DNA and RNA Appliance are used to Treat a wide variety of issues including TMJ disorders, Headaches, Migraines, Snoring and Sleep Apnea. Postural disorders to impaired breathing can be related to chronic head and neck pain and spread postural issues throughout the body.
It is vitally important for dentistry and medicine to address the development of airway issues that last a lifetime. I primarily work with older children, adolescents and adults in my practice. Children, even very young children receive the biggest benefit from expansion of airways. The DNA/RNA Appliance gives an important second chance to patients who did not properly develop as children. Adults can now be treated without orthognathic surgery, tongue reduction and other invasive procedures.
The DNA Appliances are changing the field or dental orthodontics from cosmetic shifting of teeth in available bone into the field of Epigenetic Orthopedics correcting problems that conventional orthodontics never addressed.
Orthodontics utilizing braces and brackets or plastic aligners as used by Invisalign, Smile Direct and other systems is about moving the teeth in the available bone to create a prettier smile and straighter teeth. Phased orthodontics in children has to a small extent embraced expansion of bone to create more space to straighten the teeth. Airway has only been minimally addressed by most of orthodontics.
There are many orthodontists who still practice “Contraction Orthodontics” also known as “Four on the Floor” or Bicuspid Extraction cases. The thought process is the you “Amputate” the teeth to make room in the mouth for all of the remaining teeth. This Contraction Orthodontics” makes the teeeth fit but crowds the tongue and impairs breathing.
Unfortunately, until recently the question of airway and ideal development of the jaws has not been addressed. There have been major changes in the last few hundred years to patterns of orofacial and cranial bone growth. These are negative epigenetic changes due to environmental issues including pollution, changes in how babies are fed and nurtured as new borns ant throughout their early lives. This has led to a massive problem of underdeveloped maxillas, mandiibles and airways.
I became involved in the early 1980’s in managing airway in adults by treating sleep apnea and snoring. I saw my son Billy had issues but when he was ready to start Kindergarten he was evaluated and I was told he had ADD, ADHD, could not start Kindergarten and needed to be on
Ritalin for life. You worry about your child’s when they cannot start kindergarten and I refused the diagnosis and took Billy to Rush Medical School for a sleep study. He had severe sleep apnea and we proceeded to have tonsils and adenoids removed and at 5 orthopedic expansion of hist maxilla. He had a tongue and lip tie corrected as well. He became a straight “A” student, went from 50% growth curve to 90% growth curve, slept well and mood was vastly improved. He graduated college double major, double minor Magna Cum Laude, His drug of choice was Oxygen not Ritalin. I became a Visiting Assistant Professor at Rush Medical School Sleep Center in 1985 and did research into similarities in jaw position in sleep apnea patients and TMJ patients.
Breast feeding is a major factor in the development of proper facial form. “Form follows function” is a truth in medicine and the changes in how babies are fed and nurtured has changed, which changes their development. These changes in growth and development affect airway and sleep, intelligence and learning and most importantly brain development and function and can lead to learning and behavioral disorders including ADD, ADHD and ODD. Many of these disorders are related to sleep disordered breathing including snoring, increased upper airway resistance syndrome (UARS), Respiratory effort related arousals (RERA) Hypopnea, Sleep Apnea.
The underdevelopment of the nasal oropharyngeal airway is the single biggest culprit and creates problems not just in infants, children and adolescents but also problems that last a lifetime. Sleep Apnea can cause issues with insulin resistance, memory loss and dementia, they cause a 300-600% increase in heart attacks and strokes as well as motor vehicle accidents, are implicated in hypertension, metabolic syndrome and obesity. Ideally a narrow airway is corrected before 8 years of age and it was thought expansion was limited if not impossible in adolescents and adults. The DNA Appliance has changed all that and expansion is possible throughout your life.
The DNA Appliance is an FDA approved orthodontic device that can often correct all of these issues. The RNA version of the
DNA Appliance is an FDA approved Sleep Apnea Appliance. Both the DNA and RNA Appliance utilize Epigenetic Orthopedics to grow larger airways and offer the possibility of curing sleep disordered breathing in all forms. The process of growing a larger airway has been called Pneumopedics by Dr David Singh who invented the DNA Appliance.
I will present several video testimonials of patients who have utilized the DNA/RNA Appliances. The first one is a patient experiencing major improvement in nasal breathing after just a few months of treatment. When the maxilla is expanded the roof of the mouth widens and high palates correct themselves flattening out. The hard palate is the roof of the mouth but that same bone is also the floor of the nose. With epigenetic expansion the cross section of the nose dramatically increases in both height and width. The expansion of the mouth makes more room for the tongue.
Nasal breathing increase the amount of Nitric Oxide the body produces which is the single most powerful antioxidant known. A Nobel prize has been given for work on Nitric oxide.
Sleep Apnea is a serious medical issue for millions of Americans. There are many treatments available to treat Sleep Apnea, the best known treatment is CPAP or Continuous Positive Airway Pressure which uses a compressor to deliver pressurized air through the nose and/or mouth through a mask. CPAP is extremely effective when it is used by patients but only about one in four patients prescribed CPAP actually use it on a regular basis. The 25% of patients who utilize CPAP is dwarfed in number by the 60% of patients who reject or fail CPAP completely. Approximately 15% try to manage CPAP but do poorly. Success is not the norm with CPAP in spite of the fact that it is extremely effective when used and is considered the “Gold Standard” of treatment.
The primary reason patients don’t use CPAP is that they “Hate CPAP”. Oral Appliances are also extremely successful at treating Sleep Apnea and are considered a first line approach for mild to moderate sleep apnea and an alternative to CPAP for severe sleep apnea. They are under prescribed primarily due ignorance in the medical community about effectiveness. CPAP is a billion dollar industry that has tremendous monetary power and thee makers of CPAP machines also make much of the diagnostic instrumentation for sleep.
The website https://www.IHATECPAP.com is an excellent resource to learn more about Sleep Apnea diagnosis and treatment. The name of the website is from patients who when asked why the wanted an oral appliance would commonly reply “I HATE CPAP!”
The following is a video of a physician describing his experience with an oral appliance to treat sleep apnea. Many physicians choose not to utilize CPAP but rather a comfortable oral appliance. Oral Appliances are excellent for managing Sleep Apnea but the DNA/RNA Appliances offer a “CURE”! Patients with sleep apnea must have their sleep apnea treated but it can be managed for a lifetime without negative consequences.
The following video is a physician whose life was affected by her sleep apnea and who chose to seek a cure for her apnea rather than just a treatment. She has not completed treatment at the time this video was made. Prior to treatment she was living in a state of exhaustion. The RNA Appliance is acting as both a sleep appliance and is growing her airway orthopedically. When the DNA/RNA Appliance is used to cure sleep apnea it actually results in a 24/7 improvement in airway not just a correction during sleep. This patient discusses oral Myofunctional Therapy which can aid in expansion and ideally should be utilized in every single orthodontic treatment. More important pediatric dentists and physicians should learn to be aware of these developmental issues and address them as soon as possible to prevent future issues. In retrospect, my son would have been far better off having his airway issues treated far earlier. Brain development is changed by sleep apnea even in infants and very young children.
TMJ Disorders, Chronic Headaches and Migraines and other types of Orofacial pain are often associated with airway issues. The National Heart Lung and Blood Institute published a report “The cardiovascular and sleep related consequences of TMJ disorders” The NHLBI of the NIH considers Sleep Apnea to be a TMJ disorder. The DNA Appliance is often utilized as a second phase of treatment for patients with TMD. The following is a patient who has lived her entire life with an underdeveloped maxilla and is using the DNA/RNA appliance to pneumopedically grow a larger airway and orthopedically grow her maxilla in order to treat her TMJ disorder. While she is still early in treatment she feels that her TMJ disorder has been cured. Her lower jaw (mandible) was locked in a posterior position and maxillary expansion has given it freedom to move forward and relieve abnormal pressure in the TM Joints
The next video is a patient who has lived with chronic head and neck pain for many years and initially was treated with a neuromuscular dental orthotic and is now utilizing the DNA Appliance to complete her treatment (Phase 2 ). She describes a wide variety of improvements after wearing the DNA Appliance for a couple of months. When you breathe better and correct airway issues it has positive effects throughout the entire body.
The next video is a patient who has had a lifetime of sinus issues and TMJ issues. While here TMJ issues were dealt with her small airway would create a less stable result and relapse. The DNA Appliance is being utilized to increase her airway and led to dramatic improvements in he sinus issues. Listen as she discusses how improved breathing is improving all aspects of her life.
Shimshak et al published a paper in Cranio Journal in 1998 looking at medical expenses in patients with TMJ disorders and found that there was a 300% increase in medical expenses in every single field of medicine. We now know that sleep and airway are very closely related and that the increase in medical expenses has many causes but treatment with the DNA Appliance addresses a wide spectrum of these issues. I wrote an article for Cranio Journal in 2013. The full ediitorial can be found at https://www.tandfonline.com/doi/pdf/10.1179/crn.2013.001?needAccess=true. I was asked to write this editorial by Riley Lunn tthe editor of
Cranio Journal because I had been treating sleep and airway issues since 1982 long before most of medicine or dentistry ever looked at airway and sleep apnea.
TMJ Alias, The Great Imposter, Has a Co-Conspirator: Poor Sleep
The next patient is much younger and his parents who are both Chiropractors brought him in to address airway issues that were leading to forward head posture and was affecting his posture in his entire body. Chiropractors are very aware of how head and jaw position affect the entire body.
The DNA Appliance is giving three dimensional expansion and there is a cascade of positive outcomes that occur as airway improves.
The next video is of Lewis who is now utilizing his RNA Appliance instead of CPAP while he is growing a larger airway. He appreciates being able to go camping with his appliance, something he could not do with CPAP.His teeeth have straightened out and he has a bigger better lower jaw.
The DNA and RNA Appliance utilize Epigenetic Orthodontics which is the single most exciting advancement in dentistry today. While it is called epigenetic orthodontics a more accurate name would be epigenetic orthopedics because it actually grows and reshapes and idealizes the bone rather than just move the teeth. This is far different than typical orthodontics.
This technological advances of the Vivos System allows us to comfortably create (grow) big wide healthy looking smiles even in patients with narrow arches. Patients with weak chins and poor profiles can see improvements often even early in treatment. In an ideal world every patient would naturally have developed big wide healthy arches with resultant large airways and enough room for their lower jaw to grow ideally.
One very special aspect of utilizing the DNA Appliance and Epigenetic Orthodontics is that the appliances are only worn for 14-16 hours per day. This is very different that standard orthodontics with brackets and wire or Invisalign®. Most of the wear can be done in your sleep, watching TV or commuting. During the day at work or with friends you can be free of the appliance. This is one of the special features patients love about the DNA Appliance, the convenient fit into your lifestyle.
The time when the appliances are out the teeth move to ideal position as nature and/or genes intended.
Typical orthodontics is a four-step process designed to move teeth through the bone. The first step is FORCE that creates PRESSURE (1) that compresses the periodontal ligament and puts pressure on the bone. The second step is INFLAMATION (2) which is associated with pain and discomfort. The third step which is RESORBTION (3) which is breaking down the bone by osteoclasts to create space. The fourth step is CONSOLIDATION (4) where new bone is formed. The process is then repeated after every orthodontic visit when braces are tightened or with each new Invisalign® tray.
Epigenetic Orthodontics is very different because it is a two step process. The forces are very light and movement is limited to 250 microns approximately every four days. The light forces are applied and growth and movement occur without inflammation which makes the entire process practically pain free. If there is any discomfort the adjustments are spaced out further.
Relapse is frequently a problem with orthodontics after orthodontists have used fixed braces to straighten crooked teeth. Relapse is the teeth moving back to their original position and relapse is why orthodontists make retainers. The reason for relapse is complex and not well understood. The hours when the appliance is out let the teeth follow natural eruption processes with far lower risks of relapse.
According to Dr. Dave Singh the Founder of the field of pneumopedics and craniofacial epigenetics which includes epigenetic orthodontics “there is a natural way for the body to remodel the upper airway, reshape bone and move teeth into their correct positions painlessly without the use of surgery, drugs or injections.”
Professor G. Dave Singh DDSc, PhD, BDS states on his website: “However, the entire human genome has now been sequenced, and we now know that certain genes are involved in moving teeth. Teeth are naturally-designed to move, for example, tooth eruption in a normally-growing child. In addition, the teeth in some people erupt in a specific arrangement, producing a beautiful smile. Dr Singh believes that the specific arrangement of teeth is due to certain genes. In fact, a natural process called ‘temporo-spatial patterning’ is at work. This process is the blueprint or body plan that is encoded by genes. In other words, the right and left sides of the body, the top and bottom of the body as well as the front and back of the entire body is under the control of a genetic body plan, including the teeth. Sometimes, however, the plan gets disturbed, producing crooked teeth and improper orthopedics.”:
Getting Older or Getting Better™. THE CHOICE IS YOURS! Come in and find out what is possible.
The Vivos DNA Appliance allows us to grow and develop a more ideal facial structure and a healthier airway.
Dr. Shapira has long had a special interest in developmental processes because of his work with sleep apnea in children and adults. Dr Shapira also has over 38 years experience in treating difficult TMJ Disorders, Migraines, headaches and other Chronic Pain. When these processes go are disturbed it changes how people breathe and swallow. Young children are frequently put in expanders to expand their maxilla or upper jaw. This is needed because of negative epigenetic changes caused by environmental allergies, food allergies or disturbed growth from insufficient breast feeding and bottle feeding.
Dr. Shapira, has taught classes to hundreds of dentists and their teams on how to treat sleep apnea with oral appliance therapy. It is one of Dr. Shapira’s students Dr .Martha Cortes who first introduced him to Dr Singh and to this exciting new field.
Dr Shapira has studied this field extensively and in 2014 gave a lecture in Buenos Aires, Argentina on the “Common Developmental Pathways of TMJ Disorders and Sleep Apnea.” These pathways are an example of negative environmental effects on development that can be reversed in adults who were not expanded as children. Prior to the DNA Appliance only extensive orthognathic surgery was available to widen or move bone.
Faces are different and each and every one of us is unique. Our appearance and physiology is determined by our DNA or genes. Genes determine our physiology and everything else about us. This is a description of Genetics
What many people are not aware of is that the environment and other factors can change how our genes express themselves. These types of changes are called Epigenetic changes.
Each person has a unique Genotype, these are the genes we inherited from our parents that when combined created a unique and special person. Identical twins actually share a identical DNA .
The Phenotype is how are Genes are expressed, the effects of the environment on us. These are the epigenetic changes that can be positive or negative in nature. This can be the difference between a big wide smile that shows all the teeth
What makes the DNA Appliance special is that it uses the patient’s own genes to modify and change not just the position of the teeth but the size, shape and position of the bone that holds the teeth as well as Pneumopedically change the size and shape of the airway. This 3-D spatial reconfiguring of the teeth and bone can make amazing changes not just in the teeth but in the face as well. The changes the DNA Appliance stimulates mimic the natural developmental process that occur in an ideal world. Biomimetic is the term used to describe what the DNA Appliance accomplishes, it mimics through biologic means what an ideal environment would have developed.
Oral appliances are frequently worn as a comfortable alternative to CPAP to manage snoring and obstructive sleep apnea. These appliances often protrude the lower jaw and are needed for life. Pneumopedics® is a term coined by Dr Singh to describe non-surgical upper airway remodeling is a different approach because instead of merely repositioning the lower jaw during sleep it gently allows allows the body to gently and gradually orthopedically increase the size of the upper jaw and increase the nasal airway. This has been shown in some clinical cases to create a cure for sleep apnea and snoring. The FDA-registered Daytime-Nighttime Appliance® system (or DNA appliance®) is worn during the evening and night for a total of 14-16 hours/day
Patients who are CPAP intolerant can utilize the FDA-cleared, patented mandibular Repositioning-Nighttime Appliance® (or mRNA appliance®) which works to maintain an open airway in the fashion of sleep apnea oral while gently re-developing the upper airway and moving the mandible or lower jaw and the teeth into a more natural position.
The DNA appliance® and mRNA appliance® protocols can effectively address TMD issues and headaches in both adults and children. Dr Shapira is a leader in the use of the DNA Appliance to finish phase two treatment in TMD patients.