TMJ Treatment Without Surgery
Are you suffering from jaw pain but don’t want to have surgery? Dr. David Frey is the only dentist in Los Angeles to offer treatment for TMJ pain with a Fixed Anterior Growth Guidance Appliance (FAGGA). Dr. Frey uses this treatment to grow the bone organically without the need for surgery or restorations. If your jawbone is deficient, our office can fix it.
What is Physiological Orthodontic Treatment?
Physiological Orthodontics is our revolutionary approach to straighten teeth while adapting the jaw bones to their full genetic potential. Physiological Orthodontics stimulates your facial bones to create a healthy airway, full jaw function and straighten the teeth all at the same time. Our orthodontic approach focuses on the entire face, not just the teeth, unlike traditional orthodontics. FAGGA makes it possible to straighten teeth without the risk of TMJ or Sleep apnea later on in life, and can cure existing TMJ and sleep apnea symptoms.
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What is Fixed Anterior Growth Guidance Appliance (FAGGA)?
The Fixed Anterior Growth Guidance Appliance (FAGGA) is the first phase of a two-phase orthodontic treatment system. The appliance fits on the roof of your mouth while giving the tongue enough space to comfortably rest. It applies a gentle force to the bones and teeth which stimulates growth on the upper jaw (maxilla).
Who is a Candidate For FAGGA?
Dr. Frey offers this system for TMJ sufferers, headache sufferers, neck pain sufferers and even sleep apnea sufferers. This system is also great for anyone who wants to look more beautiful with more proportionate facial features, as it brings the jaw into the proper alignment.
How does FAGGA Help me?
The FAGGA appliance helps patients in a number of ways, both aesthetically and functionally. This appliance will develop the upper jaw three-dimensionally over time by remodeling the bones to improve form and function. By adjusting the bones, we have the ability to bring your body into DNA potential that was corrupted during growth by your environment. This not only improves facial features, but also opens the airway which can cure sleep apnea. This will eliminate TMJ pain and make your overall appearance more beautiful.
Treating Sleep Apnea Without CPAP
At our office in Beverly Hills, we have the ability to treat sleep apnea through the use of a Fixed Anterior Growth Guidance Appliance. This treatment is not a guarantee, but it allows the airway to open while putting the jaw in proper physiologic positioning and allowing the tongue to rest. By growing the arch, we can create a better airway. This can possibly cure sleep apnea without the use of a CPAP machine which previously would have been used for life. This treatment also eliminates the need for a dental mouthguard.
How Long Does the FAGGA process take?
Everybody is different which means the treatment process varies per person. The full process depends on you, your face and the level of correction needed. Typically this appliance can grow the jaw 1-2 mm per month, so it is important to come in every 4-6 weeks so Dr. Frey can adjust the appliance. Once this phase is completed, Controlled Arch braces will be placed on both the upper and lower teeth.
Why Does FAGGA Have Superior Results Compared to ALF?
- Alf is attached to teeth on the lingual of the uppers. As such it is stimulating movement of teeth. This form of arch development is slow and has a degree of unpredictability, as pushing on teeth means you are relying on the periosteum for appositional bone formation.
- ALF as with any appliance that pushes on teeth means you get unwanted flaring or tipping of teeth. You ideally want bodily movement of teeth and not tipping.
- ALF does not create the stimulus on the palate at the correct location of the nasopalatine neurovascular bundle. The microtrauma from pressure on the nerve creates a response that lays down bone and the ALF does not do this.
- ALF cannot create the robust sagittal forward development which is the direction the body wants to go, that was obstructed during growth and development. This means the 3-dimensional remodeling potential of the entire Nasomaxillary complex is stimulated. ALF, thus is much less robust in activation of remodeling since sagittal forward bone pressure is not achieved.
- ALF is notably slow, usually a year or more for even minor changes to occur.
- ALF has notoriety because osteopaths who treat cranial strains have interfaced with dentists who use this appliance. We do owe credit to the ALF dentists, as they have brought a lot of information to dentistry regarding cranial strain patterns.
- ALF follows many other earlier appliances that all work more or less within the dento-alveolar housing. The AGGA gets to the foundational basal bone of the Maxilla and stimulates it to fully remodel.
- AGGA provides superior stimulation to the Ramus allowing both jaws to develop. It is truly a face forward complete change we are getting. Other appliances (ALF) have much less effect ( if at all) on the Mandibular Ramus. You need both jaws to develop to get superior results.
- ALF will tip anterior teeth as a part of sagittal development…. that is risky and you do not want that in that region. The AGGA holds the teeth from moving at all and only allows bone formation, which is much safer in the sagittal plane of development.
Why Does FAGGA Have Superior Results Compared to The DNA Appliance?
The DNA appliance tries to do the same thing as the FAGGA growth appliance but fall short. David Singh developed the DNA appliance, which stands for DAY and NIGHT, don’t be fooled that it helps your DNA. As for the DNA (vivos) just know that there are some (few) people who benefit from these appliances but honestly most need more controlled movement. You end up with an upper arch that either doesn’t change because the patient wasn’t compliant or the arch is too wide and gives you a scissors bite where the upper is way broader than the lower. You need to wear the appliance for 14-18 hours. As a person who wore one myself, I would get in bed at 11 pm and realize I forgot to wear it.. what happens, in this case, is people crank the appliance because they want it to work but it stops fitting properly. It’s frustrating because you are relying on tremendous compliance. I had patients who ran the gambit. AVOID Skeletal Surgery (Maxillomandibular Advancement) at all costs. Go non-surgical!
What is the Fixed-Removable lingual arch (FRLA)?
The Fixed-Removable Lingual Arch (FRLA) is a fixed appliance worn around the first molars of the lower jaw. It acts as an anchor for the molars and also helps to widen the arch allowing more room for the tongue. The appliance is put in the mouth by temporarily bonding composite pads to the lower molars to open up the bite and allow the jaw to freely move as it remodels.
What is Myofunctional Therapy?
Myofunctional Therapy is given as a part of your comprehensive orthodontic treatment. At our office, we refer to this as “The Big 3” which encompasses no weird tongue habits, nasal breathing and lip competence. In order for the bone to grow and the teeth to move properly, we have to have control of The Big 3. If any of these are weakened, it can affect the treatment. The purpose of the exercise is to strengthen the muscles of the lips, jaw, and tongue with proven techniques so the mouth functions properly. Patients doing the exercises is crucial to the treatment. It is very important that the tongue has posture in the palate, the patient can breath through nose and the lips can touch. Without that, it will be difficult to achieve success with this therapy.
Controlled Arch (Braces)
Braces will be placed on the upper and lower teeth after the patient completes the growth appliance phase. During this phase, the spaces in the teeth formed during the first phase will be corrected by moving the posterior teeth forward and straightening the teeth. The FRLA appliance will also be placed on the upper jaw to provide stability and maintain width. The braces and FRLA appliance will remain in the mouth for approximately 12 to 15 months.
Once the braces are removed patients must wear retainers every day to provide retention. Eventually, Dr. Frey will allow the patient to switch to nighttime wear only.