Note: This post may contain statements that I no longer consider true.
See: The Vivos mRNA Appliance Didn't Improve My Obstructive Sleep Apnea.
One option I considered for treating my obstructive sleep apnea was Dr Theodore Belfor’s Homeoblock appliance. I had a one-on-one consultation online with Dr Belfor to evaluate my CBCT scan and see if it would work for me. At the time, there were no Homeoblock providers in Sydney so it turned out not to be an option. However, I did learn a lot in the process.
Homeoblock recently received some high profile attention with James Nestor’s account of his positive results with it in his book Breath: The New Science of a Lost Art, and his subsequent interview with Joe Rogan. This has been met with some skepticism, and much rampant unfounded speculation, about removable oral expansion appliances and the claims made by their manufacturers.
I see no reason to doubt James Nestor’s account of his experience with Homeoblock and I’d like to see it become more widely available to provide some price competition for Vivos. When a dentist considering becoming a Homeoblock provider contacted me recently to ask if I would have chosen it had it been available, I replied:
“Yes, if it was cheaper”
My Vivos DNA provider also does Homeoblock and is using it to treat his own upper airway resistance. I did a lot of research myself and also talked to him about the difference.
Vivos DNA Upper and Homeoblock Appliances.
Homeoblock photo credit: Dr Theodore Belfor
The Similarities
The original prototype of both Vivos DNA and Homeoblock appliances was designed by Dr Dave Singh and Dr Ted Belfor when they were working together. Hence both appliances are covered by the same U.S. patent 7,357,635 which describes the appliances and the epigenetic process by which they claim to operate.
They both:
- Are custom-fitted removable acrylic oral expansion appliances
- Aim to permanently treat the root cause of obstructive sleep apnea, among other things
- Claim to trigger natural jaw growth processes using epigenetic signalling
- Claim to improve nasal airway resistance
However, the inventors have both moved forward in slightly different directions in the 15 years since their joint patent was first filed. The devices available today are slightly different from each other and are each covered by their own patents. There are also significant differences in the support infrastructure available to providers.
Vivos DNA
Here’s Dr Singh discussing the DNA appliance at the 2019 Vivos Breathing Wellness conference:
The How does it work? slide at the start of the presentation looks like unscientific spaghetti to me, filled with gobbledegook buzzwords and vague relationships. It seems he’s trying to convey the idea that this is all very complex and they must be really smart to have worked it all out. It’s just a palate expander with fancy springs, for goodness sake. The guy playing with a bit of wire for two minutes was weird too, but my intention is to focus on appliance differences so I’ll refrain from putting the boot into the presentation.
The DNA Appliance is backed by the Vivos Integrated Practice Program, which appears much more substantial than the support available to Homeoblock providers. This may not represent a difference in the actual appliances, but the choices made by the provider are important to patient results and while there’s only one Ted Belfor, Vivos have multiple experienced clinical advisors.
Dr Singh has published more research into the safety and effectiveness of the DNA appliance, including in small patient groups. I’d like to see larger, long-term studies; but at least it’s a start.
Dr Felix Liao’s book 6 Foot Tiger, 3 Foot Cage is largely about his use of DNA appliances to treat a range of serious health problems including obstructive sleep apnea caused by what he calls Impaired Mouth Syndrome, and includes several brief case reports.
The Vivos DNA Appliance is available in three variants: full occlusion, wireframe and a hybrid.
There is a variant of the DNA Appliance with seperate adjusters for the left and right sides to treat cases of facial asymmetry, whereas Homeoblock has the unilateral bite block to achieve the same aim.
It appears that the DNA Appliance is much more widely used, has more providers, a larger existing patient base, and more overall clinical experience behind it.
Homeoblock
Here’s Dr Belfor in 2020 discussing epigenetic orthodontics and the Homeoblock appliance:
I felt like I was in trouble with the headmaster watching this. It seemed like Dr Belfor was frustrated that people haven’t been listening to his ideas judging by the rising tone of voice in most of his sentences. The paper published in CRANIO that he mentions, The Missed and The Misdiagnosed, is a one-page opinion piece with no supporting evidence and 5 references that don’t mention Homeoblock. Still, I’ll focus here on the appliances rather than the flaws in the presentation.
Dr Belfor used to recommend using an upper Homeoblock Appliance to expand the maxilla forwards for 6 months before starting using a lower appliance on the mandible, but he no longer uses a lower appliance since he believes that the mandible will remodel itself once the maxilla is expanded. He also includes a daytime appliance with Myofunctional therapy. He doesn’t claim to cure sleep apnea but says he can improve the airway, which is what he told me in my consultation with him.
The Homeoblock Appliance doesn’t have a Y-shaped body option with a forward expander because the premaxillary suture fuses in most people very early in life, so he sees no benefit from attempting to expand forwards. This makes the Homeoblock Appliance significantly less bulky than a Y-shaped DNA appliance because only a single adjustment screw is required.
The other main difference between the appliances is the unilateral (one sided) bite block. It is supposed to trigger the genioglossus muscle to contract when chewing, toning the muscle so that it pulls the tongue forward out of the airway. Dr Belfor explains this in his interview on Dr Steve Park’s podcast, and this is his answer to the question about it at 44:00.
Homeoblock is mostly a wireframe design with full occlusion over only a couple of teeth to create the unilateral bite block.
It sounds as if he has copped some flack from people who believe that this could lead to TMJ issues since the forces involved act only on one side. He rebuts this criticism in the video without giving solid evidence. I haven’t read of anyone being harmed by this, but I’m sceptical of the epigenetic claims made for these devices and I’d prefer to have the same force on each side of my jaws so all growth is symmetrical, but this feature could be an advantage in helping correct cases of facial asymmetry.
He describes a 2-year treatment protocol and says that the device should be worn during sleep for life to maintain the signalling to the body and prevent collapse of the airway, but this would be equally true of the DNA appliance.
Research published by Dr Belfor is currently limited to individual case reports. He says he’s seen a thousand patients and I’d like to see research with groups of patients published, which is currently lacking.
I’m not aware of any Homeoblock provider who has independently written a book or published case reports with results from their patients using the appliance.
There seems to be some love lost between the two inventors. At one point Dr Belfor has a swipe at Dr Singh’s book Epigenetic Orthodontics in Adults, saying it “doesn’t even mention the epigenome”. Perhaps he’s jealous that his one-time collaborator has been more successful in commercialising their invention, but it’s taken many years and a couple of commercial ventures to do so.
I hope Dr Belfor gets his act together so Homeoblock can give Vivos a run for their money in the marketplace soon. Unfortunately, the fact that the Homeoblock trademark has been adandoned doesn’t give me much hope.
18 Comments
Kevin · March 4, 2021 at 4:17 PM
Thank you for putting your thoughts and reflections down Graham. It seems that we both had similar dental experiences when we were younger (I am 49). I had the great misfortune of having to wear “headgear” that essentially looked like the inside of a football, meant to pull my jaw back (to correct an underbite). This along with some sports related nose-trauma has made breathing, and sleeping, an exhausting chore.
Graham Stoney · March 4, 2021 at 5:20 PM
I’m sorry to hear you went through that Kevin, and I hope you find a solution that enables you to breathe and sleep easily.
Kevin · March 4, 2021 at 6:36 PM
Thanks for your kind words Graham. I certainly hope your treatment provides you with the relief you detergent. Did you look at MSE as a solution? It is a bit more intrusive but apparently the room in the mouth and the expanded sinus passages is very pronounced.
I am just curious. I am close to getting the DNA device, but have read that the MSE is significantly more effective for apnea.
Graham Stoney · March 4, 2021 at 7:04 PM
You’re welcome. I explored MSE in some detail while researching maxillary expansion options for treating obstructive sleep apnea. It seems quite popular, and research has been published showing it is effective in treating sleep apnea, especially in cases where the obstruction is primarily related to insufficient width of the maxilla and in upper airway resistance syndrome (UARS). My principal concerns with MSE in my case were that it doesn’t address the mandible, it provides only minimal forwards growth (although this can be increased by using it with a facemask), and the rate of expansion is very aggressive. You can read more details in my article Why I Chose DNA over Homeoblock, MSE, DOME, MMA and AGGA.
Scott · July 29, 2023 at 2:13 AM
I have been using the Homeoblock device for almost 6 months to treat moderate to severe sleep apnea. So far, I get better results (diminished symptoms with improved sleep quality) by losing body fat (but I have to get down to about 10-11% body fat to get results) than with the Homeblock appliance. I’m frustrated that I have spent $10K on an appliance that could possibly yield no beneficial effect in alleviating my sleep quality issues. After this treatment course, I’m done with all doctors except my Primary Care one. Medicine in this country is one giant “milk cow.”
Graham, You mentioned that you have recovered from Obstructive Sleep Apnea. Did the Homeblock Device work for you, or so another treatment course?
Thanks in advance.
Graham Stoney · July 29, 2023 at 9:50 AM
I hear your frustration Scott, as OSA is difficult to treat. After my experience with the Vivos mRNA appliance, I doubt Homeoblock is likely to be effective at treating sleep apnea. I have not recovered but am using CPAP to reduce my symptoms. I’m having maxillomandibular advancement surgery in September in the hope of curing my OSA.
KIM RIOUX · January 23, 2021 at 4:27 AM
What a great article Graham! I’ve been treating apnea and UARS for a years now and had investigated VIVOS but unfortunately couldn’t justify the initial cost of the education just to learn more. I’m currently in class with Dr. Belfor and I believe the only reason VIVOS has gotten so much more traction than homeoblock is that Dr. Belfor doesn’t market himself or his device as well. I am very interested in addressing facial asymmetry as part of the problem so the unilateral nature of his appliances makes total sense to me.
Graham Stoney · January 23, 2021 at 7:15 AM
Thanks Kim, glad you found it helpful. That’s interesting what you say about Homeoblock and facial asymmetry; I may have downplayed this benefit because it’s not an issue for me. There is a variant of the DNA Appliance with seperate left and right adjusters for dealing with facial asymmetry, and I’d be interested to hear if the same is true of Homeoblock. I’m glad to hear you’re doing Dr Belfor’s class because the more Homeoblock providers there are out there, the greater the potential price competition which is ultimately good for consumers. Sleep apnea is such a widespread and under-recognised problem that raising awareness of the problem and the fact that solutions exist is huge. There’s more than enough room in the market for both appliances because the problem is exploding as people like me who had extraction/retraction orthodontics in the 1970’s & 80’s hit middle age and develop obstructive sleep apnea as we lose muscle tone in our airways. It’s great to hear that you’ll be out there helping with a solution. Good luck! Graham
Lupita M Roca · October 18, 2020 at 2:44 AM
As a dentist, these two appliances are like apples and oranges and serve very different purposes. I never choose the same appliance for every patient, not everyone has the same need. You need to look at the chief complaint and the most serious compromise the body is facing. If we want strict expansion, we are going to offer MSE (Maxillary Surgical Expansion) but often patients don’t want to go with a surgical route as a solution to their concerns. Instead many patients choose a less invasive method that we have found many have reached a much-needed relief in symptoms. If a patient’s main concern is to help facial symmetry, help cervical instability and stabilize the autonomic nervous system plus do what we can to tone the base of the tongue and soft palate I would put all my money on the Homeoblock.
Like someone said above, Dr. Belfor believes “In order to get oxygen, your body will sacrifice anything it needs to survive— your teeth (bruxism), your TMJ, your cervical …” I think he’s absolutely right that. I have seen it with my own eyes that many patients have a stronger side and a less developed side and when you put the bite block on the weaker side the body feels more balanced, stronger and less in a sympathetic panic mode.
Many of us, always tilt our head to one side when standing or sitting or have eyes that are not even, or one ear attached higher on the head than the other ear….. the list goes on and on. This asymmetry can be improved with the Homeoblock. When the Homeoblock is worn at night, it allows the body to get a workout on the side that needs the most stimulation with the idea being over time the patient has more symmetrical forces on both sides of the body instead of the body having a stronger side it is tricked to thinking it is in balance and starts working on the weaker side. I have seen this happen with my patients. If we want a tooth borne expander, the message we get from the marketing of the DNA appliance is that it will expand and help tone the airway to help with sleep apnea. But the Homeoblock is not made to expand it is made to balance the body and at the same time develop the bone into a wider maxilla. These are two very different beasts of an appliance.
I am not sure of the reasons that Dr. Singh and Dr. Belfor split partnership but if you ask me from hearing them both speak. I speculate both men were very proud of their invention and both extremely passionate about their views. Again, I have no idea why they split but it appears to me that Dr. Singh wanted to market to the most people possible to train as many dentists and treat as many patients as he could to help bring them relief from their sleep apnea. He wanted to start a company (VIVOS) and focus on expansion and sleep apnea having dentists buy into his product. Whereas, I feel that Dr. Belfor was not interested in moving in the same direction. I feel that Dr. Belfor wanted to personally train each dentist, that was going to provide his product to ensure it was done correctly and to his specifications. I also feel from training under Dr. Belfor, he was strict about not calling his appliance an expander. He wanted it called a Morphogenic appliance and he was adamant about the bite block being only on one side which why it is uni-block. He said if a block was placed on both sides, as in the DNA appliance, it would defeat the purpose of letting the weaker side grow more bone, it would also not loosen up the sutures as effectively because the point of the uni-block is to stimulate the bone growth by our teeth occluding every time we swallow. He said the uniblock was to trick our mouth into thinking we were chewing hard foods while we were sleeping every time we swallowed.
When you said in your piece that “I’d prefer to have the same force on each side of my jaws, so all growth is symmetrical”, for me this is a negative.” That makes so much sense and I fully agree if you were symmetrical you could choose the DNA, but you still don’t have the chewing force on one side that is so crucial to stimulate the stem cells and sutures. Dr. Singh has the acrylic bite blocks cover the entire upper arch and all the teeth to try an expand symmetrically (which I have found very hard to get a symmetrical expansion with any type of an expander, no matter how hard we try one side always seems to wins). Whereas, Dr. Belfor does not want the teeth all covered, this is his whole point and it is what makes the Homeoblock different than any other appliance on the market. I have yet to find another appliance that can do what the Homeoblock can do.
Also, remember Dr. Belfor is only one man that has developed his product over the last 20 years realizing what works and what does not work, he does not have a gigantic company behind him because that is not who he is, hopefully over time, some will be able to gather data for you and help spread the word on the results.
It is hard to spend the time gathering data when all you want to do is keep helping patients on a product that makes them feel better. Remember, they both have the same patten on the product to help sleep apnea. I get that in this day and age we all want proof but at this point we just need to try and understand the epigenetic language and trust testimonials.
I understand that all the epigenetics sounds hokey. I get that all the language is confusing and often it is easier to say it can’t be true when we don’t completely understand. I had a hard time understanding all the science behind it since genetics is not my forte but what really made sense without all the fancy words…… plain and simple. Your face and mouth have the potential to at the very least catch up to the side that is least developed or at the very least balance out. We see this in children every day, they are growing asymmetrical because of oral muscle dysfunction and when we balance the oral function and teach the correct mouth posture and breathing they immediately grow symmetrical because they are young and still growing if we get to them in time. However, with an older patient after years of imbalance the sutures are very tight and it is improbable the weaker side will catch up to the stronger side. As Dr. Belfor said, the Homeoblock is not magic. You don’t wear it, and everything gets better. You need to put in the work to correct the oral dysfunction and correct your oral mouth posture and nasal breathing.
I also want to say that I agree that Dr. Belfor does tend to raise his voice when he teaches you his message because some of us keep missing his message. Myself included, If I ever asked a question that was about fixing teeth or about expansion he would drill into my head, the Homeoblock is not about the teeth or expansion, he does get frustrated. I know he means well and is trying to get his message out there and raises his voice when he wants to drill it into our head. I just realize his tone of voice changes when he wants to drive that message home.
I hope that cleared up some confusion. Both products are great but they both serve different functions and like all appliances both have plus and minus features you just need to look at each patient’s chief complaint or what the body needs most to be least stressed.
With gratitude for a great article in helping to clear up this confusion.
Lupita M. Roca, DDS
Enoch Robinson · March 5, 2021 at 5:51 PM
Hi Dr. Roca,
I understand that the homeoblock’s unilateral bite block goes on the underdeveloped side. If the side that is narrower and less robust is also canted higher, does introducing the bite block on that side risk intruding the upper teeth and worsening the occlusal cant? Does the bite block cause an open bite on that side? I’m interested in trying this appliance but I’m worried the unilateral bite block could make my symmetry worse instead of better.
Thanks, Enoch
Lupita M Roca · March 5, 2021 at 9:47 PM
It could make your CANT worse it would depend on the reason. For the CANT it could also improve it. Every case is different would need to see you. I know that is not the answer you are looking for with my reply.
Enoch Robinson · March 6, 2021 at 4:37 AM
Thanks for your response! You’re saying depending on the case it isn’t contraindicated to use the unilateral bite block on the side canted higher if that is the less developed side? If the maxilla grows down and forward, wouldn’t it make sense that the less developed side is higher?
Aaron · December 3, 2021 at 10:26 AM
From your response, Lupita, it sounds like you are trained in both the VIVOS and the Homeoblock, do I have that right? If you do not use BOTH devices in your practice, can you or anyone recommend a dentist who uses both devices in their practice?
In all my research, I am starting to think that finding a dentist who uses BOTH devices with their patients, might be the ONLY way for me to know which one to go with. Because as it is now, my only sources for information about each device seems to be from the people that make the devices (and therefore, totally biased).
I have communicated with Dr. Belfor and even gone through the (expensive) consultation process with one of his associate dentists in Los Angeles — all of this before I discovered that VIVOS was an option.
Before that, I was primed to do a MSE rapid palette expansion device/surgery with Dr. Moon at UCLA who took a leave of absence at the onset of the pandemic before I could begin the actual treatment.
I understand the broad strokes of ALL of these methods, but it seems like the devil is in the details of my personal case.
Scott · July 29, 2023 at 2:22 AM
The Homeoblock device hasn’t helped reduce my sleep apnea symptoms one bit after 6 months of use. Maybe, It’s still early, but I do get better results from losing a little bit of body fat ( and I’m lean already). I can’t understand why and neither can my orthodontist. Any ideas as what could be the issue? Thanks.
Doug · October 11, 2020 at 3:45 AM
“I’d prefer to have the same force on each side of my jaws so all growth is symmetrical, so for me this is a negative.”
Yep, this is the part where I really don’t follow Dr. Belfor’s thought processes … in the DNA appliance with “bite blocks” on both sides, the provider will be adjusting those over the treatment timespan, in order to make sure you end up with good and even occlusion once you come out of treatment on the other side. So as your jaws are developing and evolving, the monthly adjustments should involve grinding off a bit of the block on one side or the other (or both) as needed to make sure the “bite” is level and evolving well over time. To me, that’s such a critical part of the process – good occlusion at the end – so I’ve always been at a bit of a loss on why Dr. Belfor is so insistent on the unilateral block.
And then, for all the reasons you said above – DNA having more published research about curing sleep apnea – is why I chose them. But Dr. Belfor actually has a great line that is one one of his slides, but he ends up skipping past (I think it’s in this video you linked) which was basically something to the effect of “In order to get oxygen, your body will sacrifice anything it needs to — your teeth (bruxism), your TMJs, your cervical spine…” — I think he’s absolutely right about that.
Janet · October 10, 2020 at 10:18 AM
Thanks for providing so much detailed info not just on your experience but on these devices. I’m hoping insurance will cover the DNA for me, yet still a bit nervous about it, since I can’t find as much data about it as I can find patient testimonials. But the patient testimonials do seem to be very good.
Graham · October 10, 2020 at 10:38 PM
I’m glad you’re finding it helpful. For more information on the DNA device, check the Vivos DNA/mRNA Appliance Resource Bookmarks post. Cheers, Graham
Janet · October 11, 2020 at 12:19 AM
Thank you, Graham!