Epigenetic Orthodontics

[littlestar88]

Hi
I have been to see an orthodontist about correcting my overbite and narrow jaw. The orthodontist recomended surgery but said an improvement could be made with just braces. I wasn't completely happy with this (but havn't ruled out either option yet) so I have been having a look around for a 2nd opinion and noticed another orthodontist offers Epigenetic Orthodontics in the form of a daytime nightime (DNA) appliance that is meant to be able to expand the jaw somewhat even in an adult.

I don't think there are any orthodontist on this board but I would love to know what the opinions are in dental journals that you may read. My orthodontist said that while damon braces could help widen my smile somewhat the optimal result would come from sugery because the jaw can't widen in an adult. So how does the DNA thingy do this...it it a load of tosh?

Even if it worked a little, that in combination with the damon could be better than the damon alone...what do you think?

Thanks so much for a reply

 

[Gordon]

Re: Epigenetic Orthodontics - would love a dentist to help

I don't know enough about ortho to comment. I will ask a real orthodontist when I go back to work next week though.

 

[letsconnect]

Re: Epigenetic Orthodontics - would love a dentist to help

This got me curious and made me have a look at some ortho discussions . From what I can make out, it's not regarded as a mainstream treatment (a typical comment: "as for being "epigenetic", this is totally unfounded from what i can tell and more on the lines of absurd. to be "epigenetic" means that you are changing the gene expression and in a heritable fashion. the tradition DNA appliance can't really even be considered a palatal expander because it's removable and likely to be more of a dental expander in nature. the above appliance appears to me to have nothing to do with altering genetics and a lot more to do with mechanically altering oropharyngeal anatomy.")

It will be interesting to hear what Gordon's ortho colleague says, but I would be a bit wary of the claims made with respect to how the treatment works (which doesn't necessarily mean that the treatment itself doesn't work).

is it a load of tosh?

That would be my guess

 

[littlestar88]

Re: Epigenetic Orthodontics - would love a dentist to help

Thats kind of what I thought. There were a lot of words on the website about it like 'may be able to' and 'is thought to' which made me wonder about the scientific basis. I can see how a person could make a lot of money on snake-oil to prevent surery though. I don't understand how it would work on a genetic level which makes it sound like bollocks, lets face it human mouth genetics is pretty screwy anyway what with wisdom teeth that dont fit in many peoples heads! Wonder if by the time I come to have kids science will have advanced to the point I could prevent them inheriting my overbite!

But even as just an adult expander it would be interesting as it is meant to not be possible to expland the palate in an adult without surgery but there were some pictures where the result looks like it worked (can't see whos jaws they were though - could have been a child I suppose in which case expansion without surgery is plenty possible.)

Very interested to see what Gordons collegue thinks.

 

[Gordon]

Re: Epigenetic Orthodontics - would love a dentist to help

You do realise he's an orthodontist don't you? I'll be lucky if I can condense his comments down to a single page of A4

 

[Gordon]

Re: Epigenetic Orthodontics - would love a dentist to help

You've gone and made me look it up now, reading up about ortho on my day off, I'll get you for this!!!

Anyway, here are some comments from an orthodontist:

Robert Nisson, DDS MSD, on January 24, 2011 at 2:14 pm said:

I recently received an advertisement to one of Dr. Singh’s classes. This advertisement is directed at general dentists, not orthodontic specialists.

I searched for “epigenetic orthodontics” in both the American Journal of Orthodontics and the European Journal of Orthodontics. There are zero articles published in these most prestigious journals. I also read the description of this technique on Dr. Singh’s website. On his webite, Dr. Singh states that the “entire human genome has now been sequenced”, implying that this work is somehow related to his “new” and “different” technique. Epigenetics is when a cell’s dna expresses itself in a different manner without a change in the original dna. This means that a different protein is produced. If Dr. Singh could name a single protein which is being changed as a result of his efforts, and which is different which conventional appliances produce, he might begin to have some credibility. I would be surprised if he could find actual genes which his technique is affecting. This might give some “real world” basis for the name of his technique.

It appears that his technique involves orthotic type appliances which change the way the patient postures his jaw and sometimes positions his tongue. The cheek positioning can also be affected. I would be extremely surprised if any of his appliances do anything that could be shown to be even moderately different than the huge array of functional type appliances which have been employed by orthodontists over the past century.

Dr. Singh may have something which is an improvement, but the name of his technique appears to be throwing unsubstantiated hype at what he is doing, something done by snake oil salesmen.

One more thing…the publications he has listed under his name on his website are not from bona fide journals. The top two appear to be from a book he is publishing. The third one is from a group which puts on seminars. The fourth one I am not familiar with, but the title tells me that it is not about his appliances or epigenetics, and the last three relate to well known theories on human facial growth, where genetic and epigenetic roles are being hypothesized.
-----

Given that it's a bit hard to actually see what one of his appliances looks like, I've waded through 2 of Dr Singh (the inventor's) articles now, but they didn't actually show a photo of an appliance, I'm a bit suspicious

 

[littlestar88]

Re: Epigenetic Orthodontics - would love a dentist to help

Thank you so much, thats really helped me a lot. I can see now why the ortho I went to didn't offer it so I'm able to trust him more now too. Hope your having a great weekend (and not reading up on any ortho stuff!)

 

[Carys]

Re: Epigenetic Orthodontics - would love a dentist to help

Fascinating stuff..........


Anyone for some crocodile elixir, got some going cheap ?

 

[Gordon]

Re: Epigenetic Orthodontics - would love a dentist to help

Well, I had a chat with my orthodontist colleague today. I'll try to condense things down a bit. He was fascinated by the whole topic and spent most of his lunch break on Google.

He was extremely sceptical of the whole concept, there is absolutely no evidence that the treatment does anything like it says it can do, the photo of the appliance he managed to find looks like a standard removable appliance that would cost very little to make, but which would be very hard for the patient to wear.

He doesn't think that it could possibly do anything to open the maxilla as it claims to do, but would tip the upper teeth outwards a little. Unfortunately this would never be stable and would need permanent retention. He doubted if many patients would be able to wear the appliance sufficiently to actually move the teeth at all however.

The inventor's list of published articles gave him a good chuckle as well, none of them were in what he would consider to be authoritative journals.

And with that he took his leave, away out to go for a wee jog up Ben Nevis (no I'm not kidding!)

 

[littlestar88]

Many thanks to you Gordon (and your crazy jogging collegue!) for all that info and for wading through all the confusing stuff on the internet that seems to be put there to confuse the lay-people! Many thanks

 

[gdsingh27]

Dr Nisson:

In 2012 you posted on this forum regarding the DNA appliance system. Since that time, the work was presented at the Asia-Pacific Orthodontic Congress where approx. 2000 Orthodontists heard the presentation. The speaker was invited by the organizers as a keynote speaker the following year but couldn't make it, so the paper was submitted to them for publication. Since that time, the speaker was awarded a prize at the International Association for Orthodontics in both 2013 and this year 2014 - two years in a row. It's taken a while for the paper to appear but here is the citation:

Singh GD, Heit T, Preble D. Changes in 3D midfacial parameters after biomimetic oral appliance therapy in adults. J Ind Orthod Soc. 48(2), 104-108, 2014.

The paper provides definitive evidence of increased bone volume in adults, using no surgery and no drugs. The second paper in this series, showing increased nasal airway volume was presented at the Sleep (medical) meeting. Here is that citation:

Singh GD, Heit T, Preble D, Chandrashekhar R. Changes in 3D nasal volume after biomimetic oral appliance therapy in adults. Sleep (Abstract Suppl) 37:A150, 2014.

The next paper in this series has been submitted to the World Association of Sleep Medicine. The findings are quite remarkable, but based on strong, scientific principles of Epigenetic orthodontics.