ALF Appliance is a Gentle Alternative to Braces

ALF Palatal Expander Advantages


The ALF appliance is an alternative to traditional braces. It works by gently expanding the palate to provide more space for all the teeth to fit and bite in a more balanced way. The ALF straightens teeth but it does so in a much different way than braces. The ALF straightens teeth by creating more room so the teeth can better align and naturally be straighter. ALF stands for advanced light wire functional.

The ALF clips onto the molars and canines and wraps around the back surfaces of the teeth. The ALF device can be used for adult palate expansion. And the ALF can be used for kids as well. In contrast braces on the front surfaces of the teeth can restrict anterior growth and may move the teeth and jaws backwards.


What is the ALF Appliance?


ALF advanced lightwire functional expander


The ALF appliance is a gentle palatal expander made of “Elgiloy” wire.  It is very flexible and springy and applies a very light tongue-like pressure to the teeth and palate. The ALF appliance is removed and slowly adjusted to expand the diameter of the upper and lower jaws. As the device is slowly adjusted from one visit to the next it slowly stimulates the jaws to grow wider and forward. The ALF naturally straightens teeth by growing the jaws large enough so all the teeth fit and the bite is aligned.


The history of the ALF Expander


The ALF was originally designed and created by Dr. Nordstrom in the 1980s. The ALF is a gentle non-traditional orthodontic device. The forces placed on the jaws, face and cranial bones during treatment are more balanced and gentle than conventional orthodontic wires and rapid palatal expanders. This treatment is the favorite among cranial sacral therapists and osteopathic doctors. That is because light expansion does not cause cranial bones stuck and out of balance. Most Osteopaths believe that heavy orthodontic pressure causes cranial bones to get stuck and out of balance.


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Our most common treatment protocols


  1. Adult Palatal Expansion
  2. Breathing Exercises
  3. Posture Correction
  4. Myofunctional Therapy
  5. Tongue tie and lip tie releases if needed


What does the ALF device do?


  1. Straight teeth
  2. Improved Jaw structure and facial profile
  3. Good Posture
  4. Healthy breathing patterns
  5. Overall health


ALF appliance before and after


The Goals of ALF Appliance Treatment:


  • Optimize facial growth and profile
  • Improve tongue function
  • Promote healthy breathing patterns
  • Balance the  bite
  • Balance the jaw and facial bone relationships
  • Create healthy posture


What Causes Teeth to be Crooked?


crooked crowded teeth


The reason why teeth grow crooked and crowded is because of poor tongue function, unhealthy mouth breathing patterns and a diet consisting of foods that are too soft. This is why kids mouths and faces do not grow large enough for all their teeth to fit and bite properly. If tongue and breathing problems are not corrected, your child will fall behind again in their development 1-2 years after appliance therapy. That is right, the teeth will get crowded and crooked all over again, if the root cause of developmental problems are not corrected. Kids continue to grow till at least the age of 19.


Tongue Pressure Expands the Palate Naturally


Treatment uses tongue pressure and light outward force from the ALF to correct teeth crowding. The biologic forces promotes jaw bone growth in the direction the dentist adjusts the appliance and the tongue pushes. Success of the ALF hinges on tongue pressure. Therefore diagnosis and treatment of tongue and lip ties is necessary. Anterior growth creates more space for teeth to fit and bite better. As the treatment progresses, space in the entire mouth and nasal passageways increase. The gain of volume in the mouth and nasal passageways allows for breathing with less airway resistance. The upper airway is basically the mouth and nasal membrane spaces.

The ALF can improve smiles, TMJ pain, sleep apnea and posture problems. Many posture problems are linked to airway obstruction and mouth breathing.  The treatment also decreases loud breathing, snoring, teeth clenching and nasal stuffiness. Teeth clenching is one of the leading causes of tooth loss. Sleep disordered breathing (including sleep apnea) causes heart disease.


ALF Appliance Treatment Goals


  • Growth of the jaws. creates more space for the teeth to fit.
  • Increased tongue space
  • Better nose breathing
  • Optimizes size, shape and dimension of facial profile
  • Creates balance and symmetry between the jaws and facial bones
  • Improves posture
  • Improves the bite or occlusion

How Does the ALF Expand the Palate?


The ALF produces a light springy outward pressure. The device works with proper tongue forces during eating and swallowing. ALF therapy creates the perfect conditions for natural jaw development and growth. The tongue during normal function such as talking and swallowing puts outward pressure on the teeth and jawbones. In a growing child, pressure on jaw by the tongue is the primary stimulus for jaw growth.


What is a Tongue Tie?


tongue tie


Tongue tie is also known as lingual frenum. The tie is a connection between the tongue muscle and the mandible. A strong tongue tie can limit the range of motion of the tongue. And it changes the shape of the tongue as it moves. Usually a tie will cause the tongue to get pointy, taper and curl down on extension. Tongue ties can cause speech problems, feeding problems for babies. The biggest problem with tongue tie is then tongue will not apply proper pressure to the jaw bones in a growing child. Less pressure leads to under development of the mouth and nasal passageways. Tongue ties can be easily be released with a laser.  The procedure is easily done with a laser. The procedure is called a lingual frenectomy. After untying the tongue, tongue exercises and myofunctional therapy is necessary for reattachment.


What is a Lip Tie?


A lip tie is a connection between the lip muscles and the jaw that restricts the range of motion of the lip. When the connection draws the lips too tightly up against the teeth, there is a change to the size and shape of the jaw bones. Problems may include displacement of the teeth backwards, loss of gum tissue around the teeth and opening of a space in between the teeth called a diastema. A “lip tie” is an example of a maxillary frenum. The ties can be easily removed a laser. There is no bleeding, minimal discomfort and huge benefits.


Myofunctional Therapy


Myofunctional therapy is very important when doing any form of palatal expansion and tongue and lip ties. Myofunctional Therapy is everything about strengthening the tongue, correcting tongue function and perfecting tongue posture. But why do we care so much about the tongue? When the tongue is working properly we do not see:

  1. Mouth Breathing
  2. TMJ pain and teeth clenching
  3. Sleep apnea
  4. Poor facial profile and jaw asymmetries
  5. Posture problems related to airway obstruction
  6. Crooked teeth and biting problems


How to Stop Mouth Breathing Video


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Is the ALF a Rapid Palatal Expander


No. The ALF appliance uses light forces and is a slow palatal expander. The ALF is shaped like the mouth and tongue should be shaped. A rapid palatal expander uses heavier forces with a screw mechanism. Rapid palatal expanders grow the back of the back of the mouth more than the front. The result is lots of space in the back of the mouth and minimal space in the front. The main problem with RPE is minimal growth in the anterior palate and expansion is too fast and appliance pressure too much.


ALF Appliance Cost


ALF treatment time can last 12 – 18 months. Treatment involves a cone beam CBCT scan, full examination, diagnosis and appliance treatment plan. The therapy includes periodic adjustments and evaluations. The cost of ALF appliance therapy is usually between $8000 – $12,000 depending on the complexity and treatment time.

The TMJ Sleep and Breathe Center uses other adult expanders such as the DNA appliance and Homeoblock device.

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