Dental Malpractice: Anterior Growth Guidance Appliance (AGGA: FAGGA) and ALF
Patient’s searching for alternatives to traditional orthodontic surgery, unfortunately, have been taken in by a small group of general dentists who advocate use of several, non-traditional, palatal expansion devices: Anterior Growth Guidance Appliance (AGGA); Fixed Anterior Growth Guidance Appliance (FAGGA); Controlled Arch Braces (CAB); and Advanced Lightwire Functionals (ALF- not the alien TV character). Advertisements and websites of the alternative-to-orthontia crowd claim that these devices will cure malocclusion, sleep disorders, TMJ disorders, migraines, heal facial trauma, as well as improve airways and esthetics.
Board certified orthodontists complete a rigorous three-year residency program and pass a written and clinical examination before they can claim specialty certification in this ADA approved specialty. Those who espouse these non-traditional forms of “treatment” are often self-trained or attend minimal commercially sponsored courses, sometimes for no more than a weekend to be “certified” by the company offering the course. Such certification is not approved by the American Dental Association for specialty certification; and advertising such “specialty” training runs afoul of the ADA Code of Ethics and Code of Professional Responsibility.
Proponents of these various devices differ on which are more effective, ALF or AGGA. The ALF crowd claims that applying light, flexible wires to the lingual (tongue) side of the teeth, gently relaxes the jaws to widen or reposition the jaws. AGGA proponents claim the ability to expand the palate and actually gain bone to remodel and reshape the face. Traditional orthodontists call “BS” on these claims. AGGA is used to create “expansion” when, in fact, it is forcing the anterior teeth out of the alveolar bone, creating tooth mobility, loss of oral volume and root destruction. AGGA treatment is then followed by the application of what they refer to as Controlled Arch Braces (CAB), which have the effect of pushing those misaligned teeth back
This yoyo effect further destroys the alveolar bone and periodontal ligaments that hold our teeth firmly in our jaws. Victims of this treatment often find they need extractions and implant supported crowns to remedy the damage. The more fortunate are able to undergo tunnel grafting to replace lost bone and give those mobile teeth a chance to be redeemed.
One particular advocate of AGGA speaking on a holistic treatment podcast actually claims to have utilized AGGA on a child as young as 2 years old. Who knows what damage will be done in that child’s development from this fringe treatment?
One former AGGA patient evolved from being a proponent of the treatment to now being a vocal YouTube critic after suffering life altering changes to his upper jaw. He tells his story from a layperson’s viewpoint. (https://www.youtube.com/watch?v=r9xJJgi67iQ) That same patient published another YouTube video to illustrate the damage that AGGA and CAB have done to his front teeth. Despite not being a dentist, he uses and compares two cone beam CT scans of his jaw, one taken just prior to installation of his AGGA appliance with a later cone beam CT scan taken just before the controlled arch braces were removed, that led to his evolution away from AGGA treatment. (https://www.youtube.com/watch?v=rNpNLCgjyE8) This young man does not profess to be an expert in dental treatment but makes a commonsense argument to warn AGGA patients or those considering this treatment. His comparison illustrates the destruction of his upper anterior alveolar bone from AGGA and CAB treatments.
Several websites use staged photos taken from different angles claiming they show successful treatment, when all the patient has done is turn his head slightly, changing the angle of the picture, to suggest that a retrusive upper jaw has been properly repositioned. A highly credentialed orthodontist, Dr. Jeffrey Miller, from Baltimore, Md. has also taken to YouTube to condemn AGGA after having been consulted by numerous AGGA victims. In his video he uses a number of videos and photos that AGGA patients or their treaters have posted on the internet, employing photographic tricks to claim bone growth occurred.
Dr. Miller states, “There are many claims associated with AGGA treatment. Most all of them are not based in any legitimate science. In fact, in addition to causing potential damage, it does not actually accomplish its intended use. I will review an actual patient that ended up with significant damage from this treatment.” https://www.youtube.com/watch?v=XWqKi1ldW7g).
If there is a lesson for these patients, it is there are no easy fixes to complex dental issues. Consult a board certified orthodontist before going down the slippery slope of alternative medicine.
At MeehanLaw, LLC we have developed an expertise in representing those injured by these misguided treatments.