ALF Appliance

The Advanced Lightweight Functional (ALF) Appliance is a form of non-traditional orthodontic treatment that advances and expands the mandible and promotes change in muscle function, using the principles of cranial osteopathy and epigenetics. This custom-made removable appliance is constructed from a thin, flexible, non-reactive wire that is connected from molar to molar. Because the ALF Appliance is worn on the lingual (tongue side) of the teeth, it is virtually invisible. The ALF Appliance combines the optimal features from many traditional functional appliances, while applying gentle pressure that imitates the natural growth and development process. ALF Appliances provide many advantages over traditional orthodontics, such as:

  • Convenience- ALF patients can floss easier and brush more thoroughly than patients with traditional braces.
  • Cosmetics- ALF Appliance is worn on the inside of the teeth with no metal brackets, making it much more esthetically pleasing than traditional braces.
  • Gentle Pressure- ALF patients experience significantly less discomfort than patients with traditional braces.
  • Time Saving- ALF patients typically only need to visit their dentist once every 6-8 weeks for exam and adjustment.
  • Wellness Enhancement- ALF Appliance Therapy encourages proper facial development, airway enlargement, improved posture, and many other possible health benefits.

To better understand how the ALF Appliance works, it is helpful to have basic knowledge of Epigenetic Orthodontics as well as Cranial Osteopathy. Epigenetic Orthodontics is a field of dentistry that provides non-surgical options to help correct irregularities in facial symmetry, improper bite, and underdeveloped palates of the mouth. Through years of practice and research, it appears that a patient’s genes can be stimulated to change the biological structure of the teeth. As these genes change, it can allow correction and straightening of the teeth without surgery. Cranial Osteopathy is a hands-on practice in which a patient’s cranial bones are gently manipulated to treat dysfunction, realign, and improve overall health. A main principle of Osteopathic Medicine is that proper structure leads to healthy overall function. While most times ALF treatment does not include the actual practice of cranial osteopathy, ALF Appliance Therapy works through gentle manipulation of cranial structures to achieve similar realignment results.

The human body requires balance and symmetry to work effectively and efficiently. As a child’s face begins to develop, the jaws are influenced and reshaped by facial muscles. For example: the tongue should be naturally resting at the roof of the mouth, promoting expansion in the upper jaw. When facial muscles are functioning correctly, a child can reach their full genetic potential with enough room for all teeth and the tongue to fit in their correct position. Poor facial muscle function prohibits proper development of the jaws and midface, causing crowding, crooked teeth, misalignment, and can lead to more serious health problems when left untreated. While traditional orthodontics can be sufficient and an effective form of teeth straightening for many patients, an expansion appliance works best for patients with true underdevelopment and crowding issues. ALF Appliance Therapy produces a natural increase in jaw size and bone volume, creating space and promoting proper function.

Without treatment, improper facial and jaw development can cause:

  • Poor Posture
  • TMJ/TMD Issues
  • Sleep Apnea
  • Poor Sleep Habits
  • Headaches
  • Shoulder/Neck Pain
  • Chronic Illness
  • Enlarged Tonsils and Adenoids
  • Mouth-Breathing
  • Facial Defects
  • Teeth Crowding
  • Malocclusion
  • Improper Bite
  • Sinus Issues
  • Facial Asymmetry
  • Tooth/Jaw Pain
  • Restricted Airways
  • Clenching/Grinding/Bruxism
  • Allergies
  • Developmental Delays
  • Digestive Problems

As you can see, underdevelopment of the face and jaws can significantly alter an assortment of bodily functions. Which exemplifies why expansion is so important in restoring a patient’s overall health, not just crooked and crowded teeth. Many patients who are treated using ALF Appliance Therapy were originally seeking treatment for other seemingly non-related conditions, such as migraines or neck pain. ALF Appliance Therapy is incredibly unique due to both the wide range of potential health benefits as well as the gentle and natural expansion process. Here is a look at some of the benefits of Advanced Lightwire Functional Appliance Therapy:


Many times, TMJ disorders are caused by improper bite alignment, clenching, grinding, or other issues related to positioning and size of the oral structure. ALF appliance therapy creates space for function, providing many patients relief from TMJ symptoms.

Postural Improvement/Correction

Often, when an airway is obstructed, a person will modify their muscle function to optimize breathing, creating postural issues. Expanding the airway through ALF appliance therapy can correct these postural issues.

Sleep Apnea

The floor of the sinus is the same bone as the roof of the mouth. Jaw expansion through ALF appliance therapy increases the size of the airway which can effectively prevent and treat many airway problems, including sleep apnea.

Improved Sleep Habits

Patients with a small mouth and crowded teeth often do not have enough room in their mouth for their tongue during sleep. During deep sleep, the tongue relaxes into a comfortable position. For patients with smaller mouths, the tongue “fits” better at the back of the throat, blocking the airway. This disruption in airflow causes many sleeping problems. As the ALF appliance expands the upper palate, the tongue can rest at the roof of your mouth, keeping the airway open. This means less sleep disruptions due to breathing, and in turn, improved sleep.

Less Headaches

Clenching, grinding, and other misalignment issues can cause severe chronic headaches. The shifting from the appliance relieves these symptoms, and many patients get fewer headaches or migraines during and after ALF Appliance Therapy.

Improved Nasal Breathing

When a patient cannot breathe through his or her nose due to lack of space and small airways, it creates mouth breathing. Mouth breathing drops the tongue and forces the mandible to a down and/or forward posture. This strains muscles and jaw joints which can cause headaches, sleep apnea, pain, and other issues. As the ALF appliance opens and re-structures the airway and nasal passageways, nasal breathing can be relearned.


When you doze off to sleep, the muscles in your mouth, tongue, and throat relax. If these muscles relax enough, they can partially block your airway and may vibrate which is when snoring occurs. The narrower your airway, the more forceful the airflow becomes, and the louder the snoring. Expanding the airway through ALF appliance therapy can reduce or even resolve snoring.

Allergy/Sinus Relief

A small mouth means a small nasal and sinus area, which creates stuffy nasal passageways and can make drainage difficult. Creating more space can improve allergies and other sinus issues by promoting drainage and healthy nasal breathing.

Bite Balance and Alignment

Improper or under development of the jaws, arches, and airways can cause teeth and jaws to become misaligned, creating a “bad bite.” A bad bite can cause chipped or worn teeth, pain, and other issues. As the ALF expands, it allows teeth and jaws to shift into a more natural position, correcting many bite and alignment issues.

Improve Facial Symmetry and Aesthetics

During facial development, airway factors can affect the shape of your jaws. The underdevelopment of jaws can cause facial asymmetry or other facial esthetic issues. Over time, through ALF Appliance Therapy, bones in the craniofacial region are remodeled. As the appliance gently expands your jaws and airways, it encourages a more natural facial structure, increasing facial symmetry, and improving overall facial aesthetics.

The ALF Appliance was created by Dr. Darick Nordstrom in 1982. The appliance is made from .025 or .028 Elgiroy wire, giving it a high degree of flexibility. The ALF uses the natural force of the tongue, coupled with strategic adjustments by an experienced dentist, to produce a light outward force promoting jawbone growth. Your ALF dentist can adjust the (Omega) “loops” on your appliance to slowly increase the diameter of the appliance. As the diameter of the appliance increases, expansion happens.

ALF Treatment times can vary greatly, depending on the complexity of the case. Though patients may suffer from similar symptoms, each patient has their own unique needs and there is no cookie cutter treatment plan. Typically, ALF treatment begins between ages 6 and 8, as the four permanent teeth are erupting, but some children are ready to begin treatment sooner. Keep in mind that by age 4, 60% of facial growth is complete. And by age 6, 80% of facial growth is complete. Because of ALF’s relation to growth and development, treatment can be extremely effective when beginning during a patient’s growth stage. However, ALF appliance therapy can provide noticeable and effective results for patients of all ages. Because the ALF Appliance provides so many overall health benefits, there really is no wrong age to begin treatment.

Whatever your symptoms may be, the first step on the road to relief is a consultation with an experienced and well-trained ALF Dentist. During your initial consultation at Natural Dentist Associates, you can expect a diagnostic exam, review of your medical history, and a 3-D Scan. Once the nature of your dental troubles has been determined, the dentist will create a treatment plan specific to your individual needs. If you decide to proceed with ALF Appliance Therapy, molds of your teeth will be taken. Your doctor will then customize the design of your appliance, tailored to fit your specific needs. The molds will be sent to a lab for fabrication. When the appliance arrives from the lab, it will be adjusted by your dentist for an optimal fit. You will be provided thorough instructions for the care and removal of your new appliance. After that, you will return to our office for periodic appliance adjustments, typically once every 6-8 weeks until treatment is complete.

There are hundreds of dental appliances on the market today. However, most of these appliances do little to nothing about treating the underlying cause. Traditional dentists often recommend sleep appliances that open the airway to reduce snoring. While this may help the snoring while wearing the appliance, it does not resolve the cause of the snoring. ALF Appliance Therapy with an experienced dentist does not just open the airway while wearing the appliance, it opens the airway for good, creating a permanent treatment solution. Schedule your ALF Appliance Consultation with Natural Dentist Associates today and be on your way to the healthy and balanced smile you deserve!

The initial treatment plan fee includes the appliance and all adjustment appointments.

It all depends on growth, which is patient dependent.

Treatment progress is monitored at every adjustment appointment through exam, measurements, and photos. Treatment is considered complete when growth is achieved, and signs and symptoms have improved.

Yes. ALF treatment promotes balanced growth and can improve facial appearance by encouraging growth in the central facial region.

The treatment is slow and guided. However, the informed consent form provided by our office includes all potential risks and benefits.

The appliance will help the areas that need help. It encourages the body to grow in the directions it is lagging. We monitor this very closely.

The ALF can address many issues, one of which is creating space.

The CBCT report will determine underdevelopment and how obstructed an airway is.

We primarily serve Rockville, North Bethesda, Silver Spring, Wheaton, Potomac, Washington DC, Gaithersburg, Kensington, Germantown, Burtonsville, Laurel, Columbia and Northern Virginia (Mclean, Tysons Corner, Great Falls, Arlington ) but people travel from all over the country for our specialty and holistic dental services.

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Natural Dentist Associates
Email: [email protected]
Phone: 301-770-2270
Fax: 301-468-5553
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5809 Nicholson Lane T123