your username imply that you are an oral/maxillofacial surgeon?

 

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Posted : 03/01/2021 11:45 am
Sergio-OMS
Trusted Member
Posted by: @toomer
Posted by: @sergio-oms
 
👏🏻👏🏻👏🏻

No ... 

👎👎👎

Does "OMS" in your username imply that you are an oral/maxillofacial surgeon?

 

yes, I am this guy

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Posted : 03/01/2021 2:08 pm
toomer
Estimable Member
Posted by: @sergio-oms

yes, I am this guy

 

Awesome.  Glad you participate here with us.

Tell me, do you think this time lapse (edited to add timestamp) ... is only showing tilting of teeth?  Or is there something else going on?  It's especially interesting seeing the time-lapse of the mandible.  

This patient was roughly 60 years old at the time of treatment, and photos were taken every 3 months over a period of 18 months by an orthodontist ... so they seem like they were properly done.  To me, it looks like those teeth are actually keeping roughly the same angulation ... but getting further apart from each other in space.  But, I'm not a professional.

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Posted : 03/01/2021 2:18 pm
Sergio-OMS
Trusted Member
Posted by: @toomer
Posted by: @sergio-oms

yes, I am this guy

 

Awesome.  Glad you participate here with us.

Tell me, do you think this time lapse (edited to add timestamp) ... is only showing tilting of teeth?  Or is there something else going on?  It's especially interesting seeing the time-lapse of the mandible.  

This patient was roughly 60 years old at the time of treatment, and photos were taken every 3 months over a period of 18 months by an orthodontist ... so they seem like they were properly done.  To me, it looks like those teeth are actually keeping roughly the same angulation ... but getting further apart from each other in space.  But, I'm not a professional.

The apparent effects on that timelapse do not seem to concur with this superposition: https://youtu.be/R5S5AZ50pAE?t=948

He says something like "green is where I started, red is where I grew up bone", doesn't he? Actually this superimpositions are done by overlaping the most stable structures, such as the sella and other cranial base references. The mandible moves so any superimpositions using these reference points also account for those movements of the jaw (like he jaw being opened by new dental interferences, or sliding under the upper jaw or closing when interferences are removed

Actually I would only trust studying and comparing the raw data of the CTs, but, to me, I do not see much effect, not even dentoalveolar effect, but if I had to trust that slide, I only see the mandible being untrapped and the left mandibular condyle sliding a bit forward.

I haven't spent much time looking for information on this appliance, but its claimed mechanisms and the unappropriate use of new and fancy scientific language (such as the word epigenetics, or the way they named it, using meaningless words just so they fix in that acronym, DNA) are those of snake oil salesmen, so it is not a very good starting point.

No ofence!

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Posted : 03/01/2021 3:00 pm
toomer
Estimable Member

@sergio-oms

No offense taken!

I try not to look too much at the cranial 3D overlays - especially for the mandible - for exactly the reasons you state.  If I'm holding my mandible further forward, then it will definitely look a little bit different in that type of analysis.  However, in the patient's right cheekbone ... there seems to be indication of some change.  Would you agree that there seems to be change there?

I also agree with you on the use of the term "epigenetic" to a certain degree.  In reality, they should just be calling it a functional appliance - because it's designed to elicit more of a functional response from the body and trigger the body to do a good portion of the work.

But can we agree that we can evaluate potential clinical efficacy (or lack thereof) regardless of the terminology used?

To that end, you seem to have avoided making any clear commentary on the time-lapse itself?  You seem to have focused your reply on the 3D superposition overlay.  But the time-lapse of the mandible change - to me - seems to clearly shows teeth moving further apart from each other in space, an overall arch shape that appears to be getting wider, and (at least to me) no real indication of tilting crowns outward, or crowns simply being pushed out to the edges of the alveolar structure.

Do you agree that those changes seem to be taking place in the time-lapse, or do we disagree on that?  

To get more clinical - I'd also leave you with this.  The inventor of the DNA appliance took a batch of patients, and on the CBCTs pre- and post-treatment they isolated just the maxilla itself, and measured the net volume of bone.  More specifically, they measured "between the anterior and posterior nasal spines, the dentoalveolar margin and the hard palate, including the palatine bone, but excluding the frontal process of the maxilla and the crowns of the teeth" (see figure 4).

https://www.researchgate.net/publication/264298692_Changes_in_3D_Midfacial_Parameters_after_Biomimetic_Oral_Appliance_Therapy_in_Adults&source=gmail&ust=1609791366799000&usg=AFQjCNHPk-sPNxvWr7m0ZYHwJLh_p6igt A"> https://www.researchgate.net/publication/264298692_Changes_in_3D_Midfacial_Parameters_after_Biomimetic_Oral_Appliance_Therapy_in_Adults

They measured about a 10% increase in the net bone volume of the maxilla itself, post-treatment.  As far as I know, this is a peer-reviewed journal - although not a US one.  There are only a few options I can see as the answer - either the maxilla did get larger by 10%, or Dr. Singh and his study collaborators either intentionally or accidentally measured wrong AND the peer-review process did not catch this.  Or, Dr. Singh and his study collaborators either intentionally or accidentally measured wrong ... and there is NO peer-review process.

If we assume honest intentions and behaviors on the part of the study authors, I'm not sure how to explain this other than ... slow changes can perhaps cause the adult maxilla to adapt.  Just like slow changes in this study (not from Dr. Singh) showed zygomatic markers getting further apart from each other in space, even though the only thing that was used was a maxillary acrylic appliance adjusted very slowly.

---

I'm valuing this conversation from a scientific basis - as I am just a few days away from putting $ down on a DNA appliance to hope to cure my sleep apnea (for which they have a lot of clinical evidence of being able to accomplish, and have submitted to the FDA for review).  So I'd really enjoy continuing our conversation as much as we can from a purely scientific perspective and avoiding statements like "snake-oil salesmen" ... because I find that once statements like that are used, it's rare that any true analysis or consideration is really taking place any more.  I certainly understand you probably have a "yeah, I've heard claims like these before" - but I really would value knowing why you might think some of these results are faked, photoshopped, or somehow otherwise not real for some research methodology reason.

 

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Posted : 03/01/2021 3:41 pm
Sergio-OMS
Trusted Member

@toomer

short answer: I would look into other ways of treatment

I sounds to me like you might have convinced yourself about this, so I don’t want to take that  away from you.

Anything that creates more space for the tongue and relieves the “entrapment” of the mandible will have a positive (small or large, but positive) effect on your breathing 

But from my point of view it’s a matter  of opportunity cost (or opportunity loss).

if you are going to get into a treatment that messes with your current bite  to expand your airway you want it to be really effective. 

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Posted : 03/01/2021 5:06 pm
toomer
Estimable Member

@sergio-oms Thank you Dr. G, I appreciate all your responses so far.  I have looked into other ways of treatment.  I've spent nearly all of 2020 considering my options.

You're right - I have mostly made up my mind, but I am always open to countering facts/opinions up until the last minute.  Unfortunately, far too many opinions come packaged the same way - "I haven't spent much time looking for information on this appliance" ... but certain that it doesn't work nonetheless.  I've been searching high and low for someone who could say "I have looked into this appliance, and this is why it won't work" ... but can't seem to find someone who can support an opinion of why it won't work other than general knowledge ... nothing specific to the appliance itself.

And I don't necessarily hope or expect you to do that for some Internet stranger.  I'll just keep looking.

In terms of being "really effective" - for sleep apnea, Vivos has the data on that.  And it's not how oral surgeons typically claim a "90-95% success rate" (sorry, no offense) where "surgical success" is defined as a 50% reduction in AHI and AHI brought below 10.  For Vivos, they get AHI under 5 - which is truly clinically cured - between 70-80% of the time for mild-to-moderate cases.  As a sleep apnea patient, that seems like a very good track record to me.

Again, I am very thankful for your time.   At some point, I do hope you might be curious enough about whether or not functional (instead of mechanical) appliances might be able to slowly affect changes to the maxilla over a long time horizon, that you'll decide to dig a bit deeper.  One thing to definitely keep an eye on is whether or not Vivos is able to announce a FDA approval in the next 3-6 months, because they are going for "class II" medical device approval, which means they will have to document clinical efficacy to the FDA.  If that comes out, and the FDA validates they are curing sleep apnea for patients regularly ... I do hope you'd consider looking into it further.

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Posted : 03/01/2021 5:44 pm
Sergio-OMS
Trusted Member

@toomer
🤷‍♂️

your body, your choice

 

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Posted : 03/01/2021 8:13 pm
MarylandIsSouthern
New Member

@deebob How old are you/were you during DNA treatment. I will concede there is a convincing argument to be made that past ~25 years old that less forceful treatments may lose their effectiveness on some. I still don’t buy DNA being useless.  

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Posted : 03/01/2021 9:43 pm