Note: This post may contain statements that I no longer consider true.
See: The Vivos mRNA Appliance Didn't Improve My Obstructive Sleep Apnea.
I’ve spent the last few weeks actively researching surgical, orthodontic and dental treatments for obstructive sleep apnea and visiting a lot of specialists to fully explore my options. I have underdeveloped jaws and nasal obstruction causing severe sleep apnea, possibly the result of extraction/retraction orthodontic work done when I was 13.
I visited orthodontist Derek Mahony recently who referred me to an ENT surgeon to investigate Maxillomandibular Advancement (MMA) surgery and Distraction Osteogenesis Maxillary Expansion (DOME). The success rate is high but it looks nasty. Derek said I would need 12 months of braces before the surgery, and I would need to be on CPAP in the meantime; so no matter what I do I realised I need CPAP to stay alive while I’m getting a permanent treatment sorted out. I’ve been on it for about a month and I’m hoping my general health will improve while I explore my options to expand my jaws and sleep naturally again.
I still remember the pain of braces in high school; but life with sleep apnea is horrible so I could be trading off a short period of intense pain against ongoing fatigue, headaches and an early death. Seems like a good trade-off if only I can get through the pain.
Compared to surgery and/or orthodontic treatment, the Vivos DNA appliance looks like a really good alternative. The mRNA version could potentially replace my Mandibular Advancement Device I’ve been using to help lower the pressure required by my CPAP machine.
The Vivos mRNA is a 3-way palate expander with mandibular expansion and advancement
There are heaps of glowing patient testimonials online and they have published a paper with case studies showing it is effective in severe cases like mine. I’m not entirely convinced by all the epigenetic and biomimetic claims though. If it’s really that easy to expand the jaws over time with what is essentially a glorified 3-way acrylic Schwartz expander with fancy springs on the front, why do people go to the hassle of having screws put into their palate or having the palatal suture surgically separated with DOME or Surgically Assisted Rapid Palate Expansion (SARPE)?
It’s also not available in Australia yet where I live, although Dr Singh recently visited Sydney and presented a lecture attempting to recruit local dentists which I gatecrashed. I even met the guy and talked to him in person where his main question to me was about insurance cover, which is secondary to my priority of picking the best treatment for me. His presentation was similar to this one and contained a lot of hype about the results people were getting and plenty of buzzwords, but very little substance on the actual device itself. Members of the audience were getting restless towards the end because Dr Singh didn’t want to show them the actual device. It was a bit weird to be honest and not the sort of thing that resonates with Australian audiences who prefer people to get to the point.
The cost for dentists to do the Vivos training was quite high (tens of thousands of dollars) and the markup on the device is also very high, so it’s expensive. The company do most of the assessment work for them and there isn’t a lot to do at the regularly scheduled follow-up visits, so it’s potentially quite a lucrative deal for the dentist to get into the exploding sleep apnea market. If it works, it would probably be way cheaper and less painful than surgery and orthodontic treatment. The guy who organised the tour said that he personally underwent the Vivos evaluation procedure just to be able to experience it first-hand, and ended up discovering he actually had undiagnosed sleep apnea. He said after a few weeks the mRNA had cured his brain fog. They overcatered the event and gave me a $50 tray of prawns to take home afterwards, but I’ll still try to be objective about what I heard.
I’m not so concerned about how long the DNA treatment would take, especially if CPAP restores my health so I can enjoy life in the mean time. I don’t see CPAP as a long term solution but I could tolerate it for a couple of years while doing DNA. I’ve also been mewing fairly consistently for a few weeks, and increased my consumption of crunchy foods as jaws grow in response to mastication; well, they do in children anyway. As for adults, I wonder. I eat my carrots raw now, dipped in hummus to make them more palatable, for instance. I started to notice that my 6-month-old Mandibular Advancement Device (MAD) doesn’t fit so well any more; it hurts putting it in now and feels as though it’s pulling my teeth inwards; which is the exact opposite of what I want. I got it after finding my CPAP trial intolerable due to mask fit and pressure issues, and since getting the CPAP a month ago have used both together. However the last few nights I haven’t put the MAD in because it hurts my teeth and I wonder if it’s really necessary, and I haven’t noticed any difference.
This is good news for a few reasons, including that if I proceed with surgery I’ll need to be able to sleep with the CPAP alone since the MAD won’t fit any more. In fact, anything I do is going to render the MAD an obsolete chunk of $2K acrylic. One side-effect of the MAD is that my lower jaw now sits further forward during the day than it used to, and I can’t chew on my molars any more. It is possible that the device has merely relaxed my jaw muscles to the place where my lower jaw is meant to sit, and now my front teeth clash due to my underdeveloped upper jaw (a.k.a. retrognathic maxilla). I will need some sort of treatment to fix this and it is another reason why CPAP alone isn’t enough for me long term. I’ve seen pictures of DNA devices which have a three-way action that includes pushing forward as well as sideways and I suspect I would require this to fix my bite.
Another upside of DNA is that it appears you don’t appear to need braces afterward because there is no diastema. It seems the gradual expansion can allow the teeth to settle in what would have been their normal uncrowded position, like they would have if I’d eaten enough crunchy foods as a kid and/or an orthodontist had used an expander or self-ligating braces on me; which may not have been invented back then.
I’ve also been in touch with Theodore Belfor who invented the Homeoblock appliance, which appears to be essentially the same thing as DNA without the fancy/expensive Vivos marketing. He and Dr Singh are coinventors on the patent which appears to cover both devices. He asked me to send him my CBCT scans to see what he recommends, and a couple of weeks ago I visited a dentist who did a CBCT scan and is preparing his own treatment proposal which I’ll learn about at my next appointment on Monday. I have no idea the relative cost of Homeoblock vs DNA yet.
Surgical standards for sleep apnea generally define “success” as a 50% improvement in AHI, but this is bullshit in my opinion; it just allows the surgeon to feel good about what he’s done and claim higher than reasonable success rates. A 50% improvement would still leave me with an AHI of 25, which is at the high end of moderate sleep apnea; and probably a hugely compromised quality of life. Most sleep apnea surgery has low success rates even by this metric. A true cure reduces your AHI to < 5. MMA has high cure rates so it’s the only surgery I’m contemplating; possibly with nasal turbinate reduction which I may not need if palate expansion is successful in reducing my nasal airway resistance. DOME with MMA gives a better result than MMA alone, so I’m thinking of having DOME with self-ligating braces to prepare for MMA, and then make the final decision after 12 months of that about whether to go under the knife. Relapse rates for MMA surgery are low, although sleep apnea is a degenerative condition and there are cases of people who have had their sleep apnea successfully cured by MMA surgery and later had it return. Studies suggest that they probably would have been even worse off if they hadn’t had the surgery in the first place.
If wearing a fancy acrylic expander in my sleep for a couple of years can avoid all that pain, I’m up for it. My inner skeptic says that Vivos DNA sounds a little too good to be true. Why would anyone get their palatal suture split and their jaws cut apart if the gentle pain-free force of DNA really works as well? Rapid Palate Expansion in adults generally fails or has high relapse rates because it’s just pushing on teeth and not actually moving the bones of the skull apart. That’s why Prof Won Moon and the like put screws into the palate with MARPE expanders like MSE. Why would they go to that length if it wasn’t really necessary and you could widen the thing with gentle pressure applied over a long time?
I don’t see any real magic in the DNA or Homeoblock that a regular Schwarz expander doesn’t have, save the fancy springs. Maybe Homeoblock really does work the way Dr Belfor says in his video by flexing in response to swallowing and this does widen the palatal suture and jaws. If so, I’m up for it and it’s going to put a lot of MMA surgeons like Dr Li out of business. I haven’t seen a study showing relapse rates from people using DNA and I suspect you’ve got to wear the device for life afterwards as a retainer to prevent your teeth shifting back. In his Sydney presentation Dr Singh said it was so comfortable that he/people (I can’t exactly remember) want to wear it anyway. My bullshit detector went off at that point.
Vivos make a point about the mRNA being approved by the FDA to treat mild-moderate sleep apnea, but in the 510(k) Premarket Notification for the Vivos mRNA, the claim which the FDA accepted is based on Substantial Equivalence to other Mandibular Advancement Devices including the SomnoMed I have. In the submission they say “An adjustment mechanism enables the devices to be customised for each patient”, but don’t claim that it will permanently expand the jaws and cure the condition, or use any of the buzzwords like biomimetic or epicgenetics; like they do in their marketing. They even downplay the adjustability of the device in the conclusion to argue that it’s still substantially equivalent to a regular old MAD. This allows Vivos to accurately claim that the mRNA is approved for the treatment of mild to moderate sleep apnea in their presentations, but probably leaves most listeners believing that the FDA agree with the biomimetic claims for the device; when in fact they have not.
It’s a grey area because MADs and CPAPs are presented as an effective “treatment” for sleep apnea, but they don’t address the cause and they certainly don’t cure it because you need to keep using them for life. Some research indicates that they either make the condition worse over time, or at best don’t prevent it worsening naturally.
One of the few long-term studies on mandibular advancement device use is Marklund’s Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea, which Dr Singh often cites in his presentations. In a group of only 9 patients aged a median of 68.1 years, after 16.5 years use their condition had deteriorated to the point where they had a worse AHI with the device in place (35.1) than they did without it (32.4)! This is an astonishing finding which still wonder whether there is a mistake in the data. I can understand the treatment making the AHI worse over time as the force of the mandible slowly pulls the maxilla backwards, but how could advancing the mandible then make their AHI worse? It’s a wonder anyone would buy one if they’ve read this study.
Ironically after mentioning this study in his presentations, Dr Singh proclaims that the mRNA is approved by the FDA… but it’s only approved as an MAD, by arguing substantial equivalence with the SomnoMed appliance which failed to treat my severe sleep apnea effectively. Also, Biomodelling Solutions Inc, the precursor to Vivos, got busted by the FDA for not having adequate design control systems in place. I was a Biomedical Engineer before the mystery illness which I now think was undiagnosed sleep apnea forced me into early retirement, and this doesn’t bode particularly well for Dr Singh; especially when I suspect his grand claims of being able to re-enable dormant adult stem cells to grow new bone via some mysterious biomimetic process may be playing a little fast with the truth.
That said, if the Vivos system was available in Australia and I knew it would work for me, I’d get it. I just can’t predict either of those two things, so I keep exploring other options too. So that’s where I’m at right now. I expect it will change again after the next specialist I see. I have no real experience yet with anything other than MAD and CPAP at this point. Other people’s milage may vary but please let me know your thoughts and conclusions. I feel better knowing that other people are sorting their way out of this maze too.
Cheers,
Graham
Update: A dentist I met at Dr Singh’s presentation joined the Vivos provider program and did the training during lockdown when he was unable to see patients, so I got a Vivos mRNA Appliance. You can read more about why I chose it here. You can read my latest progress update here.
85 Comments
michael · July 3, 2024 at 12:31 PM
I have consulted with two sleep dentists who both recommended the vivos dna device though Dr. Alan Ko does think Marphe would give me better results. I have obstructive sleep apnea, small palate need an expander and had many tooth extractions as a child. I am working with myofunctional therapist who is now wants me to consider doing a tongue tie release with sutures. They did do full evaluation and got a report from VIvos and will get evaluation from Dr. Evans in Philadelphia for marphe.
Dr. ko evaluation:
Extraoral:
Michael is presented with negative intercanthal angle and commissure below horizontal. Shoulder is up on the
left. Cervical tilt up with downward gaze. Bilateral TMJ pushback when examining external auditory meatus
which indicates distalization of TMJ and underdevelopment of the maxilla.
Intraoral:
Moderate-Severe anterior wear of incisors both upper and lower indicative of parafunctional habits anteriorly to
decompress TMJ. Transpalatal measurement at 31mm indicating narrow high vaulted palate, which typically
translate to possible deviated septum, turbulent nasal airflow. Cottle test positive also confirm narrow
constricted nasal passage. Ankyloglossia (TRMR Grade 3). Patient unable to create palatal suction. Habitual
edge to edge function.
Visual inspection of tongue size compared to functional space, appears to be restrictive. Bilateral scalloping of
tongue noted.
Impression:
Maxillary deficiency in transverse and anterior-posterior dimension. Mandibular entrapment and distalization
of TMJ bilaterally. There is high possibility tongue is impinging on airway during sleep, especially during
REM in supine position.
any suggestions ?
Graham Stoney · July 3, 2024 at 2:08 PM
MARPE or SARPE could address the transverse maxillary deficiency, and only MMA can address the anterior-posterior. An MAD, Inspire or CPAP may also be worth exploring.
Sam Hakim · January 19, 2023 at 2:36 PM
I’m a dentist who deals with TMD and apnea, your story is amazing and interesting but I have no more comments . you covered the whole world
Alyssa · February 22, 2022 at 4:14 AM
Hello,
I’ve recently started using the DNA appliance and I notice that appliance only seems to be expanding on one side. Did you experience this at all? Like the gap is starting to be on one tooth instead of in the middle.
Graham Stoney · February 26, 2022 at 4:11 PM
No I didn’t notice this Alyssa. Might be a good question to ask your provider. Cheers, Graham
SimiS · May 2, 2022 at 1:20 PM
I’m a dentist in Ottawa. I’m very confused why you went ahead with the Vivos appliance after having nothing good to say about it. Can you explain?
Alba Vaz · February 16, 2022 at 9:44 AM
Hello Graham. Would sure appreciate an update on how you are faring with the DNA appliance therapy. I did not do well but my case is rather unique. Hope all is well with you!
Graham Stoney · February 16, 2022 at 10:16 AM
Hi Alba. It’s not going quite as well as I had hoped. You can always read my latest update here. Cheers, Graham
Lisa · August 11, 2021 at 3:09 AM
Hi Graham,
Very interesting, all of it! I was searching for information for my 6 year old daughter and found your post. I’m on the fence with whether or not to pursue Vivos or HealthyStart with her. We have an appointment next week for CBCT and impressions and results if that will determine which “program” to move forward with. As with everyone looking into this, my daughter has a small crowded mouth and is starting to lose her teeth, with no room for adult teeth. She does not necessarily have sleep apnea, but has many symptoms that point us in the direction of such a program (open mouth breathing, slight speech changes with the “r” sound, sweating at night, large tonsils, lymph nodes and assuming adenoids (we have not seen an ENT), etc). I read the book “Jaws” and it has opened my eyes. In addition, reading all the comments about experiences from adults on this site. I’m on the fence about how a child would handle all this, and, if I don’t do anything at this time, she will most likely grow up with a gummy smile and a protruding face. The pediatrician said if the dentist has expertise with children and is not a “family dentist”, she approves. My daughter’s dentist (the Vivos and HealthyStart are at an integrative dental office) waits until age 7-8 to ensure most baby teeth are out before an expander is used. My question is do I wait a little longer and maybe the dentist can start an expander earlier or do I pursue a Vivos or HealthyStart program? What is so different with these programs vs regular expanders and braces?
I’m even having 2nd thoughts about the CBCT scan for my 6 year old, haha! (If not truly necessary, it’s like having 11 xrays), but of course, required for evaluation for these programs. Any insight or thoughts are so appreciated! I wish everyone on this site the best of luck with their paths they are taking and hope that the outlook for those with sleep apnea will have a bright future ?. Thank you for having a site like this available!
Respectfully,
Lisa Crivello
Graham Stoney · August 11, 2021 at 6:34 AM
Hi Lisa,
I get that it must be confusing trying to work out the best way to help your daughter. I haven’t done much research into this, but I don’t see the logic in waiting to treat a developmental problem. I would imagine the sooner expansion is started, the sooner your daughter’s facial growth and development will get back on track. Perhaps someone with more experience with children can comment.
Cheers,
Graham
Lisa · August 15, 2022 at 3:25 AM
Hi Graham,
Thank you for your response. It’s a year later and I had no idea you responded. I just happen to stumble onto your post today. So sorry to hear about your experiences with Vivos. At least you tried and know it’s not a good fit. Good luck to you in the future. Hopefully technology will advance in this field and offer less invasive options. My daughter is in myofunctional therapy to work on tongue and facial strength and we have also visited 5 different orthos (all have different appliances and different opinions!). I was hoping for consistent evaluations to make our decision for expansion easier, but that didn’t happen haha. At this point, my daughter is 7 years old and was told we are a little old for Healthy start since that does not give adequate expansion. We will move forward with an expander in the next few weeks once we decide if RPE, SPE, or BioBlock is the best fit. I’m so confused! Again, I appreciate your journey and time dedicated to find the best fit for those with CF and sleep apnea. Best wishes!
Lisa
Graham Stoney · August 15, 2022 at 7:40 PM
Thanks Lisa. I hope you find something that works for your daughter. Cheers, Graham
ANON · August 13, 2021 at 8:17 PM
Hi Lisa,
I hope I can help answer some of your queries. I am a dental practitioner in Sydney with a huge interest in children and adult’s airways. I also have training in Orofacial Myology (it’s like physiotherapist for the mouth).
Firstly, it’s never too early to treat crowded teeth and underdeveloped jaws! In fact, it’s much better to treat earlier when young ages bones are very malleable.
In short, the difference between Vivos and healthy start is mainly on the mechanism. Vivos is exactly how Graham has explained. On the other hand, healthy start are a series of oral appliances that help eliminate any oral habits ( these include thumb sucking, dummy use, finger sucking, lip biting etc.) , promote good tongue posture, lip seal and nasal breathing. As you can imagine, when the tongue is sitting at the correct spot (the bumpy part of the palate just behind the upper two front teeth) it acts as a natural expander. With proper breathing habits, it obviously helps with the sleep disordered breathing/ potential sleep apnoea. Regardless of which appliance is chosen, your daughter may undergo some myofunctional therapy alongside this (that’s my field!) to help train your tongue position, tongue swallow, lip strength, and nasal breathing to ensure that our natural body can do its best to maintain the results and improve her overall health!
I understand your concerns about the CBCT, but to put it to perspective a CBCT is 0.01% of radiation dose compared to a chest x-ray. Even with relatively low doses, a CBCT captures a lot of information! It’s useful in being able to assess how wide the airway is, where the tongue is sitting, any blockages in the sinuses, any nasal blockages, and can show if there’s potential enlarged adenoids as well. With this, it will beneficial for the clinician to provide a very tailored treatment plan for your daughter and improve her outcome as best as possible.
Just a note as well, double check that your daughter doesn’t have any untreated/not managed allergies triggered regularly, hay fever, sinus issues prior to sticking any appliances in for long hours as it can make the breathing at day and night worse.
Alas, I hope I have answered some of your questions Lisa. As this is over the internet, it’s best to speak to your integrative dentist and other health profession for their best advice! I wish you and your daughter luck in restoring optimum function!! It will be a long journey but worthwhile.
Lisa · August 15, 2022 at 3:48 AM
Hi Anon,
As my post notes above I didn’t realize you responded to my post just about a year ago! I wanted to thank you for your information. We did see an ENT and he said my daughter would benefit from expansion and this would help with louder nasal breathing at night. We tried Flonase for 3 months to see if that would decrease her turbinates which were somewhat enlarged. We did not see much of a change. We have not had her allergy tested yet. She does have larger tonsils, but he did not seem concerned, at this point, and was hoping expansion may help decrease their size due to years of open mouth breathing (she rarely open mouth breaths at night anymore). So, expansion is where we are at currently. Of course, there is always the tongue tie possibility down the road if issues with expansion?? Wow, there are so many appliances and avenues to go with this. We’re leaning towards either BioBlock (a long extensive journey) or traditional expanders on both top and bottom. We’re not a fan of headgear, which is included as part of the BioBlock system. I think it’s a forward growth so that is a bonus to open the airway. I don’t believe she has a “bite” issue so I’m not sure headgear is needed. Our concern with traditional expansion is wondering if a bite issue could occur as a result. We can’t see how both top and bottom will expand exactly as needed. Looking at a spring option instead of key to have a gentle consistent pressure instead of forced. Would love removable but sounds like those don’t offer much expansion and, of course, compliance with children.
RPE vs SPE …removable vs fixed. Relapsing and retainers, then braces. Oh my so much to learn! I appreciate your dedication as a dentist with a specialty in the airway! Please continue to spread the word to all dentists and patients alike! Take care!
Lisa
A. Vaz · February 16, 2022 at 9:34 AM
Have your child evaluated by a an orthopedic chiropractor to evaluate her cranial stability and more. Consider a DMX (digital motion xray) to evaluate her neck and head movement. And please get her off carbs especially all fructose (honey, fruit), nuts/seeds (high linoleic acid), high oxalate vegetable, off all legumes and grains. Adopt an animal based diet with high saturated fat and she will thrive.
Lisa · August 15, 2022 at 3:55 AM
Hi A. Vaz,
Thank you for your comment! We will consider visiting an orthopedic chiropractor. This is all new information to me. We will also try to work on her diet. We always try to offer healthy food choices, but it’s not an easy task when they are picky eaters to begin with. She does eat a lot of cheese! Grateful for your reply, thank you again!
Lisa
Kailee Ackerman · May 25, 2023 at 3:36 AM
Hi Lisa,
Do you have an update on your daughter? We’re going through the same decision making process with our son right now.
MaryLynn · July 2, 2021 at 12:36 AM
Hello, thank you for your posts. They are helpful. I started my Vivos appliance journey in December of 2020. Around June 2021 a 2nd appliance for the top was ordered and I began adjusting the bottom weekly. I do feel it has changed the structure of my face. Not significantly and not $10k worth. My teeth and smile were beautiful before starting and now I have spaces, my teeth are very uneven in height. I’m embarrassed by my smile. I have concern that my top teeth are flaring and the bone structure has stopped growing since the 2nd top appliance has been provided. I did not feel it fit well when it arrived. My bite is completely off and it is difficult to chew on the right side of my mouth. I’m informed by my doctor that I will do Invisalign once this process is complete. Does anyone know if the bite improves? At times I feel I am not chewing my food properly. My doctor does not communicate well. I’m not sure what to expect next because he mentioned head gear!?
Graham Stoney · July 2, 2021 at 7:44 AM
Hi MaryLynn,
It sounds like you’re disappointed with the degree of change to the structure of your face, the spaces between your teeth and their uneven height. You had a beautiful smile before but now you’re embarrassed by it. You’re also concerned about flaring of your top teeth, that your bone structure may have stopped growing, your 2nd appliance does not fit well, your bite is completely off, it’s difficult to chew on the right side of your mouth, you may need Invisalign once this process is complete, at times you feel you are not chewing your food properly, your doctor does not communicate well, and you’re not sure what to expect next because he mentioned head gear. That sounds like a lot to be dealing with; I can see why you’d be concerned.
I am assuming that my bite will improve by chewing solid food in the new position, but it will all take time. I would suggest raising your concerns with your provider and asking him specific questions about your concerns. You may also find the Vivos Support Facebook Group helpful.
Cheers,
Graham
Claudia · July 3, 2021 at 8:10 AM
Hi Marylynn. Thank you for sharing your experience. I had invisalign for 3 years and in the process my bite was off but then it improved. I Finished back on april and my back molars aren’t touching like it should. They said that is something common when wearing invisalign because the teeth get used to have a plastic( the appliance) on top of your teeth but with time they eventually close giving you a normal occlusion. Havent had that yet. Good luck to you
Claudia · June 27, 2021 at 10:24 AM
Hi Graham. I really hope you are able to answer me. I would like to know how your experience has been with Vivos when it comes to esthetics? Im currently 30 and recently had an app with a Dr for Vivos and they showed me there is a section where my airway passage is smaller. I had breathed through my mouth my whole life due to chronic allergies and underdeveloped maxilla for being a picky eater growing up. I finished a three and a half years with invisalign which was quite a journey. I have an adenoid face and the most important reason I would do any treatment is to improve my face aesthetically. At the clinic they told me there has been people that get improvement on their facial features as the result of using Vivos but that is something uncertain. It might not happen to me. They also told me I need invisalign at the end of the treatment.. again. Could you or any in here plz tell me what will be the appliance to help me with that? I had an orthotropic Dr an hour and a half away from me that uses biobloc. Fact and bionator but couldnt find much about those online. Thank you in advance and I hope someone can help me
Graham Stoney · June 27, 2021 at 10:58 AM
Hi Claudia,
I haven’t noticed any aesthetic improvement, but I haven’t really been looking. I’ll post the before and after photos my dentist has been taking when I finish treatment, but that’s not going to be for another 16 months or so. I am expecting there should be some improvement. If you have a small airway, you may find it starts to collapse in the next few years as you lose muscle tone due to ageing so be on the lookout for symptoms of obstructive sleep apnea; especially if you had any teeth extracted when you had your Invisalign treatment. Biobloc probably gives similar results to the DNA Appliance, but I have no experience with it. If aesthetics is the most important thing to you then MMA surgery with DOME, EASE or MSE is likely to be your best option, if you’re willing to deal with the pain, risks and recovery involved with major surgery.
Cheers,
Graham
Claudia · June 29, 2021 at 1:58 PM
Hi again Graham, so excited to see your reply and thank you for taking the time to answer me. I think the same as you when it comes to do the less invasive treatment first but in my case I will like to do a non invansive treatment and something that actually works for what I’m looking for and get to my goal. It will be really finantially, mentally and emotionally deteriorating for me to jump from one treatment to the other. I don’t have surgery or anything invasive on mind. I’m very conservative and like the more natural paths. Maybe my thinking is somewhat unreal. I had my premolars extractions when I was a kid and then my wisdom when I was already an adult. I contacted Dr William Hang about this because of his experience and the before and after photos on his website and he told me surgery was the only option without even looking at pictures of me which was doubful. Thank you again for this forum that is certainly helping people across the world and being able to express themselves on this subject. I will be looking at your progress closely and wish you the best outcome possible
Graham Stoney · June 29, 2021 at 3:11 PM
I’m glad you enjoyed my reply Claudia and are finding this forum helpful. Dr William Hang is one of the most experienced practitioners in this field so I’m not going to second-guess what he’s thinking but I understand that you found his recommendation doubtful or discouraging. I’m committed to expansion for the time being and if that doesn’t work, I’ll reconsider surgery. Cheers, Graham
Claudia · July 1, 2021 at 2:03 PM
Yes, it definitely was Graham. He said that if I find something nonsurgically that could improve a face esthetically I will be richer than the owner of Amazon which made me think that he mostly does surgery and doesn’t believe or work with any appliances out there. I don’t know. I had on mind making an app with him and going all the way from Florida where I live to California but either way. I will be waiting for the right doctor and treatment for me. Saludoss
Simi · May 2, 2022 at 1:43 PM
Graham, I want to thank you for this site. I am both a provider and a patient. My oldest son has just finished dental school and has also been diagnosed with severe sleep apnea! . We are both trying to figure out the wild west of airway treatment. I have been practising for 26 years and I have respect for your profession as well.
So far from where I sit, it sounds to me like you need surgery. My son does as well. I would probably recommend Dr. Reza Movahed or Dr. Kasey Li but they are in the US. Otherwise, I would highly recommend you see Dr. Marjan Jones if she is near you in Australia.
There is simply very little we can do orthopaedically without doing surgery in adults. Having said that, I do a lot of removable and fixed slow expansion in adults. I then complete it with clear aligners. Stabilizing the teeth with braces sounds good on the one hand but on the other hand I would worry about having those dual pressures on the teeth. I think a big part of what is missing in your treatment is myofunctional exercises. You need to strengthen and tone the oral pharyngeal muscles. It is a big part of helping you breathe at night! This whole field is very multi-disciplinary. It takes a lot of collaboration between different providers. I like to think of myself as a quarterback. (Thankfully, I’m a much better dentist than any kind of athlete! 🙂 I always do a thorough evaluation per the AAGO standards. Dr. Hockel could perhaps help you too. In fact he is starting treatment himself now and will be getting surgery by Dr. M! He will insist on myofunctional therapy as would I but he has gobs more experience than I will ever have because he’s been doing this his whole career and he learned at his fathers knee! An ENT can help with the nasal patency but just as there are so many different ways of what it also seem to be basic shorts expanders to me, there seem to be lots of ways of opening noses! I too am looking for a solution for both myself and my son! (I’m a drop more complicated because I also have hEDS). I’m looking into Alexo and vivaer. You can also look for a laser provider to tighten the collagen at the back of your throat which may help.
Again that’s what myofunctional therapy would do for you. Maybe I missed where are you posted that you’re doing that? You’re so well-informed I guess I’m so surprised that you’re not! Anyway, I also had four pre-molars extracted along with The strap around the neck type headgear so it’s no big surprise that I now have sleep apnoea now in my mid-50s. A sleepy dentist is definitely not a good thing! So I have a Somnomed for now but like you and now all of my children plus so many of my friends and family we are all trying to figure out the best solution. I see the tipping on your CBCT and that does seem quite extreme! Be very careful unless you want to get a mouth full of implants! OK maybe I’m being there but that does look quite extreme. It doesn’t look like you are getting any alveolar bone development at the root level. I truly hope you find help because you’re obviously a smart man with a lot to contribute and once you find a solution I think we can all Have a party for you! I hope this wasn’t too long and I hope it makes sense! Oh my goodness my family would probably be killing me right now for talking airway again ha ha thanks for taking the time to read this far
Graham Stoney · May 3, 2022 at 10:57 AM
Thanks for your encouraging words. Sorry to hear that you and your son are both dealing with this. I may well end up needing surgery, but thought it was worth trying Vivos first. This is a very confusing field for patients to navigate with a lot of contradictory information. I have done Myofunctional Therapy as part of my Vivos treatment, but I just watched this video by Dr Eric Kezirian critical of its use in adults. I suspect the truth may lie somewhere between his and Dr Zaghi’s extreme positions. The tipping is not quite as bad as I first thought, since my teeth were tipped inwards to start with and it’s normal for front incisors to angle outwards. There’s still plenty of bone around my teeth so I’m not at risk of losing them but I won’t be expanding the screw in the appliance any further. I have seen an ENT and had a septoplasty and turbinate reduction. I’m due to have a sleep study in June to see what impact everything has had so far. I hope you find an effective treatment, and that surgery goes well if you proceed down that path. Cheers, Graham
Tarek · April 23, 2021 at 11:26 AM
It was very interesting reading about your journey. I was wondering- have you read about DISE(drug induced sleep endoscopy)? Have you also considered hypoglossal nerve stimulator implants like the Inspire? I recently read about another device called the eXciteOSA. Technology seems to be booming !
Graham Stoney · April 23, 2021 at 7:27 PM
Hi Tarek,
Yes I’ve heard of DISE but I did have a regular nasal endoscopy done by an ENT and he said the obstruction was behind my tongue. Another ENT said he could tell tell I had a retrognathic maxilla just by looking at my face, so I have a classic case of trapped mandible. Hypoglossal nerve stimulation is a fancy high-tech workaround for a structural problem, which I’m aiming to fix via skeletal expansion. The OSA market is booming because all the kids like me who had extraction/retraction orthodontics in the 80’s are now middle age and losing muscle tone in their compromised airways. eXciteOSA is just a lazy person’s oral myofunctional therapy, and the claim on their website that “eXciteOSA® is the world’s first therapy to target the root cause of this problem” is clearly untrue, so it doesn’t impress me.
Cheers,
Graham
Simi · May 2, 2022 at 1:47 PM
There’s nothing wrong with being lazy when you have been tired as long as you have! This is why people go to this. The question is whether it’s actually effective and safe!
Simi · May 3, 2022 at 11:22 AM
My educated gut instinct, I’m a dentist, is that my functional therapy is important to strengthen the oropharynx. There are also lasers that can help do this by tightening the collagen. I haven’t looked at the link but just my two educated experienced cents. Also keep in mind that each person is unique and must be evaluated individually
Anonymous User · February 10, 2021 at 6:32 AM
Hey, Graham. Is this Dr Singh, Dr Narender Singh? Im 20 years old and I have sleep issues. I always wake up early, the MADS device I got worked for a bit but then I read up on the importance of maxillary expansion for breathing. Initially, I thought I had a problem with my nose, hence the sleep dentist referred me to Dr Narender Singh to possibly straighten my deviated septum and for a slight turbinate reduction. But during, this waiting period between now and the consultation phase I’ve been using nasonax and even though my nose is clear I’m still waking up too early, most likely because of a episode of Osa. I really want to fix this issue, are there any clinics I can go to in the mean time to explore and discuss other techniques to get rid of this problem? One thing I notice with my face is how recessed it is, and though it may not be severe now it still has an impact on my day to day tasks and itll just keep getting worse too. Any help would be greatly appreciated man.
Graham Stoney · February 10, 2021 at 6:52 AM
No, this is Dr Dave Singh the orthodontist who co-invented the Vivos DNA Appliance. If you’re in Sydney, you may be thinking of Dr Narinder Singh the ENT, who I also met at Dr Dave Singh’s Vivos presentation in Sydney back in November 2019. Dr Narinder said he could see I had a retrognathic maxilla just by looking at my face, and he knows about the DNA Appliance because he watched the same presentation by Dr Dave that I did. He’s not located very close to me in Sydney though so I never had a consultation with him, but he said he also does MMA surgery. If you haven’t had a polysomnograph yet to see whether you really have obstructive sleep apnea, that would be the logical first step. If you do have OSA, the next step is to find out where the obstruction is via either a CBCT scan or endoscopy so you can pick a treatment that addresses that area. I got second opinions from two ENT’s, one of which recommended turbinate reduction and the other didn’t. I decided not to have surgery and went with Vivos instead. If I were you, I’d get the polysomnograph if you haven’t already done so, have the consultation with Dr Narinder Singh to see what he recommends, and then go see Dr Jalal Khan from The Dental Station in North Sydney to get a Vivos assessment. They know each other and between them they ought to be able to help you. Cheers, Graham
Brittany Cruz · January 9, 2021 at 1:42 PM
Hi! I just started my Vivo’s journey. I had a question for you. The first week of wearing it did you have headaches from the slight pressure of the appliance? I naturally have a small mouth and I find that the top appliance doesn’t bother me but the bottom one causes slight ear pain and I cannot close my mouth all the way. Thanks for your feedback!
Graham Stoney · January 9, 2021 at 5:51 PM
Hi Brittany,
Welcome on board! I hope the journey is a smashing success for you. I’m sorry to hear you’re in pain. I didn’t notice any worsening of the tension headache I normally have which I attribute to obstructive sleep apnea; so no. I can’t close my mouth all the way with the mRNA in but when my lower jaw stops, it feels like all the bottom acrylic surface of the the upper appliance is resting on the top surface on the lower appliance and it’s not uncomfortable for me. If it’s your first week, have you expanded yet? Perhaps you need a week or two to just get used to the feel of it in your mouth; it might be worth asking your provider about this.
Cheers,
Graham
ashley · December 16, 2020 at 3:11 AM
I was supportive of the vivos dna appliance and very excited to use it. But the affects are so gradual and entirely dependent on how often you choose to wear it, that I feel defeats the purpose of what it was meant to do. The first few months of wearing the appliance were amazing. Allergy/stuffy nose symptoms we’re almost completely gone, even if I suffered a cold— and I was suffering from chronic sinus infections and congestion prior to it. My sleep quality improved, I snored less, but this was all temporary. After a year of use there wasn’t anything else noticeable. My mouth was only very slightly less narrow than it was, cross bite was corrected, slightly. It’s very dependant on the dentist you have and how often you get the appliance adjusted, which for me was every couple weeks, and their availability. Mine was pretty limited. After a certain point in time, the appliance never fit right, had broken in my mouth, and still never fit right again. It requires a LOT of patience, and you do have to wear it for significant lengths of time if you want to see any changes, not just at night.
So, only slight reward. It’s good if you don’t want anything invasive. But I think that’s the only way you can do it if you want to see any significant changes.
Graham · December 16, 2020 at 7:22 AM
Thanks for your feedback Ashley. Since posting this article I’ve taken the plunge and am now 2 months into wearing my mRNA Appliance. My dentist is great because he’s always available for adjustments, and I’m very committed to wearing the appliance, using my Facemask and doing my myofunctional therapy exercises twice daily. I’ll keep your comments in mind and see what results I get. Cheers, Graham
Carolina Sarnevesht · December 4, 2020 at 9:55 AM
Hi Graham,
Thank you for providing such great information.
I am curious, did you start the Vivos DNA almost a year ago?
If so, I am curious to know how you’ve been doing so far with the treatment… has it been tolerable? has there been any improvement at all? has there been expansion? how much? etc
Thank you so much in advance.
Graham · December 4, 2020 at 10:24 AM
Hi Carolina. I started two months ago. I’ll post an update on the weekend so subscribe to my newsletter so you don’t miss it. Essentially: yes it’s been tolerable, my sleep is improving, I feel slightly less tired during the day, I’ve expanded the appliance 2.3mm, I’ve just started with the facemask, and I’m still using my CPAP machine… but hopefully for not too much longer. Cheers, Graham
Anna · November 17, 2020 at 12:17 AM
Very excited to find this page.
Thank you for sharing your research and progress.
I’ve just finished the “breath” book and it’s littlest blown me away.
Already familiar with all this as my 11 year old son has terrible bed wetting problems and my gut has always knows something wasn’t right with the way he was sleeping.
Fast forward to COVID and getting lucky as I only work one day a week in retail as I have three kids so suddenly had an extra $500 a week and stumbled on dr Levi. Already peicing together that my son mouth breaths and that this is cause server problems all over the place (social, school his neurosis and of course the bed wetting was if anything getting worse)
So but the bullet and got him set up with the DNA applicence without being able to find any information along with dr Levi being very vague and feeling like I knew almost as much as him (obviously not but you know what I mean) this was a couple of months ago now.
Needless to say my 11 year old has done a full turn around. Still along way to go but at least I feel more in control and helping him.
Now my question in what do you know about the myo munchee
As no one is comparing this to the DNA which I know…. STEM CELLS. Hahaha still don’t know how this works exactly
Also can strongly recommend Dr Levi as he really helped me keep the cost down as much as possible and you can see he wants to help my kids. He said he has used it himself for sleep apnea and that’s why he chose to bring it out here.
Having read breath I’m wondering now is it possible to get Belfords device here. Certainly doesn’t look as comfortable as the DNA but seems like the same science.
My husband has server obstruction problems and thought I was losing my mind as he was booked in for nasal surgery right when covid hit and hasn’t had it yet. I’m trying to convince him to go down this other path less traveled. However how the bleep are people going to be able to afford this when you can look at a family and see everyone’s sagging facial features. (I’ve been a makeup artist for 15 years and I tell you once you know what your looking at you see it everywhere.)
My god will be following your progress. Thanks again
Graham · November 17, 2020 at 1:43 AM
I’m glad you found the page helpful. I’ve heard Dr Liao (the author of Six Foot Tiger, Three Foot Cage) talk about the connection between paediatric OSA, bed wetting and ADHD. It makes me wonder how far back my own OSA goes given that I had these problems too, even long before my orthodontic extractions; I was just lucky I grew up before Ritalin but unlucky that I grew up before these were recognised as symptoms of OSA.
I haven’t researched treating children but I just looked at the Myo Munchee and I gather it’s a myofunctional therapy trainer, but I wonder if it’s really necessary if you feed the child solid food to begin with. If they eat the apple in the first picture, do they still need it? I have no idea at what point it’s too late to just switch to a chewing-intensive diet without also needing remedial appliances.
I’m not aware of anyone providing Dr Belfor’s Homeoblock in Australia, but you can see how similar they are in this article.
It is amazing how often you see symptoms of craniofacial underdevelopment once you know what to look for. I was sitting in a local park on the weekend and a jogger ran past with his mouth hanging open, and I thought: “Should I tell that guy that he’s likely to die in his sleep one day?”
Let me know how your son and husband get on. Cheers, Graham
Nicole · September 13, 2023 at 10:13 AM
Hi Anna can i contact you in regards to Dr Levi and your experience please?
Lisa · November 9, 2020 at 1:01 PM
Just stumbled on your great site. I’m also a CFS survivor. I gather you obtained your DNA appliance from Dr Levi in Sydney from what I read. I live in northern NSW so would be interested in finding an orthotropic dentist near me or possibly going to Sydney.
Since watching the Mike Mews youtube videos I’ve been improving my posture and getting the tongue on the roof of the mouth. This has cured my blocked nose and I’m breathing and sleeping better. I’d like to expand the archers to create more tongue space and extend the mandible due to an overbite. I know of someone who uses a mandibular advancement splint and said that it worked for him to correct his overbite but I don’t know if it’s a proper orthodontic appliance. Dr Mews says it pushes and maxilla inwards if you wear it for too long.
I asked an orthodontist if I could extend my mandible with something like a Herbst appliance and she said that bone doesn’t grow after the age of 40 or something but this conflicts with Dr Anne-Marie Cole in Brisbane (who isn’t an orthodontist but has done LVI training and has given lectures and youtube videos on the importance of getting the jaw into the right size shape and position) She says that bone can grow at any age and uses adult appliances. I’m wondering however if the DNA appliance or mandibular advancement splint actually grows bone for someone in their 50s or 60s or if not, is it bone cartilage that is growing or is the appliance just pushing on the teeth and extending them out towards the edge which might weaken teeth roots or something as Ronnald warns in his youtube video “AGGA is not the holy grail.“ (he expanded too far) I read that the DNA is better than AGGA though .
I was wondering what the DNA cost you? I’ll read your progress with interest.
If anyone knows a suitable dentist in Northern NSW or nearby I’d be grateful for your info.
Thank you
sleep well
Lisa
Graham · November 9, 2020 at 6:08 PM
Hi Lisa,
Welcome to the unenviable club; it’s nice to hear from you.
I got my DNA appliance from Dr Jalal Khan from The Dental Station in North Sydney. I know he has a mobile dental truck that he uses to provided dental services to outback regional communities, but I don’t know if he heads to northern NSW.
Mandibular advancement splints aren’t orthodontic because they don’t move teeth; they simply hold the lower jaw forward during sleep. They aren’t intended to be orthopaedic either, but unfortunately they exert a backwards force on the maxilla, which is the opposite of what you want and will slowly cause your maxilla to move backwards over a long period of time. This can make your condition deteriorate even faster than it otherwise would given that it’s not dealing with the underlying problem of underdeveloped jaws.
In his talks, Dr Singh has shown before-and-after CBCT scans which appear to demonstrate bone growth using a DNA Appliance. Dr Theodore Belfor has published similar results with the Homeoblock, including those of James Nestor who claims to have experienced bone growth in his book Breath: The New Science of a Lost Art and in his interview on Joe Rogan’s podcast. Distraction Osteogenesis techniques such as Mandibular Symphyseal Distraction Osteogenesis (MSDO) can certainly grow bone in mature adults, so it’s reasonable to believe that a DNA appliance can also grow bone as described by the science of bone biomechanics. I will find out for myself over the next 2 years whether this is really true.
DNA appears a lot safer to me than AGGA, and I doubt you’d be able to do the sort of damage Ronald did without your provider noticing at the monthly check-ups because the expansion rate is so much slower. I paid about $9K all up, and this close supervision by the provider is really what I paid for.
I know of DNA providers in Melbourne and Perth who are not listed on the Vivos website, so you may find one in Brisbane if you ask in the Adult non-surgical palate expansion Facebook group.
Good luck!
Graham
Lisa · December 27, 2020 at 4:21 PM
Thanks so much Graham. Hope you are going well with the appliance.
I was wondering if you had your CO2 levels checked as part of your treatment? If so, I’d be interested to know something about it or what the test is for.
I sometimes get disordered breathing remembering panic attacks and hyperventilation. It washes out CO2 levels but the cause is psychological. If I forget about the attacks, it goes away. If I try to control it with breathing methods, it can prolong it (the brain keeps fetching ‘the problem’ for me to ‘fix’).
I also have enlarged turbinates in one nostril but I think these can enlarge and reduce by themselves. Turbinate reduction surgery can in rare cases lead to ‘empty nose syndrome’ which makes the condition worse so I don’t think I’ll opt for that. Apparently nose massage can help.
Best wishes and health for the new year.
Lisa
Graham Stoney · January 2, 2021 at 12:21 PM
Thanks Lisa. It’s going OK so far. I haven’t had my CO2 levels checked, but it’s on my list of things to try. I’ve also experienced panic attacks in the past and would be open to talking with you about an alternative approach that addresses the underlying psychological issue, which you’re likely to find easier in the long run. Drop me a line via my contact page if you’re interested. Cheers, Graham
nicole · September 13, 2023 at 10:24 AM
Hi Lisa did you end up dealing with Dr Levi? Can i contact you in regards to it
Nicole · September 13, 2023 at 10:24 AM
Hi Lisa did you end up seeing Dr Levi?
Nikki · October 4, 2020 at 6:58 AM
Hey there,
I appreciate this post a lot, I have also been feeling a bit skeptical as I’ve started to research VIVOS. I also have a unique perspective that might be helpful (or at the very least interesting haha). I am a current patient of Dr. Kasey Li. I had the EASE procedure done in July 2020, which is similar to DOME but less invasive, from what I understand. I am now on the path to MMA, but constantly on the lookout for something that might eliminate the need to get my face broken in order to sleep better and get my quality of life back. Hence my research into DNA appliances. My experience with Dr. Li has been wonderful, and I’ve met with a few other doctors who work frequently with him and they say he is not “surgery happy,” but is actually quite conservative in his recommendation of MMA. I definitely have felt that from him as well, as he wanted me to look into multiple other options before deciding that MMA was the correct move for me. I have also read reviews where patients were frustrated that he would not do MMA on them. All that to say, I messaged him about VIVOS and other DNA appliances. He had a veeeerrrryyy strong negative response. He said it does nothing at best and can cause damage (teeth falling out, bone exposure) at worst. He said it does not stimulate new growth in an adult jaw but flares the teeth and postures the chin forward. He was very clear that it was not only not a treatment, but could cause harm. Obviously it could be argued that he would not be happy with this treatment bc it could potentially put him out of business, but I have really not gotten that vibe from him, and like I mentioned above I do not feel he is surgery happy or just looking to line his pockets. Throughout my experience with him he has actively encouraged me to look at other options and treatments in order to be sure about MMA, but also does not sugar coat his opinion about treatments that do not work or won’t be helpful. Take it for what it’s worth, just thought I’d add my experience!
Graham · October 4, 2020 at 11:06 AM
Hi Nikki,
That’s really interesting. MMA is on my list of future treatments if Vivos doesn’t deliver for me, and Dr Kasey Li is clearly the man. I’m committed to Vivos now and I’ll be paying close attention to whether it merely flares my teeth. Mind you, my lower teeth are all angled inward so they actually need some flaring. As to whether it stimulates growth or not, check out this recent post with independent scientific evidence suggesting that it may be possible.
Thanks for the tip and let me know how you decide to proceed.
Cheers,
Graham
Nikki · October 6, 2020 at 9:29 AM
I’ll go check out that post! I am moving forward with MMA. I’m scheduled to get braces in two weeks. Best of luck with VIVOS! I hope it ends up being the fix for you!
Lana Tasker · September 24, 2020 at 1:00 PM
I am looking into Vivos too. Does it also do any forward growth?
Graham · September 24, 2020 at 2:03 PM
It’s got a segment that expands forward, so yes that’s one reason I chose it.
Shae Nault · May 22, 2021 at 2:25 AM
Hi Graham
I also suffer from chronic fatigue and sleep apnea
I was recently evaluated by a biological dentist that recommended the dna device with tounge therapy and tongue tie surgery
I just received the quote for the device and it’s $9,000us
This seems really high to me and this seems like a new concept so I don’t really have many resources to check and make sure this is legit.
I stumbled upon this post and it’s very informative thank you!!
Does this amount sound like the same amount you’ve paid?
Any insight is very appreciated
Thank you!!
Shae
Graham Stoney · May 22, 2021 at 7:24 AM
Hi Shae. I agree it’s a lot of money for a fancy 3-way Schwartz expander but I justified it to myself as paying for the dentist to keep a close eye on things to make sure nothing goes wrong, plus all the alternatives are also expensive and/or painful. I paid AU$9000. Cheers, Graham
Janet · September 19, 2020 at 7:27 AM
Thanks for posting this. My dentist did an assessment and a $500 3D X-Ray and the course of treatment she recommends is the Vivos DNA appliance ($8500) as well as myofunctional therapy and a frenectomy (together another $3k to $4k, I think). There’s no way I have a budget for any of that! The Vivos DNA sounds like it could make a big difference with my energy, which would help me basically live my life. But it’s so expensive! I saw in the comments that you are now trying this, Graham. I’d love to hear more from you and others about how you’re doing with it and how much of a difference it is making.
Graham · September 19, 2020 at 1:52 PM
Hey Janet,
Yes it’s expensive alright. I really hope Dr Belfor gets his marketing act together so the Homeoblock can provide some reasonable price competition. However, like you I’m hoping it turns out to be life-changing for me. Imagine finally being able to breathe properly; not just at night, but during the day too. I won’t recognise myself if all goes well. I suggest you subscribe to this blog so you get email updates, and that way I can keep you informed of my progress.
Cheers,
Graham
Amanda · August 29, 2020 at 9:36 AM
Hi, I just want to concur with Ronald Ead’s experience. I got a very similar to DNA appliance (sagittal) in hopes that it would solve my sleep breathing issues and all it has done is cause my teeth to flare out and tilt back toward my ear. My dentist does not like what he sees and now I’m trying to figure out the next most viable option. Argh.
Graham · August 31, 2020 at 6:41 PM
I’m sorry to hear about your experience Amanda; that must be very frustrating. I’m curious exactly what appliance you used and what your expansion protocol was?
Bettina · August 2, 2020 at 9:47 AM
Hi Graham, thanks for your post. I’m currently having my 7 year old daughter accessed for the vivos appliance to cure light sleep apnea as well as expanding her upper jaw and growing her maxilla bone vs traditional RPE. I feel like vivos is making a big secret about their appliance and are not giving out a lot of info on their website. Its very expensive here in the US (cheapest quote I got was $8,500) and I’m not sure if it will do what its promising. My daughter is a complicated case. She has a severe underbite and is missing permanent teeth. Please post a link to your blog about your vivos experience.
Graham · August 2, 2020 at 10:59 AM
Hi Bettina,
Vivos’s website is awful when it comes to finding information about the appliance. I’ve only recently committed to getting a Vivos mRNA appliance myself, and it hasn’t arrived yet so I haven’t started treatment. However, you can find a wealth of resources including other people’s experiences in my recent Vivos DNA/mRNA Appliance Resource Bookmarks post.
Cheers,
Graham
Bettina · August 2, 2020 at 11:22 AM
Thanks so much! I will check out the bookmarks. What I found interesting too is when I went to another vivos provider in our area, he later told me he trained directly under Dr Singh, and when I asked him if he had tried it out himself or if he was one of the lucky ones with a wide palate ( I feel like the narrow palate/jaw is a hidden epidemic) he said he’s not and was going to get it for himself in the future. Why would you wait and not use it right away if you knew how great it is?!
Anyway, I’m very curious about your experience and please keep posting once you get it. Also how much is it in AUS?
Kristin Tigani-Taylor · July 23, 2020 at 7:51 PM
I am actually currently in treatment with the Vivos system. I completely understand your skepticism but I need to point out an error. You mentioned that rapid palatal expansion in an adult doesn’t work. You are absolutely correct about that but the DNA doesn’t use rapid palatal expansion. It uses intermittent passive pressure and that’s what causes the stem cells to activate. That’s also what the springs in the front are for. The suture doesn’t go to the premaxilla so in order to get the stem cells in the PDL to activate you need the springs. I was so skeptical about the comfort because I had a rapid palatal expander as a kids and it was so painful. But because it is a passive expansion it doesn’t hurt and in fact if it does hurt you are doing something wrong and you and the treating doctor need to course correct. I have been in mine for about a year and I have never felt better. I started out with moderate sleep apnea and I just took a follow up sleep study WITHOUT my appliance in and my AHI went from a 23 to a 6. I have never felt better in my life. If you would like to talk more about my experience I am happy to do so. Best of luck with whatever direction you choose
Graham · July 24, 2020 at 2:16 PM
Thanks Kristin, I really appreciate your feedback on my post. Dr Singh did say during the presentation I attended last year that the Vivos system doesn’t do palate expansion, and when I questioned him on what he meant exactly, he basically said that it was causing growth in the manner that you describe, rather than what a rapid palate expander does. Now that there is a local DNA provider in Sydney, I’ve taken the plunge and ordered one despite my own skepticism. It just seems like the best alternative I have to CPAP, which hasn’t been 100% effective at alleviating my daytime fatigue despite 6 months of nightly use. I’ll write a blog post about this soon, and I appreciate you sharing your experience with me since I find it very encouraging. Thanks, Graham
Marie · July 26, 2020 at 4:02 AM
Hi Kristin, happy to read you are experiencing improvements with Vivos! How often do you visit your provider for evaluation and adjustment? Did you go more frequently at the start of treatment?
Kristin Tigani-Taylor · July 26, 2020 at 8:02 PM
I saw my Dr every 4 months initially because I had TMJ issues so he wanted to watch me closely but when those started going away it moved to every six weeks then 8. There were unscheduled appointments when I needed the appliance adjusted (as the roof of your mouth begins to drop down it starts to touch the appliance and the appliance needs to be adjusted to allow room to continue your growth).
Marie · July 27, 2020 at 4:17 AM
Good to know! I had started the Vivos treatment earlier this year and have been experiencing the appliance up against my palette likely within 3-4 weeks of an adjustment. Provider has me on an eval/adjustment schedule of every three months, although I think these appointments should be more frequent given the amount of time I’m wearing each day and with the appliance touching up against my gums in the upper posterior area (2nd-3rd molar location). I wake with an indentation in my gum tissue from the pressure and don’t think this should be occurring regularly. Curious if you have experienced anything similar?
Kristin Tigani-Taylor · July 27, 2020 at 8:14 AM
Yes I have experienced that. You should call your provider and let them know when that happens. Let them know that it is digging in and you need it adjusted. From my understanding that can actually slow your progress if it digs in
Marie · December 24, 2021 at 10:04 AM
I have upper airway resistance syndrome and tmj from the same type of orthodontic work grham mentioned from the good ole 90s. Are there any other options besides vivos and sugery for those of us who are conservative and dont have that kind of money? Any good mandibular advancement devices? I wonder with homeoblock if you need orthodontic work afterward?
Shae Nault · May 22, 2021 at 2:30 AM
Hi Kristin! I’d love to talk to you about your experience
I’m on the fence if I should go forward with purchase of dna as it is very expensive
Ahmed Abdulhamed · June 8, 2020 at 1:59 PM
Thanks for this , Graham. Just wondering Is it treated gummy smile?!
Graham · June 13, 2020 at 10:42 PM
Sorry Ahmed, I don’t know.
Jeanette · June 5, 2020 at 12:23 PM
Dr. Mark Levi in Sydney works with DNA/Vivos directly
Leilani · May 30, 2020 at 1:04 PM
I wonder if you have compared the DNA/Vivos/Homeoblock to the other epigenetic orthodontics on the market – ALF, Anterior Growth Guidance Appliance, Orthotropics, and Myobrace? My 12 yo has been on the AGGA program, my 4 yo is on myobrace. I am considering for myself whether the AGGA or Vivos is the more appropriate orthodontic.
Graham · June 3, 2020 at 9:06 PM
Hi Leilani,
I’ve heard of them all but only know what I’ve discovered reading about them online and from YouTube videos made by providers and users. I’m skeptical of the epigenetic claims made by their manufacturers. I’m sure they’re very effective in growing children, but I doubt they’re going to cause an adult to grow new bone unless you’re looking at DOME (Distraction Osteogenesis Maxillary Expansion) or an MARPE (Miniscrew/Microimplant Assisted Rapid Palatal Expander) like MSE (Won Moon’s Maxillary Skeletal Expander) which splits the suture in the middle of the upper palate.
I suggest getting advice from someone who has experience working with adults who have the problem you’re trying to solve. That’s my plan.
Cheers,
Graham
Maya · May 25, 2020 at 3:40 AM
Thanks for this, Graham. Just wondering why haven’t you considered MSE? It sounds pretty promising, although a bit scary (procedure-wise). The research looks promising. I myself have mild sleep apnea and a doctor has recommended MSE and then braces afterwards to me. Only issue for me is that he hasn’t done a lot of MSE cases.
Graham · May 29, 2020 at 2:52 AM
Hi Maya,
I am considering MSE, possibly with Facemask as described in this thread on The Great Work forum. It is more invasive than Vivos DNA but more likely to work too in my opinion. MSE only expands sideways though and I suspect I need some forward movement to open my airway behind my lower jaw; which is why I’m considering it with Facemask. All the solutions to this seem to have some big drawbacks though. Let me know how you get on if you go through with it.
Cheers,
Graham
Chrissy · September 15, 2020 at 9:42 PM
Hi Graham,
I just stumbled across your website and I am so glad I did! I have severe orthodontic relapse because I had two teeth removed because of an overbite. and it’s really affecting my mental health. Not just how I look, but the function and feeling of my misaligned bite. I have literally seen over 15 orthos and dentists who have not been able to help me, however I was told that I need the MSE appliance. Does anyone know the cost of the MSE? I’m in Australia also. Any information on the MSE will be greatly appreciated. Thankyou!
Graham · September 15, 2020 at 10:33 PM
Hey Chrissy,
Sorry to hear about your orthodontic relapse; that must really suck. I get the frustration of seeing a heap of professionals who can’t help. I’m curious where in Australia you are and who recommended MSE to you? I did quite a bit of research into it, so you may find my MSE bookmarks helpful.
Cheers,
Graham
Chrissy · September 15, 2020 at 10:52 PM
Hi Graham!
Thankyou for your reply. I think we are going through a very similar problem and your website is going to provide me a wealth of information, as well as for others.
It was Dr. Derek Mahony that recommenced I needed the MSE appliance, however I am based in another state, so at the moment I’m trying to figure out the best treatment, and to be honest he’s the only one so far that has offered treatment because everyone else has said it’s too complex to deal with. I just can’t believe it. I thought braces was the best thing I could’ve done (after they were off), but now it’s caused a world of grief and stress, as well as the burden of the financial cost involved. This blog has made me realise I’m not alone, as I don’t personally know anyone going through this. I hope we can all find a way to receive treatment and a positive outcome.
Graham · September 18, 2020 at 9:03 AM
Hey Chrissie,
I saw Derek too. He’s great because he understands the primary importance of airway in orthodontic treatment. He recommended DOME (which is similar to MSE) and MMA surgery for me, but the ENT he referred me to said it wouldn’t work for me. Vivos became available in Australia before I got around to getting a second opinion so I went with it instead. I’m not gonna spruik it because I haven’t even got my device yet, don’t know what result I will get, and don’t know your circumstances; but have you explored whether it might be an option for you?
A lot of people have been severely injured by extraction orthodontic treatment, so no, we are not alone; unfortunately.
Cheers,
Graham
Lea · May 4, 2020 at 3:01 AM
Thanks for your assessment Graham! I am on the same path and considering Vivos as well.
Graham · May 5, 2020 at 10:30 AM
You’re welcome Lea. Let me know if you proceed, and how it goes! Cheers, Graham
Kathy · June 25, 2020 at 7:30 AM
Hi Graham
I, too have been on a journey of discovery for the best approach to curing sleep apnea. You might be interested in checking out a YouTube channel called jaw hacks. I learned a lot from Ron and even went to his orthodontist for a consultation. I’m going to try the DNA appliance. I’m CPAP intolerant. My husband uses a MAD. It certainly has limitations. Anyway, I don’t want to wear anything for the rest of my life. I want the sleep apnea to go away. Good luck to you.
Graham · June 25, 2020 at 2:05 PM
Hi Kathy,
Thanks for dropping by. Yes, I have seen out Ron’s channel. I have some reservations about what he’s doing and his lack of qualifications. For me he goes beyond just a patient describing their experience. I got the impression he expanded way too far with AGGA for instance, and now blames the appliance for his loose teeth. That said, he clearly has experience as a patient. For another perspective, check out the Adult non-surgical palate expansion ALF/AGGA/Controlled Arch Ortho/Vivos/MSE group on Facebook. They have a lot of discussion of the DNA appliance too, from people who are also contemplating it and/or currently using it. I also want the sleep apnea to go away; please let me know how you go with it!
Cheers,
Graham