Welcome to the TMJ Sleep and Breathe Center in Vienna Virginia. Our patients are adults who have jaw, neck and/or back pain. Many also clench their teeth, have sleep problems and mouth breathe. The structural cause of these problems is inadequate space and balance in the jaws and airway, and misalignment in the neck and back.
Our practice integrates adult palate expanders, posture correction, breathing exercises and myofunctional therapy. Our treatments help people smile, bite, breathe, sleep and posture better. Our therapy can eliminate the need for night guards, bite splints and CPAP and mouth breathing habits forever.
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What are Adult Palatal Expanders?
We prefer the use of the term “growth appliances.” Orthotropics is a term created by Dr. John Mew. It is used for natural facial growth produced by Mewing (tongue exercises) and a Biobloc removable expanders. Dr. Mew is the father of “Mewing.”
Expanders are small retainer-like devices that promote growth of the jaws by placing very light pressure in the direction of the planned growth. Expanders come in all shapes and sizes for different types of growth needed. The goal is to grow the jaws into a more optimal size and shape. Teeth will have space to fit. The tongue will have room to fit into the palate. And air will pass without resistance between the nose, airway and lungs. Expanders work by applying a light pressure in the direction the jaws need to grow. Palatal expanders are not mechanical devices and do not cause pain. The appliance mimics tongue pressure and encourages proper tongue posture. The appliances only need to be worn at night and are removed during the day.
Adult Palatal Expander Options:
If you are suffering from TMJ pain, sleep apnea and mouth breathing, adult expanders will correct your problem. Dr. Adams‘ favorite appliance, the DNA appliance can stop mouth breathing in adults. No one appliance is the best for every case. Every patient is different and needs to be individually diagnosed. We design treatment plans and appliances depending on the specific needs of each patient. For example a patient with severe sleep apnea will be treated differently than someone with only jaw pain, head aches and forward head posture.
Our Treatment Modalities:
- Adult palate expander appliances
- Myofunctional tongue therapy
- Breathing exercises
- Posture restoration therapy
Treatment Goals:
- Alleviate TMJ pain and headaches
- Restore healthy breathing patterns
- Decrease airway resistance
- Balance the bite
- Improve posture
- Balance upper and lower jaw relationships
- Correct tongue function
The DNA Appliance:
The DNA appliance was originally invented by Dr. Singh. The DNA is one of the most popular expander for adults. The technology has been purchased by Vivoslife.com The DNA has a sister appliance called the mRNA appliance which is a combination of a DNA appliance and a mandibular repositioning feature. The DNA device is the most versatile of all adult expanders. It is the most comfortable adult appliance. The Homeoblock device is very similar to the DNA and it is equally comfortable and works the same as he Vivos DNA appliance.
The Homeoblock Appliance:
The Homeoblock appliance was invented by Dr. Belfor and is exclusively for adults. The Homeoblock appliance is a palatal expansion device that can be designed exactly as the DNA appliance. The Homeoblock is he grandfather of all adult expanders. It has been in use for over 30 years. The DNA and the Homeoblock look very similar in appearance with the exception of the different spring design. The similarities are not surprising because Dr. Singh and Dr. Belfor used to work together.
The Homeoblock works by stimulating bone growth with a unilateral bite block. The theory is everyone has one side of their face that is under developed more than the other. The bite block is classically placed on the weaker side and stimulates bone to start growing. The Homeoblock can also be designed with a bilateral bite block by the provider. The Homeoblock is custom designed to address the individual needs of each patient. The device is highly customizable and versatile.
The Homeoblock is very similar to the DNA appliance, but may be better in cases where there are more facial asymmetries and cranial strains. The DNA and Homeoblock appliances are both adapted Schwarz devices with a special spring and bite plane area.
The ALF Appliance:
The ALF appliance is the “advanced lightwire functional.” The ALF is one of the oldest adult palatal expansion appliances. It was invented in the 1980s by Dr. Nordstrom. It is a light gauge wire that is very flexible and springy.
The ALF typically stays in the mouth all the time and is not removed by the patient. It puts a constant outward springy pressure and its growth potential is aided by tongue movement. The tongue pushes on the device and creates an increase in expansive pressure during swallowing and talking. The ALF is custom made to fit around teeth in narrow spaces.
The device is especially helpful when there is severe crowding because it is so small. The ALF results in a decent amount of teeth movement and will usually need to be followed by conventional braces or Invisalign.
The disadvantage of the ALF is the lack of a bite plane and the appliance gets less bone growth than the DNA and Homeoblock devices. The ALF is also more difficult to adjust and requires a more experienced provider. The ALF has a tendency to dislodge during eating and is generally more difficult to tolerate. ALF also requires more trips to the dental office for adjustments and replacements after dislodging.
The Crozat Appliance
The Crozat appliance looks similar to the ALF but it works a bit differently. The Crozat is better at expanding the posterior palate than the ALF. The ALF is better at expanding the anterior part of the maxilla than the Crozat. The Crozat wire is typically a heavier gauge than the ALF. The wire crosses across the back part of the palate whereas the ALF passes behind the front part of the mouth. The Crozat like the ALF uses tongue pressure and function to promote jaw development.
Does Palatal Expansion Work for Adults?
Yes. Light and flexible springs on adult expansion appliances increases bone cell activity and makes expansion possible for many adults. Growth is a lot slower in adults vs kids, but it does work. There is more to it than “expansion” though. Small changes in upper and lower jaw positions makes a big improvement in tongue position, posture and airway resistance. Sometimes improving bite and jaw balance is the best way to alleviate TMJ pain and posture problems.
Are Adult Palatal Expanders an Alternative to Braces
Braces are for straightening teeth. Growth appliances grow the jaws to be a more optimal size and shape. Optimal treatment is to first expand the jaws to be the correct size and shape. And then straighten the teeth and balance the bite. Many times during expansion, the teeth will naturally get straighter and less crowded and crooked. Sometimes orthodontics is necessary after expanders, whereas in others, an acceptable cosmetic result can be obtained with expanders alone.
Removable vs Fixed Adult Expanders
Some orthodontic growth appliances stay in the mouth all the time hence the term “fixed.” Other appliances are removable and can be taken out of the mouth by the patient. Removable appliances are more comfortable because they do not get in your way while talking or eating. They are usually only worn at night time. Also, it is not always good to have an appliance in the way of normal forces places on teeth top to bottom. Biting pressure on the teeth keeps the upper a lower jaw bones in sync. The ALF and the Crozat are fixed appliances whereas the Homeoblock and DNA appliances are removable.
MARPE and MSE Skeletal Expanders
MSE stands for maxillary skeletal expander. MARPE is micro-screw assisted rapid palatal expander. MSE and MARPE are forms of palatal expansion that happens by putting rapid expansion force directly on the the maxillary bone. MSE is really good at making the upper jaw wider. And it does so quickly by rapid palatal expansion. The MSE does not do anything to the lower jaw and it does not get any forward growth. MSE does not correct facial asymmetry. In fact MSE has been accused of making facial asymmetries worse, but that is not true. When a facial asymmetry is present it gets bigger and more noticeable as the upper jaw gets bigger.