Q: What are the pros and cons of a DNA appliance?

Pros Oral appliance therapy is a nonsurgical way to treat snoring, sleep apnea, and symptoms of TMD and TMJ disorder, as well as improve teeth and dental arches alignment and facial contours. It’s a gradual process that should be pain-free. The removable appliance is easy to wear and care for—and because you wear it at night, it won’t disrupt your lifestyle. It may expand the nasal passages, which can help mitigate headaches and sinus infections. It's an alternative to the CPAP machine, which can feel bulky and come with side effects. Cons A DNA appliance can be expensive, if it's not covered by your insurance plan. The process usually takes between 18 and 24 months to complete.

Question 1

What is a DNA appliance?

Accepted Answer

A daytime-nighttime appliance, also called a DNA or mRNA (mandibular Repositioning-Nighttime Appliance), is an FDA-approved system for the treatment of snoring and mild to moderate obstructive sleep apnea (OSA). Similar to an orthodontic retainer, it can nonsurgically shift and realign your teeth and jaw, to correct obstructive breathing issues.

Obstructive sleep apnea is a sleep disorder in which the tongue and throat tissue relax and block the upper airway during sleep, causing you to stop breathing for seconds or even minutes at a time.

A DNA appliance is a kind of epigenetic orthodontic, orthopedic, and pneumopedic (nonsurgical airway remodeling) treatment.

The American Academy of Sleep Medicine has approved DNA appliances (and other oral orthodontic appliances) as a first line of treatment for cases of mild to moderate sleep apnea, according to the American Sleep Apnea Association.

Question 2

What are the pros and cons of a DNA appliance?

Accepted Answer

Pros

Oral appliance therapy is a nonsurgical way to treat snoring, sleep apnea, and symptoms of TMD and TMJ disorder, as well as improve teeth and dental arches alignment and facial contours.
It’s a gradual process that should be pain-free.
The removable appliance is easy to wear and care for—and because you wear it at night, it won’t disrupt your lifestyle.
It may expand the nasal passages, which can help mitigate headaches and sinus infections.
It's an alternative to the CPAP machine, which can feel bulky and come with side effects.

Cons

A DNA appliance can be expensive, if it's not covered by your insurance plan.
The process usually takes between 18 and 24 months to complete.

Question 3

How does a DNA appliance work?

Accepted Answer

The DNA appliance is typically used to widen the upper jaw and restructure the bones in the craniofacial region, which resolves breathing issues caused by anatomical imbalances. Treatment is biomimetic, meaning it accomplishes it through biological means rather than surgery. Most people wear the removable device in the evening and overnight.

Similar to expanders, the DNA appliance uses pressure to expand the arch space along the top of the mouth and increase the size of the upper jaw over time. This makes it easier for the lower jaw to slide forward into alignment with the top, which also brings the tongue and soft tissue forward, enlarging the throat airway. This less obstructed airway means easier breathing patterns.

Your orthodontist will make adjustments to the DNA appliance every two to three months, to gradually widen your upper jaw. According to Vivos, the manufacturer of DNA appliances, the entire process usually takes between 18 and 24 months to complete.

Compared to braces, this treatment option “will grow your maxilla [the upper jaw bone] wider, which is ideal for cosmetics and physiologic health,” explains Dr. Ira Shapira. “Braces can improve the look of your teeth, while the DNA appliance can improve your breathing.” That said, the DNA appliance can also help with repositioning of crooked teeth or crowded teeth, especially if the crowding is due to your jaw size.

DNA appliances may also help treat TMJ. “Expansion with the DNA appliance makes room for the mandible to advance, which can help with clicking, popping, and locking,” says Dr. Shapira.

Question 4

How does a DNA appliance compare to jaw surgery?

Accepted Answer

The DNA appliance is considered a first-line treatment option for sleep apnea, before a patient considers jaw surgery (also called orthognathic surgery). It takes much longer to see and feel results than with a surgical option, but it’s much less invasive and expensive.

If an oral appliance doesn’t relieve your symptoms or you have more severe jaw alignment issues, orthognathic surgery may be worth the significant expense (more than $16,000 on average, according to RealSelf members), the risk of general anesthesia, and downtime of up to four weeks.

Question 5

Does insurance cover DNA Appliance?

Accepted Answer

Your insurance may cover all or a portion of a DNA appliance, particularly if it's intended to treat a diagnosed medical condition such as TMJ or sleep apnea.

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Rebecca Dancer

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