Note: This post may contain statements that I no longer consider true.
See: The Vivos mRNA Appliance Didn't Improve My Obstructive Sleep Apnea.
For some insane reason, only two Australian DNA Appliance providers are listed in Vivos’s provider locator; and they’re both in Sydney. This leads a lot of people in other states of Australia to contact me in despair because they think they can’t get treatment; yet there are other providers out there so here’s a list of all the ones I’ve heard of. I’ll also include Homeoblock providers because the appliances are so similar.
If you know of Australian providers who aren’t on this list, please leave a comment with their name, location and a link to their website and I’ll add them.
New South Wales
Dr Jalal Khan, The Dental Station, North Sydney: Vivos, Homeoblock.
Dr Mark Levi, The Smile Shop, Darlinghurst: Vivos
Victoria
Dimos Dental, Melbourne CDB: DNA
Queensland
Western Australia
Dr Alan Lim, Maven Dental QV1, Perth: DNA
13 Comments
Blythe · December 6, 2022 at 11:56 PM
Hi I’m looking for someone who is working in the Gold Coast or Northern NSW area. Do you know anyone or can you recommend anyone please. I’d be truely grateful!!
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Jack · May 21, 2021 at 8:13 AM
Hey Graham just thought I’d let you know that Robina town dental in Queensland doesn’t do DNA anymore because the He retired 🙁 looks like I’m going to have to travel even further now. Thank you for putting out information and helping other!
Graham Stoney · May 21, 2021 at 8:24 AM
Sorry to hear that Jack; thanks for the heads-up. Perhaps another dentist will step up to the plate and take the opportunity to corner the market there. Good luck in your search!
Fiona Smith · December 22, 2021 at 3:16 PM
Hi Jack! I’m seeking someone in Qld who does the Homeoblock. Have you found anyone yet? thanks, Fiona 🙂
Daniela · March 16, 2024 at 2:09 PM
Hi Fiona, I’m looking for someone on Qld, please? I’m in Brisbane
Clark · February 17, 2021 at 5:25 PM
Hi Graham,
I managed to hassle Linda to get a copy of my imaging, also consulted my exgf who is now a resident radiologist (and recent mother, rejoice!), I have no medical training and I have no idea how to use this software
https://i.imgur.com/mj0b5lO.png
You can see from the axial plane (top left) that due to the deviated septum my left nostril actually has an area where intake is almost cut off, no amount of maxillary expansion would help my nasopharyngeal airflow, only septoplasty surgery would
My turbinates and tonsils are within normal size as examined by Dr Kalish, as observed from the coronal plane (top right)
You can’t do septoplasty without turbinoplasty to adjust for the change in surface area, for this I will see Dr Jason Roth of Dee Why next month for a consult as I do not want to wait 6 months to see Dr Singh (he gets the most challenging and complex of cases, I just need a routinely operating surgeon for my routine surgery)
From the sagittal plane (bottom right) there are no obstructions at the oropharynx despite a straight cervical spine at C2 compared to your CT, I still have forward head posture, without a mandibular advancement splint I actually can’t breathe without loud guttural snoring, you can also observe my improper lip seal and maxillary overjet, all comes from the dental crowding and narrow palate
Besides wearing Vivos to the full term to develop bone and myofunctional physio to develop musclature, all there really is left for me are auxillary treatments (ie go out and buy some fish oil, vitamin D & curcumin to undo the damage from amyloid beta plaque build up from chronic sleep deprivation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781139/)
All this started late last year when someone jokingly mocked me for my nasal voice (Dr Khan disagrees both on an expert and comedic level), it set me off on a journey of self-discovery and research into the fascinating world of medicine, I had to arrive at these diagnostic conclusions myself (with Massive Attack’s Teardrop instrumental on repeat the entire time), in fact I thought Vivos would be the end-all for all my health issues, but alarm bells went ringing after Dr Kalish advised me that my sleep disorder should have had immediate improvement from the very first night, turns out it was only half of what I needed and the answer was right in front of or rather between my eyes this whole time, your blog has significantly expediated my search for an answer and I can not thank you enough having fought through the CFS & OSA to conduct this quality research
Dr Kalish has the exact same allergic rhinitis issues I have, I’d imagine his parents were much more responsible and diligent than mine in getting him the right medical attention medication, and now he is an absurdly qualified surgeon with a second specialty unrelated to his original area, while I struggle with self esteem issues due to failing out of university multiple times, despite being admitted into a 90th percentile course at USYD. I don’t even know what normal life is like as I have had breathing difficulties since birth, youth has masked my CFS up to a point now that I have entered my 30s
I thought I found the light at the end of an 18 month tunnel, turns out that’s the ENT surgeon in a helicopter speeding things up for me, The recovery time from my CFS has been tremendously reduced,
Who knows, If I do well enough academically for undergrad I may just push myself for postgraduate med, no point getting ahead if you leave the squad behind, plenty of people out there suffering without realising the true root cause of their health problems
Fight the good fight, there is hope for you yet Graham
Graham Stoney · February 17, 2021 at 6:36 PM
Hey Clark,
I’m glad you’ve found my research helpful; please vote for me when I get nominated for a Nobel prize.
Thanks for the scan… that’s quite a septum you’ve got there. I find it interesting that Dr Kalish has allergic rhinitis. I’m wary of him because he was adamant that palate expansion doesn’t improve the nasal airway even after I pointed out to him on my CT scan that the palate is the floor of the nasal cavity, and sent him a mass of research showing that it does. Maybe he was just trying to justify why he hasn’t tried palate expansion to treat his own rhinitis.
I’m not a big fan of supplements, but I’ve been cooking up heaps of bone broth to give my body the nutrients it needs.
Thanks for the tip about Massive Attack, I’ve added them to my playlist. Coincidentally I’m also a student at USYD, and my PSYC1001 lecturer was adamant that listening to music while studying impedes learning. What are you studying at USYD when you’re not studying medicine?
Thanks Clark, there’s hope for you too.
Cheers,
Graham
Clark · February 17, 2021 at 8:53 PM
Hi Graham,
A/P Kalish is an ENT, his specialty is very different from oral maxillofacial (whose surgeons perform SARME, MARPE), doctors are scientists at heart and I don’t quite see him tilting windmills at a mountain of evidence, I’d only be wary if he does not change his mind after seeing said research, hanlon’s razor
I haven’t heard too many Massive Attack songs beyond Teardrop, but it was a reference to that medical drama House M.D, great show
I am due to start a Bachelor of Nursing at UTS next Monday, I intend to transfer to USYD for the same program after this year (no mid year entries), since USYD offers clinical placements in a country I am thinking of immigrating to
Originally I majored in Finance, I now know it isn’t for me, my long history of failures caused a lot of self doubt and fear of failure, which my low self esteem didn’t help, now knowing there was a physiological cause behind my poor academic performance, I feel a renewed sense of confidence
I would have to self study high school chemistry and biology up to first year undergraduate level in my spare time to do well on the GAMSAT, along side my nursing program over the next 3 years, and if I don’t go through with it, specialist nursing isn’t exactly a bad plan B
Cheers
Graham Stoney · February 18, 2021 at 7:05 AM
Hey Clark,
I had a consultation with Dr Kalish. He gave me an endoscopy and recommended a turbinate reduction. When I questioned him about whether this was necessary given the research I had read on how palate expansion improves nasal airway resistance, he said it didn’t. I sent him an extensive summary of the research showing that he was wrong and he did not change his mind after reading it.
Good luck with your studies; I hope nursing is a better fit for you than finance was. You may find another website I run helpful for overcoming self-doubt and restoring your self-esteem; and being physically healthy should make a massive difference.
Cheers,
Graham
Clark · February 12, 2021 at 9:11 PM
Hi Graham
I am another patient of Jalal’s and I have some of the fatigue and low quality sleep symptoms you have described, I have consulted an ENT who is also a specialist in allergies and he told me if my lack of restful sleep was due to only sleep apnea (which i’m not even sure if i have) then the improvements should be immediate by wearing the mRNA
I sleep with my mouth taped on my side and I still don’t sleep very well, so my ENT noted that its likely that because of my narrow nasal passages from dust allergies. The oropharynx obstruction that the mandibular advancement of mRNA would treat would be like the manifolds on a car, which Jalal noted “wasn’t too severe”, so I think for me the bottleneck is further up given my narrow nasal passages, the intake valve, to continue the car engine analogy. He recommends septoplasty surgery if my sleep does not improve by the end of my mRNA treatment
I noticed that your CPAP data isn’t showing a clear downtrend despite 4 months of diligent use of the mRNA, have you consulted an ENT about this possibility with a narrow nasal passage?
Graham Stoney · February 13, 2021 at 8:46 AM
Hi Clark,
I’m curious if you’ve have a polysomnograph? That should tell you definitively whether you’re dealing with obstructive sleep apnea or not. The mandibular advancement function of the mRNA is likely to make an immediate improvement if you have mild to moderate OSA and the obstruction is behind your lower jaw/tongue. My OSA is severe and I’d already tried a Somnomed MAD which only slightly reduced my AHI and daytime headaches/fatigue, so I wasn’t expecting an immediate improvement with the mRNA.
I visited two ENT’s who both gave me an endoscopy to see where the obstruction was. The first specialised in nasal surgery, said I had enlarged turbinates and recommended a turbinate reduction; but he also told me that palate expansion didn’t improve nasal airway resistance, which isn’t consistent with the research I did on the topic. The second said my turbinates were fine, the obstruction was behind my tongue, assessed me for MMA surgery and said I wasn’t a candidate because he wouldn’t be able to move my jaws far enough forward to get me off my CPAP machine. I’m not convinced that an ENT surgeon is the best choice for MMA surgery though since it’s really the domain of an oral and maxillofacial surgeon, and I haven’t seen one yet because Dr Khan became a Vivos provider around that time and I preferred a non-surgical solution if at all possible.
The lack of a downward trend in my CPAP pressures so far is a little disappointing, but at only 4 months it’s still early days and the expansion of my lower appliance has been held back somewhat by impingements. I doubt my OSA is caused by my nasal passages based on the endoscopies and CBCT scans which clearly show the restriction being behind my tongue, but I’ll most likely get another opinion on it if Vivos doesn’t deliver the goods over the next couple of years.
I’m also curious if you had a consultation with Roger Price, who measured my expired CO2 level and showed me that I was breathing too fast. According to Patrick McKeown, this can reduce the effectiveness of nitric oxide absorption from your nose which can cause the appearance of allergies.
Good luck with your treatment!
Cheers,
Graham
Clark · February 13, 2021 at 11:58 AM
Hi Graham
Thanks for getting back, it’s good to feel not alone in this marathon
I am reluctant to do a sleep study as my Epsworth scale does not even qualify me for medicare subsidy, I jumped the gun in entering treatment with Jalal after all the cognitive biases that pushed me into overfitting my symptoms to yours after discovering your blog
I believe what I have is UARS, OSA occurs at oropharynx which is obesity related (20 BMI over here) and/or tongue base which we both undoubtedly have from mouth breathing and all those mandibular issues, which is improved by mRNA and tongue physio
With that said per the maxillofacial CT done by Jalal my oropharynx showed a lemony yellow, he said it is narrower than ideal but it’s “not that bad”, my ENT’s endoscopy found a deviated septum, my turbinates aren’t enlarged either, and he noticed my tongue falls backwards while on my back
Combining these findings much like an undeveloped jaw contributes to UARS/OSA, my “undeveloped nose” if you will is causing my breathing difficulties, my body still defaults to mouth breathing despite the mouth taping and mandibular advancement, especially when I only drool sleeping on the side of my deviated septum
Further evidence of this is my difficulty doing the nasal exercises of blocking one nose to inhale then exhaling through the other, one side is much more labored than the other
Can you tell me which ENTs you have consulted? I am most likely getting a second opinion from someone else, I found a Dr Narinder Singh however his website implies he should be approached when the patient is ready for surgery and not so much for assessments as he is often booked out for months at a time
I did have a consultation with Roger Price but I did not bother with a follow up, I felt that while there was a lot of interesting information most of it wasn’t pragmatic to day to day life, same with the chiropract he recommends as I feel I’d rather pay a trainer at a gym to help me do back strengthening exercises than pay a consultant to medically explain to me why i should be doing those exercises
I have had skin prick tests done for allergies, I definitely have allergic rhinitis to dust mites and it should not be related to the nitrox oxide absorption, I don’t think anyone can hyperventilate themselves into a runny nose. I was also told I was breathing far too much and had a lot of “aborted breaths”, I believe this is where our similarities end as my deviate septum severely limits my air intake and for you it is further down in the oropharyngeal if I remember your blogs correctly
Uninformed medical speculation here but I feel any nasal passage improvements I would receive from mRNA’s palate expansion would be auxiliary at best, as the deviate septum seems to be the main cause of my breathing issues, I suppose now would be a good time to get hospital cover due to my ENT being a pre-existing, if my deviated septum magically finds more room to breathe in 12 months I would be very surprised
Cheers!
Graham Stoney · February 14, 2021 at 8:08 AM
Hi Clark,
Yes, it’s a marathon all right and it certainly helps knowing people who are also on the journey.
I only have basic hospital cover with HCF, but it covered the cost of my sleep studies at St Vincent’s private hospital; unfortunately they’ve since closed their sleep lab now, I presume because home tests are more cost-effective. Chris Kelly from AER Heathcare provides home sleep tests and was super-helpful to me on the phone so it may be worth calling him to discuss your options; he has OSA himself so he gets it. You should be able to find a doctor who will approve a sleep study if you’ve had chronic fatigue. The Epsworth Sleepiness Scale is notoriously unreliable but if that’s what your GP is using to screen you, make sure you answer the questions reflecting your worst case type of day. Don’t fall for the trap of wanting to be healthier than you are and giving overly positive answers to the questions. My sleep specialist didn’t know anything about orthodontic risk factors and agreed to the study because I happened to mention that a bed partner had said I was waking up choking in the middle of the night. Otherwise I didn’t fit the standard profile of an OSA sufferer, but that’s because the standard profile doctors screen for is deficient in that it completely ignores retrognathia.
I’ve had two CBCT scans of my airway, and the first one looks much worse than the one Dr Khan took which you can see in this article. You have to take the angle of the neck into consideration when reading them though, because I can open or close my airway just by moving my head forwards or backwards respectively. I believe I’ve developed forward head posture to compensate for my retrognathia during the day, and that’s why my airway only looks mildly constricted in that CBCT scan slice, but notice that the top of my spine not vertical: it’s is angled forwards to keep the airway open.
It’s normal for one nostril to be clearer than the other. Our brain regulates the size of the turbinates according to our posture, and switches between the nostrils over time. That said, having an underdeveloped nose will make the impact more pronounced. I concluded that my post-nasal drip wasn’t due to allergies and gave up on nasal sprays and rinses after reading that elite athletes who overtrain experience the same flu-like symptoms as CFS sufferers. I don’t know exactly why, but this is part of how the body responds when it’s under chronic stress. My post nasal drip hasn’t completely gone yet, but it seems to be improving as my fatigue reduces.
The ENTs I saw were Dr Larry Kalish who recommended a turbinate reduction, and Dr Gregory Lvoff who didn’t recommend MMA for me. I met Dr Narinder Singh along with Dr Khan at Dr Dave Singh’s Sydney presentation in November 2019, and Dr Narinder said I had a retrognathic maxilla just by looking at my face. If I were starting over now, I’d see him because he already works with Dr Khan and knows about Vivos. It typically takes months to get an appointment to see an ENT. Neither of the ENTs I saw ended up helping me directly, but I learned valuable things from them; including that not everything specialists say is necessarily consistent with the latest science.
I’ve heard plenty of people say that a DNA Appliance has improved their nasal breathing, but if your problem is primarily nasal and you have no obstruction in your throat, it may be worth consulting with Dr Derek Mahony about whether MSE could be a better choice for you than Vivos. I believe the reason septums deviate is the same reason teeth crowd: the surrounding structures are underdeveloped so they just don’t fit in a space smaller than nature intended.
Cheers,
Graham