A lot of patients ask me which oral appliances are used for what specific purposes. In an effort to better inform my patients, and others who might have a similar question, I thought I would try to describe what appliances I use, and when I use each of them.

One of my very favorite appliances and one that I use extensively is the DNA. DNA stands for “daytime, nighttime appliance” because it needs to be worn 12-16 hours per day to be effective. This is wonderful news since historically most appliances needed to be worn virtually 24/7 to be effective. This appliance can easily be worn by an adult who cannot wear an appliance during working hours or a student who does not want to wear an appliance to school. This appliance is used to develop or expand the dental arch in both a side-to-side and forward and back direction. This appliance has been used with great success for many years. This is a great appliance to expand an underdeveloped dental arch. I use it for opening up spaces where bicuspid teeth were extracted. It is also a good appliance to treat sleep apnea and TMJ Dysfunction.

A newer appliance that does many of the same things as the DNA that I am using more and more often is called the Meridian. This is a newer appliance and much less well known than the DNA but has a couple of significant advantages over the DNA. One advantage is that it offers more tongue space and therefore makes it easier to wear 24/7. Whether at work or school, speech hindrance is much less of an issue. The other huge advantage is that the Meridian prevents spaces from opening up in the “smile zone” while the arch development is occurring. This appliance is also used to expand a dental arch, treat TMJ Dysfunction and sleep apnea. As a general rule, the more an appliance is worn, the faster treatment can proceed.

Each of these two appliances (the DNA and the Meridian) can be paired with a second appliance that turns the appliance into a mandibular (lower jaw) advancing appliance. If a patient’s problem is a retruded mandible then a DNA paired with a lower arch appliance is called an mRNA appliance. The Meridian paired with a mandibular appliance is called a Meridian PM. Both of these appliances are used to develop arches and reposition mandibles forward. This is useful to improve facial aesthetics and treat TMJ Dysfunction and treat sleep apnea.

I frequently use the Schwarz appliance to develop the upper arch laterally or to upright lower molars. This is a great appliance that has been around for a long time. This appliance really needs to be worn 20+ hours per day to maximize its effectiveness.

I will sometimes use various other appliances: sagittal, twin block, Herbst, etc. but with less frequency now that other appliances have been developed that work more efficiently and effectively.

All of the appliances described above are orthopedic appliances (they develop bone) compared with orthodontic appliances (they move teeth). The orthodontic appliances that I commonly use in my office are clear aligners and wire brackets. Clear aligners (Invisalign, Clear Correct, Red, White & Blue, etc.) effectively straighten teeth by using clear plastic “trays” that fit over the teeth and gradually move them. These aligners are typically changed every two to three weeks. Advantages are that no one knows that you are straightening your teeth because the aligners are virtually invisible, the teeth are more cleansable without braces glued to them and the aligners are smooth against the lips and cheeks.

The brackets we use are very similar to conventional braces only they straighten teeth faster. We use a bracket system that consists of triangular (rather than the typical square) brackets and the archwires are square (rather than the traditional round). Square archwires working with triangular brackets move teeth more comfortably and more efficiently (thus faster) than conventional square brackets and round archwires. Rarely is a patient in my office in braces longer than 12 months and usually it is considerably shorter than 12 months.

This is a pretty comprehensive summation of the various orthodontic and orthopedic appliances that I use in my office. I hope this has been instructive. If you would ever like to have a consultation to see if any of the appliances we use would be helpful for you in your specific situation we would love to have you visit our office. Please call 714-838-0760 to schedule your appointment.