DNA device? Palatal expander? Or braces? (Photos)

Question

I have verry narrow upper arch (as seen on photo), narrow smile that is just getting more narrower by year, I also have difficulty breathing and posture problems. I did alot of research lately and saw that there was successful stories of palatal expander for adults but I also saw people talking about DNA appliance. My orthodontist told me surgery in my situation would be best, and also invisalign or braces to slightly tilt my teeth but that cannot expand my arch. I would really want a second opinion

Ira Shapira, DDS · Answer

I used to recommend the SARPE procedure to patients as a far less invasive approach to cases like your than orthognathic surgery.  There was a time I bought that you cannot grow the maxilla in adults.  I was totally wrong.  
Over the years I have used various functional approached including Schwartz appliances, Crozat appliances and ALF.  For milder cases an ALF is relatively non-invasive.  
I would only approach your case with DNA Appliances in my office today.  The three dimensional growth surprises me to this day.  The maxillary appliance needs to be worn 14-16 hours daily to get the best results and in adults wear time is the biggest issue.  The DNA Appliance has dramatic evidence of airway growth on 3D cone beam radiographs.The DNA Appliance will soon be known as the Vivos Breathe Well Appliance.
The DNA Appliance is NOT IDEAL  for final finishing of tooth position and I tell patients they may need braces, Invisalign or e-cligners afterward for fine tuning.  Most patients are actually happy with facial form improvement and overall healthy appearance and final tooth position alignment is not high on their list.
You may need a series of multiple appliances for best results.  If you have diagnosed sleep apnea the mRNA version of the DNA Appliance is a FDA approved sleep apnea oral appliance and may be covered under medical insurance.

John McDonald, DMD · Answer

You need to have the bones of your upper jaw widened.  SARPE is the only method to to this.  All of the other options you mention just move the teeth.  They will actually move the teeth out of the bone which will lead to later gum recession problems and possible tooth loss.  Note:  you will read many, many positive reviews of various appliances that claim to expand adults.  Almost all of the promoters are dentists, not orthodontists.  Orthodontists treat patients that go back to their dentists so they only provide treatment that keeps peoples teeth healthy and provides a good smile.  Orthodontists do what works and stay away from treatments that are harmful or unpredictable.  Be wary when a treatment you are considering is not widely accepted by orthodontic specialists.

DNA device? Palatal expander? Or braces? (Photos)

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DNA device? Palatal expander? Or braces? (Photos)

Answers (2)

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Everything you need to know about Braces

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