The ALF Appliance: A More Effective Way to Fix Orthodontic Problems

Braces have always been the normal way to align the teeth of children, teenagers, and adults. Though braces may straighten your smile, they do not actually correct any underlying issues in your mouth. Straight teeth will not matter if the bone above and below it is not aligned properly, since it will not be stable long term.

This is where an ALF appliance comes into play. ALF stands for “advanced lightwire functional” appliance. It is used to expand the jaw laterally and anteriorly with a more natural approach to growth and development.

Orthodontists generally use a device called the rapid palatal expander to gain space in the maxilla, also known as the upper jaw. These expanders are made with a heavy wire and are tightened using a key, which often requires heavy force. When used on children, parents are the ones tightening the key. Any wrong move could cause bleeding or even irreversible damage in the mouth.

Janet Stoess-Allen, DMD—the owner of Park Avenue Orthodontics on the Upper East Side—used rapid palatal expanders on her patients for many years. She did not know of anything else that was available to accomplish these goals. Then, about 15 years ago, she was at an orthodontic conference in California and listened to Darick Nordstrom, DDS, speak about his revolutionary invention: the ALF appliance. 

“It just really rang a bell for me and all of the misconceptions that I had about the old-fashioned palatal expander all of a sudden didn’t matter because I knew that I would never use it again,” Stoess-Allen said.

Unlike the rapid palatal expander, the ALF appliance offers a more natural approach because it uses light force to progressively shift the maxilla. Not only does it fix any jaw problems, but it also opens nasal and oral airway spaces to help people who may snore or have nasal congestion. It also promotes proper tongue positioning to encourage good breathing and midfacial development and can reduce the risk of sleep apnea.

Stoess-Allen uses the ALF appliance on patients of all ages and uses it in conjunction with braces or Invisalign/Teen Invisalign. The appliance is placed behind the teeth, so it is unobtrusive in the mouth. She has been using it in her practice for the past 15 years on more than 1,000 of her patients.

“It changed my entire practice from one where I was uncomfortable using something on patients and really felt like it could create problems, to something that I’m never concerned with, and the results are superior,” Stoess-Allen said.

According to the ALF website, there are only 19 practices in the state of New York to offer the appliance for patients. These include dentists, orthodontists, doctors of osteopathy, and orofacial myologists. Not just anyone can offer the use of the ALF appliance. It requires a learning curve and attention to be able to activate it on a patient and it took Stoess-Allen years of her own personal time to master it, as it was not offered in her orthodontic residency program at NYU.

“My feeling is that many other practitioners will begin to use it over the years to come once it becomes part of the learning curriculum during dental school and orthodontic residencies,” Stoess-Allen said.

Stoess-Allen has noticed the trend of parents doing their own research to make sure they opt for the best treatment for their children. Many of them call her to ask about the ALF appliance because they are wary of the rapid palatal expander, or have seen her use it in a YouTube video and want more information. In addition, many pediatric dentists, pediatricians, ENT specialists, and other physicians have been referring patients to Dr. Stoess-Allen so that they can benefit from treatment with the ALF.

“It’s my obligation to my patients to keep up with the latest technology and all of the great things that are being invented, and not settling for what we historically learned was okay to use,” Stoess-Allen said.

Main image: A girl visits a dental clinic
Courtesy Bigphoto/stockyimages


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