Does the ALF work?

The ALF is a popular lightwire appliance that is designed to put a constant, expansive force on the skull.

This almost feels like the age old question and I, myself, have some mixed feelings about the ALF.

So in this post I’m going to break down my view.

What is the ALF?

So the ALF (Advanced Lightwire Functionals) is a lightwire appliance that typically goes on the upper teeth, but can also go on the lower teeth.

As opposed to braces or aligners it doesn’t fix a position that it wants to move the teeth to. Rather it just tries to expand everything outwards in a gentle way.

It uses a light, but constant force that tries to use teeth as the anchor to bones. Thus it tries to unlock cranial bones and undo cranial assymetries.

Additionally, ALF dentists tend to work with osteopaths as they believe working in tandem to achieve the goal of improving both the skull and skeleton.

How to get ALF treatment?

So there are probably 100+ dentists around the world now that utilize the ALF. I believe there is some kind of training that they go through to be certified.

But I do not believe the ALF is formally taught in dental school.

Rather it was founded by a dentist, Darrick Nordstrom, in the early 1980’s. And Darrick is still alive today and an active supporter of the community around ALF.

I believe he is completely retired now but back a decade or so it was viewed that he would take on some of the more complex cases.

My experience with the ALF

I started using the ALF in early 2016 with a practitioner named Dr. Risto Hurme. And this picture above is the exact appliance I used.

It was a ‘Twinblock ALF’ because it has two acrylic blocks. One on the lower teeth towards the front and another block on the upper teeth near the black.

I wore this for about a year before moving to the ‘Stealth ALF’ in mid-2017.

The Stealth ALF was a design that was only a wire on the upper teeth and used the 2nd molars are the clamp as you see here.

And on the lower teeth I essentially wore a splint that had flat contact only on the last tooth.

Dr. Hurme also gave me my first Myobrace (a Myobrace A1) pictured below.

I would often wear this Myobrace when I wasn’t wearing the ALF and it was from this Myobrace that I learned the most about how this stuff works.

All-in-all, I can say honestly that I progressed nicely under Dr. Hurme and these years in 2016-17 were also when I did a lot of self experimentation (much to his dismay haha).

In a way I consider it my ‘golden years’ in terms of understanding this stuff.

I did ALF a few more times in the ensuing years

So in late 2017 my son began using ALF with a dentist in Boston. And in 2018 I got a new ALF from Dr. Jeff Brown and was following his treatment approach for awhile.

His treatment approach was to leave the posterior open bite that I had at the beginning and then put buildups (ie. composite) on the lower teeth a bit later on.

Then in 2019 I had gotten a new ALF and was working with Dr. Dmitry Markin in Russia.

I would say my progress was up and down. And so it had me mystified at the time.

Now I completely understand why my progress was up and down… it was because progress was not being driven by the ALF at all. Rather it was being driven by what type of contact I had between the upper and lower teeth.

Meaning…. I made a lot of progress with Dr. Hurme because at the same time I had the blocks of the twin block adding height without locking the occlusion.

So it adhered to my two main principles about how you beat this thing:
1- Add vertical
2- Do it in a way that doesn’t lock an occlusion (ie. doesn’t fix a position b/w upper and lower teeth)

I almost think I could have completely removed the ALF and the outcomes would have been exactly the same. Because the ALF was a sideshow.

I still wear an ALF but I don’t think it does anything

So to this day I still wear an upper ALF. But the ALF I wear for the last year is the ‘stealth ALF’ that Dr. Hurme gave me in 2017.

Meaning it is 7 years old and has pretty much completely lost its elasticity.

So I do not think it is actually doing anything. I just keep it there because I kinda like the feel of it. And perhaps it is doing a little ‘something’.

But note that I went more than a year from late 2021 - early 2023 without wearing any ALF at all and I was still making progress.

In fact I think I was progressing at the same rate then (without an ALF) as I am now (with an ALF). Because the core physics of how you improve has nothing to do with the ALF itself.

Closing thoughts

So there you have it… that is my view on ALF. It is at most a sideshow to the core physics of how this stuff works.

Because what is absolute key is that you stretch the soft tissue of the jaw and skull. Something that is achieved by dental height + a non-locking occlusion.

And accelerated by ~10x through a set of jaw stretches that I learned to do all the way back around 2016.