What is going on with the AGGA Appliance?
For the record, we have never used the AGGA and we never will use it. The AGGA has an unproven and unpredictable track record. There are several documented cases of poor treatment outcomes. Most notably, class action lawsuit filed against AGGA, the inventor of the appliance, Dr. Steve Galella and his Facial Beauty Institute. Other adult palatal expander appliances exist including the DNA appliance (Vivos), ALF, and Homeoblock devices. The after-mentioned appliances are removable appliances with proven track records and completely different mechanisms of clinical action. The MSE expander for adults is another widely used appliance that works differently than all of the above mentioned devices.
The AGGA has always been a “different” appliance with a “different” and “unconventional” dental orthodontic, dental orthopedic mechanism. The AGGA draws ire from most orthodontists and other dental specialists. Suffice to say, there has been a strong desire to throw the AGGA under the bus for years.
Is the AGGA as bad as CBS made it seem?
In all fairness to the AGGA, there are more cases with good outcomes than bad. And the AGGA was a darling appliance for many dentists, until the high profile lawsuit a la Michael Avenatti-style referenced above was filed. The plaintiff’s attorney wasted no time launching a massive media smear campaign. The truth of the matter is the complainant had many questionable orthodontic treatments done by many different dentists prior to receiving treatment with the AGGA. The AGGA has been in wide use for years and the facts about the appliance (good and bad) have been known for years. Now suddenly everyone is talking about it because of recent negative press given by CBS. For the better or worse, the air has been taken out of the AGGA and most dentists have deleted their AGGA appliance web pages and have disgraced and forsaken the appliance.
Many attorneys are now bidding Google and Bing Ads for “patients harmed by AGGA.” It almost reminds of when I was shopping divorce attorneys. No doubt the piranha are schooling.
The Facts will decide the Case
People should let the case take its course prior to forming opinions. Many unknown facts will come out. Perhaps the plaintiff sabotaged her own case by not following the Drs Instructions. Perhaps the damage was done by treatments done by other dentists prior to when the defendant treated the patient and the AGGA was used. Perhaps the plaintiff was told that one of the risks of treatment was tooth loss and the risk was accepted. Perhaps the defendant was negligent and used the AGGA improperly. Hopefully we will find out.
Why Not to get the AGGA by Facial Beauty Institute
The AGGA works completely differently than any other adult expander appliance on the market. We do not use the AGGA and we have never used the AGGA. The AGGA is basically an orthodontic wire that connects to the back teeth and is connected to the front teeth. We do not understand how the wire can do anything other than move the front teeth forward through the upper jaw bone. Dr. Galella has a piece of plastic built into the AGGA that puts pressure on a small part of the middle of the palate. The hypothesis is the pressure causes bone to grow throughout the jaws and face. It really sounds too good to be true and makes no scientific sense (in our opinion). We cannot disprove Galella’s hypothesis. But the idea and concept behind the AGGA makes us nervous and has no scientific basis we understand or subscribe to.
Homeblock DNA and ALF use Different mechanism than AGGA
The DNA, Homeoblock appliance and the ALF appliances have been proven to stimulate bone growth in adults and kids. All of these appliances are removable and they all use light springy pressure. This mechanism is completely different than how the AGGA works. The ALF uses a removable wire that flexes into place that moves and springs when the tongue pushes it. The DNA and Homeoblock appliances are basically Schwarz appliances with the addition of a spring that puts light pressure and moves upon tongue pressure. All of these appliances are removable and all have springy action that move upon tongue pressure. The “springy” mechanism activated by the tongue is a familiar and explainable action that grows bone and much different that an orthodontic wire that pushes teeth and has a braces-like mechanism. All these appliances have a proven track record and there are very few bad outcomes. The mechanism of action of theses removable appliances is much different than that of the AGGA which has no springy action.
AGGA is Expensive and Questionable
Practically speaking, treatments with the AGGA usually last 3 – 5 years and usually involve expensive braces and other appliances as well. I have personally seen treatment plans costing $30,000 – $50,000. Other effective treatments exist such as the Homeoblock device and Vivos DNA appliances that take much less time and are a lot less expensive.
Contact Dr. Adams for a complimentary appliance consultation
Anterior Growth Appliance Therapy Video
Disadvantages of the AGGA Device
The biggest problems with the AGGA is the apparatus is fixed permanently into the mouth and can only be removed by the dentist. It has a tendency to be more difficult to eat with and clean. The device also does not promote any vertical or transverse (width) bone growth. The AGGA device is frequently used by doctors associated with the LVI cosmetic dental academy and is very expensive. Finally forward growth is only one piece to the puzzle. Additional orthodontic treatments such as braces and other expanders are usually necessary after AGGA treatment to optimize the bite and align teeth. The cost of braces and other appliances should be understood prior to getting into treatment with the AGGA.
AGGA is not FDA Cleared
And it does not have a very long proven track record, if a track record at all. Many dental professionals do not believe it grows bone the way Dr. Steve Galella, the inventor of the appliance, claims. Most professionals in the TMD and dental sleep apnea community believe it does work, but not necessarily the way Dr. Galella claims.
How Does the AGGA Grow the Jaw Bones Forward?
According to Dr. Galella, the Anterior Growth device stimulates an exact spot on the palate that triggers the body’s own built-in bone-building response. Specifically, the frame of the growth apparatus presses a nerve located on the roof of the mouth. The pressure supposedly sets in motion a rapid bone growing event throughout the entire cranial-facial region. Dr. Galella also invented the Controlled Arch System. His main focus is on facial beauty and facial growth modification. Dr Galella is the director of the Facial Beauty Institute and is one of the founders of OrthoMatrix Corp.
How Does Facial Bone Grow in Appliance Therapy Video:
There are many different kinds of expanders for kids to help prevent problems in adulthood.
Is the AGGA the Best Way to Get Anterior Facial Growth?
No. There are many other more effective and proven devices such as the DNA appliance. But the AGGA is not a comprehensive stand-alone therapy for forward facial growth. The AGGA needs to be used as one appliance in a series of treatments to achieve facial growth. This can be explained by the fact that faces grow in three dimensions and not just forward. There is also the issue of teeth positions and how they look. Anterior facial growth cannot happen without also managing the changes in the other dimensions and the teeth that fit into the jaw structures. Obviously if bone is growing forward the teeth in the bones are going to change. And what about the lower teeth? The AGGA connects to the upper jaw. Obviously, something needs to be done to manage the relationship between the upper and lower jaws and how the teeth fit together. The DNA and Homeoblock appliances are capable of managing growth in all dimensions. The Homeoblock and DNA also do a decent job of managing teeth positions as well. The DNA and Homeoblock may not be as good at forward growth as the AGGA, but they are just about as good. Other considerable facial growth appliances exist as well and new ones are coming out all the time.
Forward Facial Growth Treatment Plans
It is very important to correct a problem when doing any medical or dental treatment. You do not want to trade one problem for another. Very rarely are problems only cosmetic. And you do want to correct all the functional problems and not just cosmetics. Typically treatment that is only cosmetic will not be stable and problems will recur. Such is the case with anterior facial growth therapy with dental appliances. At the point facial growth treatment commences other treatment has failed. Such as orthodontics, dental sleep appliances, bite splints and night guards. The treatments failed because they did not correct the root cause of the problems. For anterior facial growth therapy to be successful, the treatment needs to do the following things:
- grow the facial bony structures forward
- increase the volume and spaces inside the mouth.
- facial width and height growth.
- improve the function of the bite and temporomandibular joint
- improve breathing patterns such as nasal breathing vs mouth breathing
- create a cosmetic smile
The AGGA cannot do all the above. The DNA and Homeoblock appliances can sometimes. The reasons for doing anterior growth sometimes vary. People may have:
- temporomandibular joint pain
- poor sleep with probable sleep apnea
- teeth crowding and crooking
- poor facial profile
- history of teeth extractions and retraction orthodontics
- poor posture
- neck and upper back pain
- headaches
What is the Cure for Facial Under Development
The most important thing is when treatment is complete that all the problems are addressed. The main cause of all these problems is not enough facial growth to begin with in childhood. The tongue needs enough room to function properly. And when the mouth and nasal passageways are not large enough, problems with the airway occur. Airway problems lead to TMJ / TMD problems and sleep apnea. With proper comprehensive forward facial growth therapy all these issues can be cured. There is no one miracle appliance.