DNA Appliance and Epigenetic orthodontics/orthopedics?

Expansion of the Maxilla (upper jaw) should ideally be done prior to 8 years old.  Until the DNA Appliance the SARPE procedure was the only method to expand the maxilla in Adults.  The DNA Appliance has changed that drastically.  The DNA Appliance cannot shorten the mandible (lower jaw) but depending on the case it sometimes proves unnecessary to do the lower surgery.  I would Rx starting with Maxillary expansion without surgery.  It is the safest and least painful method and offers advantages of only being worn 12-14 hours/ day mostly during sleep.Many cases resolve mandibular position due to 3 dimensional orientation of the jaws. Rapid Maxillary Expansion with a surgical assist is a great procedure and I used to routinely recommend it prior to the DNA Appliance.There is a danger involved in shortening the mandible that you can create TMJoint problems or cause snoring and/or sleep apnea.  The surgical treatment for those disorders involves lengthening the mandible.  I have seen patients who developed sleep apnea and snoring and were offered surgery as an option to treati it.  It was only after that dicussion I learned of previous surgery.Ira L Shapira DDSDiplomate,  American Board of Dental Sleep MedicineDiplomat, American Academy of Pain ManagementRegent and Fellow, International College of CranioMandibular OrthopedicsChair, American Alliance of TMD OrganizationsThinkBetterLife.com

If you are a candidate for DNA appliance, I would use that over surgery. Manibule usually follows Maxilla. There are many orthopedic nonsurgical ways to help you.