A new study published in Cranio gives case report of using Epigenetic Orthodontics to Cure Sleep Apnea. Dr Shapira is a recognized expert in treating Sleep Apnea and the Only Dentist in Lake County, Illinois Certified in Epigenetic Orthodontics
There are many ways to treat sleep apnea including CPAP, BiPAP, Seroventilation, Numerous types of oral appliances that open the airway thru mandibular advancement with a sprinkling of other types of oral appliances and surgery. This piece will will briefly review the current treatments before discussing Epigenetic Orthodontics and the DNA appliance, the RNA appliance and Neuromuscular positioning.
Surgery for sleep apnea has been mediocre in results and frequently associated with long term morbidity. The tracheotomy was the original treatment, drastic but effective especially in the morbidly obese. The ENT community pushed UP3 surgery, Uvulopalatopharyngealplasty for many years which had dismal results, high pain and a poor cost to benefit ratio. Insurance companies rarely pay for these procedures now but tonsilectomy and adenoid removal is still helpful, especially in pediatric medicine.
Nasal surgery is helpful for many conditions including sleep apnea but it is not curatice. It is frequently used as adjunctive surgery along with an oral appliance or CPAP. The typical surgery is correction of a deviated septum, turbinate reduction or removal of polyps.
Tongue reduction is effective but very painful and the results may be transient similar to hyoid advancemet . The use of So0mnoplasty to do a series of minimally invasive and comfortable reductions. Results improve but do not eliminate sleep apnea.
BiMaxillary Advancement a procedure preformed by plastic surgeons and oral and maxilofacial surgeons is the single most effective and curative treatment for sleep apnea. It is a major surgery involving removint the upper jaw or Maxilla from the skull often cutting it in two to three pieces and bolting the parts back together with titanium bolts and screws. The lower jaw or Mandible is cut in three pieces (sometimes four) and the middle third of the jaw is advanced bringing the tongue and hyoid bone forward as well. This is held together with titanium screws and plates as well and the jaws are usually wired shut for six weeks.
This is an extremely successful surgery but can have many different morbidities connected to it. The most severe ones are parasthesia or permanent lip or tongue numbness, chronic pain or infection and TMJ disorders. Prior to surgery it is strongly suggested that an oral appliance trial is done to determine how much advancement is needed during surgery. A trial with a mandibular advancement appliance, preferably a TAP 1 can prevent the need for additional future surgeries.
One problem often seen with oral appliances is the occurence of bite changes and most educated dentists treating sleep apnea give their patients morning exercises to restore the bite. These exercises actually push the jaw back to its original pathology and eliminate the healing that occurs overnight. If permanent correction of sleep apnea is being considered it is always best to allow the mandible to heal forward to its Neuromuscular Position. This is especially true if a patient is considering Bimaxillary advancement. I have had a large number of patients who originally planned on doing surgery and decided that the oral appliance was a good final treatment.
For patients who want to try to permanently correct their apnea the use of Epigenetic Orthodontics is now a powerful new intervention that is extremely safe and affordable. It is well known that patients with sleep apnea usually had disturances in growth and development as infants, children and adolescents. Correction of these changes can be curative. Young children can be almost 100% cured by combination of airway management with tonsil and adenoid removal and rapid maxillary expansion. This has not been an option for adult. The use of surgically assisted rapid maxillary advancement is sometimes used in adults with great success.
Epigenetic Orthodontics allows us to grow the upper and lower jaws (Maxillaa and Mandible) to their genetic ideals and when combined with neuromuscular positioning of the mandible can be curative of sleep apnea. A recent article in Cranio Mandibular & Sleep Practice journal describes a case where exactly that procedure is utilized. That patient only utilized the Maxillary DNA Appliance which increases the width of the Maxilla allowing permanent forward movement of the mandible.
The RNA Appliance covers two arches and widens the upper and lower arches while it acts as a sleep appliance maintaining air patency. The beauty of Epigenetic Orthodontics is you wear the appliance 12-16 hours a day so it does not interfer with eating, work or social activities. I have been excited by the pain free progess I see in patients utilizing the DNA and RNA Appliances. The appliances reproduce the ideal 3 dimensional growth patterns that were disturbed during development.
Read a patients perspective on Epigenetic Orthodontic Treatment with the DNA Appliance
Dr Shapira is the President of Delany Dental Care in Gurnee and is the only Lake County, Illinois doctor utilizing Dental Sleep Medicine, Neuromuscular Dentistry and Epigenetic Orthodontics in combination to treat patient. Dr Shapira is well known for his treatment of chronic head and neck pain, migraines and TMJ disorders. A new Highland Park office is opening at 3500 Western Ave in Highland Park across from the Fort Sheridan Metra Station.
Contact Dr Shapira IN GURNEE @ 847-623-5530
IN HIGHLAND PARK 847-533-8313
To learn more about Epigenetic orthodontics: https://dnaappliance.com/faq.html
To find a provider od Epigenetic Orthodontics go to: https://dnaappliance.com/certified_providers.php
Dr Signh has published a book on Epigenetic Orthodontics that can be purchased at https://dnaappliance.com/book-details.html
EPIGENETIC ORTHODONTICS IN ADULTS
By Dr. Dave Singh DDSc PhD BDS & Dr. James Krumholtz
Epigenetic orthodontics means that various human genes or combinations of the patient’s naturally-inherited genes are harnessed in combination or independently with various orthodontic/orthopedic/pneumopedic devices or DNA appliances to modify, change or attenuate the physical location of natural teeth, jaws and airway in 3-D space during orthodontic/orthopedic/pneumopedic treatments, based on the concept of ‘temporo-spatial patterning.’ The term “temporo-spatial patterning” like Global Positioning Satellite (GPS) implies that the spatial organization of the teeth, jaws and airway can be mapped in 3-D space at known anatomical locations using x, y, z coordinates. The pattern in 3-D space of craniofacial structures are encoded within the patient’s genome. Dr Singh believes that DNA appliances are capable of modulating genetic pathways, which are effectively dormant or inactive, and are capable of restarting craniofacial development in adult patients as well as in children. In addition, abnormal patterning is corrected, in part, through the deployment of orthodontic/orthopedic/pneumopedic devices or DNA appliances , which may evoke natural developmental processes that improve a patient’s airway and thereby ameliorate or prevent airway issues such as snoring and other forms of sleep-disordered breathing through non-surgical airway remodeling
Dr Ira L Shapira is an author and section editor of Sleep and Health Journal, President of I HATE CPAP LLC, President Dato-TECH, and has a Dental Practice with his partner Dr Mark Amidei. He has recently formed Chicagoland Dental Sleep Medicine Associates. He is a Regent of ICCMO and its representative to the TMD Alliance, He was a founding and certified member of the Sleep Disorder Dental Society which became the American Academy of Dental Sleep Medicine, A founding member of DOSA the Dental Organization for Sleep Apnea. He is a Diplomate of the American Board of Dental Sleep Medicine, A Diplomat of the American Academy of Pain Management, a graduate of LVI. He is a former assistant professor at Rush Medical School’s Sleep Service where he worked with Dr Rosalind Cartwright who is a founder of Sleep Medicine and Dental Sleep Medicine. Dr Shapira is a consultant to numerous sleep centers and teaches courses in Dental Sleep Medicine in his office to doctors from around the U.S. He is the Founder of I HATE CPAP LLC and http://www.ihatecpap.com Dr Shapira also holds several patents on methods and devices for the prophylactic minimally invasive early removal of wisdom teeth and collection of bone marrow and stem cells. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.