Note: This post may contain statements that I no longer consider true.
See: The Vivos mRNA Appliance Didn't Improve My Obstructive Sleep Apnea.
One option I considered for treating my obstructive sleep apnea was Dr Theodore Belfor’s Homeoblock appliance. I had a one-on-one consultation online with Dr Belfor to evaluate my CBCT scan and see if it would work for me. At the time, there were no Homeoblock providers in Sydney so it turned out not to be an option. However, I did learn a lot in the process.
Homeoblock recently received some high profile attention with James Nestor’s account of his positive results with it in his book Breath: The New Science of a Lost Art, and his subsequent interview with Joe Rogan. This has been met with some skepticism, and much rampant unfounded speculation, about removable oral expansion appliances and the claims made by their manufacturers.
I see no reason to doubt James Nestor’s account of his experience with Homeoblock and I’d like to see it become more widely available to provide some price competition for Vivos. When a dentist considering becoming a Homeoblock provider contacted me recently to ask if I would have chosen it had it been available, I replied:
“Yes, if it was cheaper”
My Vivos DNA provider also does Homeoblock and is using it to treat his own upper airway resistance. I did a lot of research myself and also talked to him about the difference.
Vivos DNA Upper and Homeoblock Appliances.
Homeoblock photo credit: Dr Theodore Belfor
The Similarities
The original prototype of both Vivos DNA and Homeoblock appliances was designed by Dr Dave Singh and Dr Ted Belfor when they were working together. Hence both appliances are covered by the same U.S. patent 7,357,635 which describes the appliances and the epigenetic process by which they claim to operate.
They both:
- Are custom-fitted removable acrylic oral expansion appliances
- Aim to permanently treat the root cause of obstructive sleep apnea, among other things
- Claim to trigger natural jaw growth processes using epigenetic signalling
- Claim to improve nasal airway resistance
However, the inventors have both moved forward in slightly different directions in the 15 years since their joint patent was first filed. The devices available today are slightly different from each other and are each covered by their own patents. There are also significant differences in the support infrastructure available to providers.
Vivos DNA
Here’s Dr Singh discussing the DNA appliance at the 2019 Vivos Breathing Wellness conference:
The How does it work? slide at the start of the presentation looks like unscientific spaghetti to me, filled with gobbledegook buzzwords and vague relationships. It seems he’s trying to convey the idea that this is all very complex and they must be really smart to have worked it all out. It’s just a palate expander with fancy springs, for goodness sake. The guy playing with a bit of wire for two minutes was weird too, but my intention is to focus on appliance differences so I’ll refrain from putting the boot into the presentation.
The DNA Appliance is backed by the Vivos Integrated Practice Program, which appears much more substantial than the support available to Homeoblock providers. This may not represent a difference in the actual appliances, but the choices made by the provider are important to patient results and while there’s only one Ted Belfor, Vivos have multiple experienced clinical advisors.
Dr Singh has published more research into the safety and effectiveness of the DNA appliance, including in small patient groups. I’d like to see larger, long-term studies; but at least it’s a start.
Dr Felix Liao’s book 6 Foot Tiger, 3 Foot Cage is largely about his use of DNA appliances to treat a range of serious health problems including obstructive sleep apnea caused by what he calls Impaired Mouth Syndrome, and includes several brief case reports.
The Vivos DNA Appliance is available in three variants: full occlusion, wireframe and a hybrid.
There is a variant of the DNA Appliance with seperate adjusters for the left and right sides to treat cases of facial asymmetry, whereas Homeoblock has the unilateral bite block to achieve the same aim.
It appears that the DNA Appliance is much more widely used, has more providers, a larger existing patient base, and more overall clinical experience behind it.
Homeoblock
Here’s Dr Belfor in 2020 discussing epigenetic orthodontics and the Homeoblock appliance:
I felt like I was in trouble with the headmaster watching this. It seemed like Dr Belfor was frustrated that people haven’t been listening to his ideas judging by the rising tone of voice in most of his sentences.The paper published in CRANIO that he mentions, The Missed and The Misdiagnosed, is a one-page opinion piece with no supporting evidence and 5 references that don’t mention Homeoblock. Still, I’ll focus here on the appliances rather than the flaws in the presentation.
Dr Belfor used to recommend using an upper Homeoblock Appliance to expand the maxilla forwards for 6 months before starting using a lower appliance on the mandible, but he no longer uses a lower appliance since he believes that the mandible will remodel itself once the maxilla is expanded. He also includes a daytime appliance with Myofunctional therapy. He doesn’t claim to cure sleep apnea but says he can improve the airway, which is what he told me in my consultation with him.
The Homeoblock Appliance doesn’t have a Y-shaped body option with a forward expander because the premaxillary suture fuses in most people very early in life, so he sees no benefit from attempting to expand forwards. This makes the Homeoblock Appliance significantly less bulky than a Y-shaped DNA appliance because only a single adjustment screw is required.
The other main difference between the appliances is the unilateral (one sided) bite block. It is supposed to trigger the genioglossus muscle to contract when chewing, toning the muscle so that it pulls the tongue forward out of the airway. Dr Belfor explains this in his interview on Dr Steve Park’s podcast, and this is his answer to the question about it at 44:00.
Homeoblock is mostly a wireframe design with full occlusion over only a couple of teeth to create the unilateral bite block.
It sounds as if he has copped some flack from people who believe that this could lead to TMJ issues since the forces involved act only on one side. He rebuts this criticism in the video without giving solid evidence. I haven’t read of anyone being harmed by this, but I’m sceptical of the epigenetic claims made for these devices and I’d prefer to have the same force on each side of my jaws so all growth is symmetrical, but this feature could be an advantage in helping correct cases of facial asymmetry.
He describes a 2-year treatment protocol and says that the device should be worn during sleep for life to maintain the signalling to the body and prevent collapse of the airway, but this would be equally true of the DNA appliance.
Research published by Dr Belfor is currently limited to individual case reports. He says he’s seen a thousand patients and I’d like to see research with groups of patients published, which is currently lacking.
I’m not aware of any Homeoblock provider who has independently written a book or published case reports with results from their patients using the appliance.
There seems to be some love lost between the two inventors. At one point Dr Belfor has a swipe at Dr Singh’s book Epigenetic Orthodontics in Adults, saying it “doesn’t even mention the epigenome”. Perhaps he’s jealous that his one-time collaborator has been more successful in commercialising their invention, but it’s taken many years and a couple of commercial ventures to do so.
I hope Dr Belfor gets his act together so Homeoblock can give Vivos a run for their money in the marketplace soon. Unfortunately, the fact that the Homeoblock trademark has been adandoned doesn’t give me much hope.
