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 finally got my Vivos mRNA appliance on Wednesday. It took one day short of 10 weeks to get the device from the day I gave the go-ahead and paid for it. Here’s what mine looks like:
My mRNA Appliance. I sure hope it’s worth the money.
However, I’m frustrated because I haven’t been able to wear it overnight since getting it on Wednesday, because the pharyngeal extension triggers my gag reflex. My dentist said we can snip it off if I can’t tolerate it, and I want to persist with it because it may help me get off my CPAP machine earlier by holding the soft tissue in the back of my throat open. I’m angry though that he didn’t tell me about it earlier: If he had, I would have spent the two months I waited for the device to arrive desensitising my gag reflex, instead of starting that now.
I used to work in Engineering and I’ve done my fair share of project management. I know what a critical path is and how to minimise it by getting tasks off the critical path, and mitigate the risk of project slippage by starting risky tasks early. Unfortunately not everyone in the world seems to get this. Grrrrr…
So it’s yet another frustrating delay before I can start treatment and ultimately get my health back. If you’re considering getting a DNA appliance and there’s any chance your device will have the pharyngeal extension, I suggest you grab a toothbrush and start desensitising now so you can hit the ground running when you do finally get it.
My dentist also says that the advice from Vivos is to start the facemask late in the process after my mandible has moved forward. Otherwise it could interfere with the temporomandibular joint somehow. That doesn’t make sense to me mechanically since it pulls on the upper appliance and the final position of the mandible is set by the way teeth mesh with those of the maxilla. As far as I can see, the longer I wear the facemask, the more forward growth I’ll get. I don’t want to get 12 months into the process and then find out that I would have been better starting face-pulling a year ago. I’d rather have a fixed face than an opportunity to say “I told you so!”
I’ve discussed this with my dentist before and he double checked it with Vivos so that seems to be the clinical advice he’s getting. I had a headache the day I picked up my device so I wasn’t in the mood for a debate and figured we could discuss it again at a later appointment once my treatment is underway.
22 Comments
Ni · March 1, 2022 at 3:12 AM
Thank you so much for sharing your experience. It’s hard to find reviews of this method of mandibular expansion. It’s been over a year since your initial report. Could you please share what progress you’ve made? Has your sleep apnea been resolved? Has there been measurable expansion to your jaws beyond tooth tilt? Thank you again.
Graham Stoney · March 16, 2022 at 3:06 PM
My experience is not going particularly well at the moment but I’m waiting for a response from Vivos on my recent mid-treatment CBCT scan. You can always read my latest update here. Cheers, Graham
Ritika · May 18, 2021 at 1:42 PM
Hi there, I have been thinking to get DNA or mRNA appliance but I’m very scared. First, where I live they don’t have the appliance anywhere in the city . I live in Vancouver. They have only one in a city close to me . I’m scared if the one who cares the appliance doesn’t have enough knowledge about it .
I had braces when I was 17 and 2 extraction that was worst mistake of my life I ever made . Then in my earthly 20s I started to see facial assmetry and my smile too narrow and even my teeth , jaw .. .then I went to another dentist where I discover I have TMJ . They gave me therapy and appliance to wear but it didn’t work out for me . They told me to get me braces and it even made so worst that now I have a very dee bite and recessed chin. It looks like my face have moved to one side .. I never had double chin before the 2 nd time braces I got . Now it’s so much visible and makes me feel so insecure that many times I’m so depressed all day , cry all day and think no ortho can fix it . That’s where I have decided to become a dentist myself and I’m studying for my undergrads now .. I almost spent 10,000$ till now from my pocket on braces . Sometimes I feel like dying because I can see myself even in the mirror with even facial symmetry. I think the 2nd time braces caused me sleeping problems too , I feel I can’t breathe sometimes . When I open my jaw or speak it’s even worst I can feel my ear drum making a sound .. they gonna remove my braces soon . I told the dentist I’m not happy with the smile and everything . I also told him that my lower jaw is narrow and even became narrow too because of that and feels like it moving to one side . He didn’t listen . He said we will see what functional appliance you need . I’m not going back to this dentist . I’m just so scared to even let any dentist touch my teeth now but I can’t live with this . I’m so depressed cause of this , I almost cry everyday when I look at myself . He even told you need jaw surgery but I don’t think it would have been required . I know it can be fixed without surgery . Just now a days these dentist just wanna make money , doesn’t care about patient .. I’m just scared even if I get DNA appliance . Will it cause relapse after treatment or my teeth become even more weak .. I’m just so scared . Please help me how to deal with this .. please tell me if this appliance will make my life better. Dr Dave Singh also said that if you have extraction , this appliance bring back ur teeth back to ur original way they were before and cause the person have to have the space where the extraction took place ..
I’m so happy that I can talk to someone about this
Graham Stoney · May 18, 2021 at 7:01 PM
I get that you’re very scared thinking about getting a DNA appliance, and I’m sorry to hear about your bad experiences with dentists in the past. I can appreciate why you might not trust them given what you’ve been through. There appears to be a provider in Vancouver according to the Vivos provider locator. I can’t say if the DNA appliance will make your life better, but the airway intelligence report should indicate whether it could help. If you want to talk on Skype or Messenger Video about what you’re going through, drop me a line. Cheers, Graham
Ritika · May 25, 2021 at 5:10 PM
Hi Graham,
I’m so happy to hear back from you. I have one vivos provider near Vancouver but it’s only one provider I guess where I live, I think the provider might not have much knowledge on this. They might mess up teeth again. I have already spend $10,000 before in 2 years . What I got is my lower and upper jaw shifted to one side( left) . Try first treated my Tmj, it didn’t go away , they said braces will help .. from experience never get braces till you fully recover from tmj .. It lead to my one should up and down . I told my dentist many time my face feels like going to one side . He said it’s not like that .. but how can u mess up stuff when u had CBCT scan of mine ..can I know how much approx. did DNA appliance cost you? I can call you via messenger my full name is ritika khuttan .
Graham Stoney · May 25, 2021 at 6:11 PM
I’m sorry to hear you’ve had your teeth messed up; I can understand why you’d be scared of dentists after that. My DNA Appliance cost A$9000.
M.T. Lorenz-Halling · March 20, 2021 at 2:57 AM
I NEVER participate in blogs but find yours helpful so here goes…
I was very recently diagnosed with almost your exact symptoms thru a new holistic DDS. I live in The States in Atlanta, GA. I have read Dr. Liao’s book. I fundamentally understand the therapy and the devices. It offers hope but it is a huge and expensive undertaking.
I’m experiencing a high level of anxiety over wearing the VIVOS device. And the sticker shock that comes with it. Please describe how it feels to wear the device both at night and during daytime. I too will not be able to tolerate the metal extension and wonder how that might impact success.
Graham Stoney · March 20, 2021 at 8:34 AM
I appreciate that you’re experiencing a high level of anxiety about the huge and expensive undertaking in wearing the Vivos device, and the sticker shock that comes with it. I relate to where you’re coming from, particularly as I had a really rough day yesterday when I felt so fatigued that I stayed in bed most of the day after a particularly bad night’s sleep because the elastics on my facemask were too tight. As a result, I’ve been feeling really anxious too.
I think the problem here is that sleep apnea exacerbates anxiety because being unable to breathe puts our nervous system into sympathetic mode. I feel anxious wearing a CPAP mask and having air blown down my throat, even though it’s keeping me alive, because it’s just not natural to have a contraption strapped to my face.
I’ve had frequent problems with my appliance impinging on the soft tissue of my gums, so I go back to my provider roughly every two weeks to get acrylic shaved off so it doesn’t cause me pain. With that proviso, wearing the device isn’t painful and it’s not particularly uncomfortable. I can talk with the appliance in, but it’s a bit uncomfortable to do so, so I remove it for all but the shortest conversations. I also try to cycle my appliance in and out every hour during the day, and that requires a lot of focus.
I don’t find the Vivos appliance difficult to sleep with compared to the CPAP machine, which I find truly unpleasant. I didn’t tolerate the OSA/pharyngeal extension so I removed it, so that’s not a problem now and I don’t expect it to make much difference to my outcome.
So in short, wearing the appliance isn’t particularly onerous but it does rule my life at the moment. I’d much rather be wearing it than wearing a CPAP machine for the rest of my life or having double jaw surgery.
Mary Lynn · December 3, 2020 at 12:24 PM
I got mine today. The dentist cut off the wire. I could not tolerate it. He did mention the head piece comes later. That is the first I’ve heard of that also. I’m hoping for a holistic approach to feeling better soon. Both the upper and lower pieces make it difficult to manage saliva or speak. Can’t imagine how I’m going to do this 16 hours a day but I will try my best.
Graham · December 3, 2020 at 2:29 PM
Welcome to the club Mary! I hope you do indeed feel better soon. You should get used to having the appliance in your mouth. I find tracking my usage in a spreadsheet helps a lot with achieving 16 hours/day… and remembering that it’s only temporary. Let me know how it goes! Cheers, Graham
Mr · October 1, 2020 at 11:49 AM
Just curious but what country do you live in? I live in the US and have mild Sleep Apnea. I tried CPAP , didn’t like it, I just got MAD appliance as well and I feel that I’m taking it off at night and it feels like a CPAP type. Would insurance cover for this DNA device after covering the costs for my MAD device? How would I go about to finding dentists who specialize in this product?
Graham · October 1, 2020 at 1:51 PM
I’m in Australia. Try asking your insurance provider and looking on the Vivos website.
Dave · September 28, 2020 at 1:54 PM
What is this facemask you’re speaking of? I thought vivos was just the appliances? Is there more on this somewhere? Thanks
Graham · September 28, 2020 at 11:08 PM
It’s a mask that you wear in front of your face that attaches to the appliance via rubber bands to provide a forward pull, and may result in more forward growth. The one I’m planning to use is The Bow from Forwardontics because it doesn’t exert any backwards force on the lower jaw. You have to make sure you get the hooks for them included when your appliance is fabricated since I don’t think they’re standard. Mine has them because I asked specifically and my dentist passed my request on to Vivos. There are a couple of examples of using a facemask with a DNA Appliance in Felix Liao’s book Six-Foot Tiger, Three-Foot Cage.
Dave · September 29, 2020 at 1:52 AM
I appreciate the details! My vivos provider actually studied under Dr. Liao, but I didn’t know about his book (I have seen his lectures though). I would say most people would benefit from more forward growth, so I wonder why this isn’t seen more often? I know Dr. Liao is a student of Dr. Singh but it’s not uncommon for clinicians to experiment in their own practice. I wonder what Dr. Singh and co think about incorporating facemasks directly under vivos. There really isn’t a lot of studies that I could find. I suppose more work needs to be done. I’ll bring up the mask next time I’m in. Good luck!
Janet · September 28, 2020 at 12:07 AM
I thought I left a reply, but it looks like it didn’t go through. Just wanted to thank you for the explanation. Looking forward to hear more about how it works for you.
Janet · September 27, 2020 at 11:59 PM
Thanks for the explanation, Graham!
LAUREN · September 27, 2020 at 11:25 AM
so do you know if you need mostly transverse or lateral growth? i’m sure you need both like most people.
Graham · September 27, 2020 at 8:27 PM
Well the main problem is that my lower jaw is too far back and this is causing the obstruction so I need forward growth. But my jaws are also too small for my tongue, so I also need sideways growth. So yeah, I need both.
Janet · September 26, 2020 at 10:34 PM
I’m so glad you told me about it activating your gag reflex. I have a strong one. My dentist wants me to get the DNA so I’m looking into it. It looks like you have both the mRNA and the DNA. Would you mind telling me which one activates the gag reflex? Thanks too for telling us that it’s the pharyngeal extension. I’ll know exactly what to ask about. By the way, I thought that the mRNA was for wearing during the day and the DNA was for wearing overnight (but for about 16 hours, so partly daytime). Is your dentist having you wear both devices overnight together? Is that how they’re supposed to work?
Janet · September 26, 2020 at 10:46 PM
Sorry – I was totally wrong about the mRNA being worn during the day. I was just surprised to see that you had both, since I thought that people mostly either one or the other.
Graham · September 27, 2020 at 8:41 PM
“DNA appliance” seems to be a generic term as the device comes in different configurations depending on what you need. I have an mRNA which has two parts: an upper part shown on the left of the photo and a lower part shown on the right. The pharyngeal extension is the long wire that is attached to the upper part. It’s intended to hold the soft tissue in the back of the throat open, so it can trigger the gag reflex. I am supposed to wear both parts 16 hours a day. Yes, you wear both parts overnight. They have interlocking tabs that hold the lower part forward to advance the mandible and open the airway while you’re expanding.