Leominster, MA dentist offers non-invasive treatment for snoring and obstructive sleep apnea
Did you know that snoring might be more than just an inconvenience? Have you familiarized yourself with certain conditions that are concurrent with snoring, such as obstructive sleep apnea? The team at Nirvana Dental help Leominster, MA area patients who are concerned about sleeping concerns such as snoring find out if they can be addressed with the use of a special sleep apnea treatment.
Nightlase Before and After
WHAT IS OBSTRUCTIVE SLEEP APNEA?
Our team at Nirvana Dental provides dental services for children and adults. We also provide solutions for common sleep disorders and problems such as obstructive sleep apnea and chronic snoring. Sometimes, snoring, and obstructive sleep apnea go hand-in-hand, while for others, snoring might just be a problem on its own and unrelated. Regardless, many patients who are looking to improve their quality of sleep for themselves and their sleeping partner may find that the use of an oral appliance can help.
HOW DOES NIRVANA DENTAL TEAM HELP IMPROVE SLEEP?
Nirvana Dental utilizes a combination of methods to help patients of all ages with a proprietary, non-invasive, nonsurgical treatment option for the treatment of apnea, snoring and sleep disordered breathing. From instant resolution such as Fotona Nightlase to longer term solutions such as mandibular devices to keep the airway open. We also target the root of the problem with solutions such as airway Ortho treatment. This can reduce or even eliminate snoring, while addressing obstructive sleep apnea in patients who have been diagnosed. Your Sleep Apnea may be the result of an obstruction in the airway caused by narrow dental arches and/or an underdeveloped jaw. “In 98% of patients with OSAS, the condition is due to abnormal anatomical features of the soft tissues and/or the structures of the maxillomandibular skeleton that cause a “disproportionate anatomy” of the airway.” *ARCH OTOLARYNGOL HEAD NECK SURG/VOL 137 (NO. 10), OCT 2011.
All About Sleep Apnea
H: Look at her you would never know how bad things were just a few months ago.
H: hear that? That is the sound of my wife getting a terrible night’s sleep and getting too tired to help around the house tomorrow. Here is a neat little game we like to play every night. Apply just enough pressure oth get her to stop snoring. I’m trying to sleep honey! I should have listened to her college roommate’s warnings – around here a good night sleep is like Santa clause or unicorns or political conversations on Facebook – it doesn’t exist.
(Baby wakes up and starts crying, then fast forwards to present day)
H: for years we were both constant sleep deprived.
(Husband is shown drinking energy drinks)
H: Kim is not the only one who has to find alternative means of making it through the day without that deep restful sleep.
(Husband pours dog food instead of cereal into child’s bowl)
H: we went to our family doctor and learned that snoring is more than just an annoying habit. Dr. Jones said that snoring is a serious medical condition that can impact the quality of your overall health.
(Husband cleans table and crashes all the crockery, drinks more coffee and energy drinks and continues to work dysfunctional)
H: snoring is associated with headache sore throat sleep apnea, chest pain, high blood pressure, feel like I am forgetting something
(Kids at school parking lot)
K: he has never been this late
(Wife snores heavily)
H: and this is our favorite TV show. Hmmm we tried everything medication, nose strips, a ridiculous looking head brace. Talk about being in the mood am I right?
(Husband loads car with groceries and leaves child at car park)
H: we even Googled alternative remedies which was so not helpful. Not the reviews online said that this should not hurt a bit
(Wife gets electrocuted and screams to take it off. Wife easts garlic unpleasantly)
H: no honey you can eat all of it, in the mouth. Oh I can smell it.
(Wife hurls into the bowl)
H: the garlic only gave the snoring a pungent Italian aroma. Kid’s breakfast! Finally we accepted defeat and brought home the dreaded CPAP machine which Kim said was worse than all the others combined.
(Wife breathes robotically and child walks in)
K: mommy I had a bad dream
(Child sees mother in Darth Vader like vision and screams and runs in fear)
H: did you say something? And that was the last straw. That was when I found the ad for the VIVOS appliance. So we made an appointment and we found out that Kim’s snoring was caused by a narrow airway. Let me explain. When you fall asleep muscles in the back of your throat relax causing your airway to constrict. For people like Kim who already have a narrow airway, this leaves very little room for air to pass through which causes vibrations or snoring. The Vivos appliance is a simple to use mouthpiece kind of like a retainer that gently expands the upper arches of your mouth that increases the sizes of your nasal cavity maximizing the size of your nasal volume to reduce snoring and release more oxygen to your body. You simply put it in easy night before bed and take it out in the morning. It is usually pain free; in fact she often forgets she is even wearing it.
(Husband pleasantly and functionally waves kids and wife off to school)
H: now Kim wakes up every day well rested, and so do i! Yes I do! Now she sleeps silently right through the night and because it causes permanent structural change, she is also breathing better during the day so she is seeing all kinds of health benefits. The Vivos appliance has really changed both our lives.
W: hey babe it’s been a while since we both spent time together
(Wife turns around to see husband snoring and rolls back in exhaustion)
1. Also half my jaw was underdeveloped. One of my joints was half the size of the other one and I was getting really bad migraines. Very uncomfortable having TMJ – the jaw popping is just – it gets annoying and you start to not notice it after a while but every, every time I ate they went oh my gosh you need to get that fixed it can’t be good and obviously it was super bad. It kept getting worse and sometime you can see like my jaw would go to the side every time I opened it was just those little headaches at first, and then light started to hurt my eyes and like studying for school was really hard. It made life not fun! I went in for a regular dental check up with Dr. Korfeild and he noticed that my bite was way off and whenever my back teeth were touching – his first suggestion was the Vivos system. Immediately I noticed a difference within like the first month of using it. My migraines were going completely, my jaw popping started to go away people started to stop noticing which was really cool. Could study longer which no one wants to do! It was so amazing, magic! It was cool I can’t wrap my head around it. I’m just so happy that I don’t have migraines that won’t stop anymore it was hard to live with. I never really talked about it yet. It definitely changed my life and it was totally worth it. Vivos team thank you for helping me fix my TMJ problems and changing my life. I am a biomedical engineer so hopefully I can help change lives too like you guys.
2.It was like an Aha moment because we had been to- like all these specialist, we had been to hospital and nobody mentioned TMJ – not once! The migraines I as expediting before eth Vivos system was extremely debilitating, I would basically be put up in my bed with a pillow over my face and sunglasses on dead quiet room nothing going on and it is still getting worse and my head is still pounding. We did actually take him to the emergency room 2 and they did a workup of cat scans blood work, spinal tap that is actually horrible it took him 4 times to get it, and when you have a headache it was awful to watch him go through that, and they weren’t able to find anything. Watching him suffer his life at such an age totally affected he couldn’t do anything. It was 3 4 months or so straight with migraines and it didn’t go away at all, and he was missing school I mean it was horrible. I went to a neurologist I have seen a lot of doctors for I and we were just struggling and the neurologist literally just sat him down checked his relaxes and then just wrote out about 7 medications to give him and said go ahead and try these – it made him into a zombie. And then one Sunday we were at church and dr Korfeild knew what was going on and he wanted to talk to us and looked at Adam and he said guys I think I can help him. He started looking at my face and he was able to point out that my eyes were crooked and that my left eye closed a little bit whereas my right eye would be wide open. So he started pointing out these things that suggested that I had some TMJ issues as well as some teeth issues. TMJ really can be a cause of migraines and he said if you are willing I would love to take a look at him sure enough we went and did the consultation with imp and pretty quickly we were able to determine that threw us a strong possibility that the Vivos system was going to be able to do a lot for me. We didn’t know what that meant but our expectations were fairly high and they ended up being well exceeded. Within about 2 3 months I began to see a substantial difference I – my migraines were going away medications were getting rid of them and I barely touched them and fairly quickly within about 4 months I was almost off my migraine medication and it was so amazing! That there was no doubt in our minds that the Vivos was what changed his life and corrected the root cause instead of covering it up with medicines. My migraines are completely gone and a headache for me is really rare. Words can’t explain my thank fullness for the Vivos system because it literally changed the course of his life because where he was headed was completely horrible. It is completely part of my path and I think about it every now and then and I am living a completely different life and I have completely moved on from the struggles I had there with migraines. I just can’t even explain how much we appreciate it and what it has done for him, not only did it get rid of my migraines but it gave me great teeth and stuff that I am really happy about – I can be happy about the way my teeth are now without having a headaches while I look at my teeth and that is just fantastic. I have so many thanks to give to the Vivos system and everyone behind it.
3. I am Deb Cozer I live in Freeport, Florida and I am retired. I love it – cats are a big part of my life and my favorite thing to do is cook. i cook all the time, which is why I am on a diet (laughs) I have never really been a good sleeper, and it has affected my life because I get tired, you can’t function you are running on adrenaline and you know caffeine. Patience is not always there and you are tired. You are tired and you have to get really fried p to try and get things done in the house and things done in your personal life. It is very difficult to function without sleep, I didn’t dream I woke up in pain, I tossed and turned, something really was not right. Well I know how she responded to sleep studies. She went every day and attempted to utilize a sleep apnea face mask and obviously it didn’t go well. The CPAP mask was a nightmare. I had an issue with a narrow airway but I had been told that before, and I met with an ENT that was highly recommended and he opened his mouth and showed me his throats and then he showed me mine and I have to say I looked like I had no space at all and he had a huge monstrous airway and I was like ok I clearly see what you are talking about. He said I primarily recommend that we actually go in and we cut the roof of your mouth and open the back of your throat and I am listening to this just horrified. At that point I saw an advertisement for Dr. Griffin and you know finding this Vivos device with Dr. Griffin was absolutely a God saving option that I could have without all the pain and discomfort I could have had with being cut open to increase the size of my mouth and enlarging the airway for me. It was not really long that I started noticing the difference, because I started making progress, my airway was expanding! I put it in I go to sleep I don’t roll around all night. It was amazing I noticed I had been sleeping better because I was dreaming all the time and I don’t recall doing that very often. Put it in and it’s like off to bed and I feel great and I sleep much better. last night I probably was out and I don’t even remember because I put my head on the pillow and I was out within 20 seconds so I thought It was really cool, that is just not something that happened. A big part of this whole thing falls on the fact that I had extremely bad arthritis and the pain is a big deal and when I am rested I am not – especially this is what is key to me where I am not constantly tossing and turning 40 50 times a night I wake up and I am not pain as opposed to waking up in excruciating pain a lot of times, I never sleep without it, it has become a part of my sleep routine because I sleep better and I feel better. It is a win for me. You can tell it is one of the things that has helped her is that she is sleeping better and her attitude during the day is better and a little bit more patience goes a long way with me (laughs) this is a much better option it is much more benign it is much more comfortable and it is effective. For her it was definitely the way to go. i cannot say enough good about it, it has really helped me a lot and I just have a better quality of life now. I have so much more energy to cook and that because I am more rested, my neighbors just love it when Deb is baking it is just relaxing I am able to stand in the kitchen and bake for 10 hours or 3. Cookies and cookies and more cookies!
4. Yes my name is Dr. Jon Caulfield and I am from Littleton Colorado, we are here in my office at Epic Dentistry. Yeah so when i was very young I had a pacifier and for a long time my mother worked nights so my dad would have to feed me with a bottle and bottle feeding is one of the big things past correct use those are the kind of things that actually suppress our jaws and our mouths from moving forward and down and so now my muscles and my joints were suffering from that. As I started doing dentistry as I started getting into more stressful situations and work postures and that, that is when I started to notice my jaw popping my ears were getting concluded, and I could always hear some kind of muffled sound it was affecting my hearing as all these things started getting worse and worse. So i was attending a lecture with Dr. Singh and he was describing and explains how our mouth and our jaw are formed and how important or lounge and what it does in that process. So I was started going through my symptoms and realizing and looking in the mirror and realizing that the things he said to look for I started thinking wow – this is something that could help me. So is started training with Dr. Singh and how to use the Vivos system so what I did was I used the appliance on myself that was very easy to wear, both evenings and nights, and that helped my upper jaw grow that let my lower jaw grow forward which really leveled out my muscles, and really leveled out my bite and also opened up my ears and I didn’t have the same problems I used to have. I would breathe through my nose, and I could feel how much more air I could take in through my nose. It just opened p my airways the upper airways and also my jaw started getting better – my clicking went away completely, my ears opened up and I was finding less and less issues and it was slowly unraveling and unwinding all the problems. So after compelling my treatment I was able to identify multiple patient that came in whether they came for TMJ problems whether they came to see me for sleep and snoring issues, whether they came to see me because they had chronic headaches and fatigue, neck pain they would have these symptoms in their body not feeling right and I started realizing that the same way the little things I started feeling were also the bigger things that they were felling that needed to be treated in the same way. So through that treatment through the Vivos system I was able to help many patients young and old so by now – you can really change the way someone can breathe you can change the way they live. The nose is really our breathing instrument, we are supposed to breathe through our nose, and we are obvious nose breathers as humans and as mammals. We are supposed oth breathe through our nose at all times. What is really great about this system is that by expanding and growing with the upper jaw, we also expanding the growth of the nose as well, so now breathe can be taken through the nose much more readily much more easily. When air is going through our nose the oxygen that is coming through our body can be filtered, humidified and warmed before it enters our lungs. Those are huge benefits along with other multiple others like nitric oxide production and some other things that really correct the correct breathing method the way we are supposed to breath and the way we are supposed to oxygenate ourselves. Without breathing we don’t last more than 2 3 minutes. So as we start oth introduce the Vivos system, it not only can move the teeth into position but also moves the bones into correct position and then move the airway into a better position and then the neck and the jaw all into a better position and so what happens is the main benefit of moving the teeth, really what we are doing is we are straightening out the symptom of other things that are lying behind it. And as patients start to get straighter teeth and heal them better, they are always amazed at the other little benefits that come alongside that. I love using the Vivos system because I know. I am actual treating causes of people problems, I am actually helping people get to the really core base of what is causing their issues. After having personal experience it is very easy to turn around and go I am going to be able to help this. This system allows some to make it convent for anyone and also make it customized. This is not a quick fix but it is an easy fix – this has the ability to let the body truly get back to a place where it was supposed to be in the first place, and by breathing better and by sleeping better you are going to be better.
5. The Vivos appliance has basically changed my life and basically changed my family’s life and has changed a lot of my patient’s lives. All of my children have had the Vivos appliance. Gracie my youngest has had it since she was6 years old and she basically went from a bulldog a class 3 to a normal bite a normal airway a normal little girl no surgery at all, all of my children have had the appliance. I myself have used the appliance it is why I am still practicing today. I have been in practice for about 15 years and I was starting to have some trouble with my back my neck and my hands, and I was oth sleeping all night long and I didn’t put 2 and 2 together. The minute I got the Vivos appliance and found out I can sleep through the night and didn’t wake up at 2 3 in the morning with all the stuff going through my brain that I thought was stress, it actually all was airway. The minute my airway started to pone up I started – or stopped creaking my neck, moving my airway into a position that facilitated an airway that was oth there. I no longer had neck pain, I no longer had numbness in my hands and that is honest oth goodness. Other wise I don’t know if I would still be in dentistry I would be lecturing. The first Vivos appliance I set up with a patient – he went home, started using the appliance and his mom came back 2 weeks later – ecstatic! You have cured him! I said what do you mean I have cured him? His little brother they sleep in the same room I put the Vivos applicant in the patient, he stopped snoring. His younger brother started getting sleep at night, and went off all of his ADD medicines. He was no longer attention deficit and he was a total different child. I had a 10 year old come in that had only had the appliance for 2 weeks, she rolled over and broke the appliance. She knew she had to get it fixed she started crying because she had to be without her appliance. A 10 year old realized how well she slept after 2 weeks. That is a child – they don’t lie. Several patients have come in with headaches especially young patients have come in with headaches, adults as well and we have taken those patients in a matter of a few weeks of the appliance, the headaches are gone so we have worked and it is funny because that is one way to get the patients to wear the appliance because some of the kids they – when they don’t sleep with the appliance they wake up with headaches, and they do sleep with the appliance – there are no headaches. We had a young man come in that had exercise induced asthma now he already had space in his teeth because it was an interesting case because he wanted the ortho to close the spaces but he didn’t have tongue room. So we put him in a Vivos appliance and we created tongue space and in less than months he went on to full participation in high school sports. He could not before with the Vivos appliance. Now again, anyone one else would have closed those spaces down but by paying attention to the tongue space and how little was there we were able to keep his smile and give him his quality of life to enjoy what he liked to do – which was basketball. How we breathe is so very implant. Do we breathe through our nose or do we breathe through our mouth. Is the airway adequate to get sufficient air in and out without resistance. By increasing the airway – by increasing the oxygen flow we can prevent things like fibromyalgic chronic fatigue high blood pressure – diabetes. Everything that I am talking about – all those metabolic related to airway – so the more we do to benefit the airway the entire body doesn’t compensate and we have better health and better quality of life down the road so when people think of smiles they think of beautiful smiles but behind that smiles is tongue space and the airway. If we don’t have room for the time, we have airway issues and the body compensates accordingly. The longer it compensates the worse it can get – sleep disorder breathing paean snoring, chronic fatigue fibroid –there is 300 metabolic disorders that follow airway so when we look at patients we are looking at available tongue space, we are looking at the airway in general and we are looking at the way to improve that and in doing so with the Vivos appliance we can not only accommodate that, we can also create a beautiful smile. So the difference between the Vivos and orthodontics, yet again it is not an inflammatory practice we are not pushing things through where there is no pain. So by working with the body when we move the teeth we move foundation around the teeth by moving the foundation we will make straw into a snorkel so our CT scans before and after verify we are literally changing the airways – oral airways and the nasal airways. We are turning mouth breathers into nose breathers. So by creating a nice smile a perfect smile a smile that is u shaped, not v shaped not cut in. the molar start we need oth look at that molar space and we don’t in orthodontics we look at what we see visually upfront. It is everything behind that is so important. So if you have headaches if you have TMJ – if you have airways issues if you have snoring if you are grinding your teeth if you are wearing your teeth down if you have crowding I strongly recommend you come in and at least get an idea of what the Vivos product is all about.
6. Probably about 7 years ago I noticed I did not sleep as well as I used to. It kind of came on gradually and as years went by it got so bad I told my wife I said I need to go see a doctor something has got to change I can’t keep going through life without getting any sleep I would wake up and get out of the bed and feel just a – I feel physically worn out I yawn all day long after lunch every day I had to fight dosing off. I quit dreaming and that was a big problem just getting no restorative rest when you have no sleep you have no patience, you can get upset about the least little thing so I went to a pulmonologist and I had a sleep study and they determined that I have obstructive sleep apnea. I don’t snore I basically just choke and I quit breathing at night and there is something in my throat I guess or in the back of my mouth that is obstructive, and so I started using a CPAP. Used it for about a year – really hated it. Very uncomfortable I tried several different types and I just couldn’t get comfortable sleeping with a CPAP and so I started doing some research I wanted to find atoner answer. There was some dentists that had some procedures that they offered and so I contacted a dentist here in town Dr. Griffin and made an appointment well initially Dr. Griffin she looked at my mouth and she took some measurements and she told me that I had a narrow pallet and she thought I was a good candidate for the Vivos device and she showed it to me and kind of explained how it worked and that is how we got started. The first 2 weeks I was amazed I dreamed every night for 2 weeks straight, and I told my wife, it is amazing I am supped tower this device every day for a minimum of 12 hour and Dr. Griffin said it could take a full year. I have seen benefits from the first 2 weeks, I have not had any trouble wearing the device for 12 hours and I can wear 16 18 hours no problem it doesn’t bother me to be in my mouth. I am able to pass air and I am able to breathe and sleep and dream and I am getting tat restorative REM sleep, so for me I am getting instant benefit from it. Oh I think I am getting 7 8 hours of sleep I am having dreams unlike I have ever had before you go 6 7 years where you don’t have dreams and you notice it is a big deal when you start having big dreams again. I tell my wife I am not just having little dreams, but it is like a movie is running in my head so I know I am getting that restorative rem sleep I know I am because I wake up and I can tell you about the movie that ran in my head last night that we call dreams – I feel sharp now and I don’t feel drowsy al the time and that is a huge difference. I don’t fall asleep in my chair anymore I watch the news, I can get on the floor and play with my dogs I can take them for a walk, take them to the dog park and I actually think to myself wow it has been a long time since I felt this good – it has been amazing like from day 1. I wouldn’t lie down and try to sleep now without my Vivos device. <br>
7. Hi, I am Sarah Warner and this is Hannah Warner my daughter and we went to 2 separate orthodontists who said the treatment would take so long into college and that it would be a lot of expense and she really didn’t want to have braces in her senior pictures and go to college with them and we just wanted an alternative and we just wanted to look and see what else was out there. I definitely felt hopeless like I should have started a long time ago and you can’t go back in time. Hannah had a lot of spaces in her teeth and they were very crooked and they were very small. I didn’t want o show my teeth at all and I always didn’t smile fully with my teeth in pictures I would open mouth breathe I could never close my mouth to breathe and sometimes I would snore in my sleep and it just made my mouth very dry. She definitely drooled and you can tell that she was keeping her mouth open all night. We went with different opinions and with Dr. Korfeild he said there is this great new system – the Vivos system. When we went in he looked at her mouth and said immediately I can see that she is a mouth breather that her pallet is A typical and that there is this product out there that can really help her. It is more gentle than a rapid expander. What it is going to do is shape her pallet and gently let her body grow into it and I think that it will help reduce the time frame that she will be in braces or orthodontics. It just like gave me hope again and I wanted to go out and take pictures and do the things that I wanted and it was definitely difficult being in high school and remembering to put it in and stuff but I am definitely happy that I didn’t it and I am really glad I didn’t go the normal way. I think I saw a difference in her teeth pretty quickly and even Dr. Korfeild saw a difference in her teeth pretty quickly. It depends on how often you wear it and if you are doing it in a programme and we had a couple of times where we went hey this is an expensive thing and we need to – you know, all orthodontists are expensive so in that she learned how to do the program and stuck with it and once she stuck with it you could tell a difference pretty quickly. Thanks yeah I am a lot more confident and just day to day even just walking around and smiling at people I just feel more like a teenager and not so scared to show who I am, I feel like teeth are a big part of how you present yourself and If you feel positive about your teeth it will show you in a positive light. One benefit though that we did not talk about it that you got to wear it at night and you don’t have to wear it during the day and so every day she came home from school put it in, and even though she talked a little funny, at first it wasn’t all the way through school because she was a little embarrassed and shortly after that we found that the way she was holding her mouth at night was making her not do the mouth breathing. My snoring has identity gone away my drooling has reduced immensely. I feel more comfortable when I sleep and I feel like I get a better night’s sleep, so I play sports – I play 2 sports. So just my breathing has gotten a lot better and I have a lot more stamina for running and it just make me feel more open and just makes it much easier to breathe. I feel like we made a really good decision, we would still be sitting here with braces and she would still be mouth breathing and we would probably have to go back in a number of years and do something different for all of that anyway. She is getting ready to take her senior picture very soon and she is happy about that, and I think with the outcome of her teeth the way that we talked about it with Dr. Korfeild about it is that you are not going to have to redo this later and that is a huge savings and less pain. If you are looking for braces I would strongly recommend looking at the Vivos system, it really worked for me and I just really recommend it.
8. I am Dr. Tara Griffin we are here today in my clinic at Panama City Beach, I have been practicing dentistry for over 11 years before I discovered the Vivos appliance I was suffering everyday with chronic head and neck pain, TMJ pain – I was practicing dentistry and I was practicing for 5 years and I was already looking for an out and I knew with this much pain I cannot continue to practice dentistry –I had chronic sinus and allergy problems, bronchitis, and I was not sleeping through-out the night very well, waking up during the night and I had severe day time fatigue and I would actually need to go home and take a nap in the afternoon just to have lunch you know and I was just looking for a solution to the problem but I didn’t know what the root cause was until I learned about the Vivos appliance. As soon as I started treatment with the Vivos appliance – within the first 2nights I was sleeping soundly throughout the night, but my inner energy was better during the day the pain that I was undergoing took a bit longer to give results but within the first 3 4 weeks, my pain level reduced by 2/3rd or more. Within a moths period of time I was breathing through my nose better. As not having the same sinus symptoms I was having before and within 3 months of treatment my asthma had improved so much, I had no more problems I had with the inhalers and the frequency I was having to use with all of my asthma inhalers. My overall health started to improve very quickly – I was my own first patient ad however as I continued to treat the next patient and the next patient, still moving forward I was worried that they were still going to have the same outcome that I had – 9/10 had very similar outcomes that I had – so they were sleeping better in just a few nights, getting their energy back and they were less irritable. The pain that they had was going away very quickly – the teeth were beginning to straighten and align with time, seven though with this kind of problem it can take some time to get the long terms results, the immediate results start to improve very quickly. Comparing my before and after picture with the Vivos appliance, my smile was not symmetrical and my teeth were crowed and the gumminess of my smile was a major problem that I dint like – and I had unevenness in my eyes and also in my nose, and my face was more round and balanced and that all helped to correct itself as well as I went through the treatment. When the Vivos appliance is worn during the early evening while you sleep at night, it allows the jaw to relax it allows the airway to open up – it allows you to breathe through your nose and allows you to get the oxygen to breathe through your body where your body can begins to heal, by breathing through your nose we can actually get much more oxygen into our brain as well as our lungs and we are producing nitric oxide which is a nasal dilator to allow better blood flow to circulate and everything is better and so a big component with this is that it forces you to actually breathe through your nose to get the oxygen to where it needs to go into the body – so that is a very important part. If you are interested in learning more about the Vivos appliance. I recommend coming into the Vivos center to determine if this is something that can help you.
9. So I would wake up every morning and my jaw would be locked and shut ad I would wake up with a horrible headache not quite a migraine but a horrible headache and I would have to massage the sides and rock my jaw from side to side and sometimes it would open up in about a minute and sometimes it would take 5 days. I could talk like I can open it about half an inch, so anything I ate would have to be like cut up like I was feeding an infant so when I laugh my jaw would lock open and that is humiliating because you can’t hide that. I couldn’t not yawn I would have to hold my mouth shut and try to hold my teeth together so that I can’t expand my jaw and it would end up locked. Right before i had the Vivo system I went through a period where my jaw was locked for 2 months and 3 and a half weeks, and it was locked about half an inch a little bit so it would be in the closed position. So every time I would eat anything even if it was as soft as spaghetti and meatballs or something hard and crunchy like an apple or hard truffles the popping was so loud that no matter where I was dining everyone at the table would hear it and comment on it, so I developed quite a complex and a little bit of anxiety about eating outside of my immediate family – anytime I opened and closed my mouth even without food in my mouth it was loud, it was obnoxious, even my oldest son would tell me shush I can’t hear the TV. Pass 20 years at that time, no other doctor or dentist or orthodontist could even think of a correctible remedy for what I was going through. My dentist all told me that the only way to fix the popping of my jaws ad the lock jaws is to have a very barbaric surgery which I would never go through so I just lived with the discomfit and the pain and the irritability that it caused even eating a sandwich and having my mouth wide open to eat a sandwich was a challenge. But I decided that I was going to live with that for the rest of my life it got so bad that it actually became a disability while I was inactive duty because the migraine and the ringing in my ears was overwhelming and so I ended up retiring after 24 years and I stayed home and I was volunteering at my sons school in the library and the librarian and I was just talking about my jawline and she was just telling me about a doctor in Denver or in the Denver area that she found – Dr. John Korfeild and that he was doing wonders for people who had the same issues that I had s I made an appointment and I went up to talk to him and he spent about 2.5 hours with me and he talked to me about the Vivos system and i saw tremendous results within 3 days the locking stopped – I would say within 3 5 days the locking stopped immediately. And within 2 weeks the headaches were completely gone. And my jaw has expanded 11 mm. my top palette has expanded 11 millimeters, I have 0 popping I have 0 lockjaw, I have 0 headaches and I am very skeptical and I am one of the most skeptical people around so if anybody wants to try to sell me something I am a hard sell, but when I sat and talked to Dr. Korfeild I was still a little skeptical but his depth of how it works and how he showed me and then the results that I had was unbelievable. Whoever doesn’t try it is just going to miss out on potentially one of the best inventions they have ever made. I am quiet when I eat and I don’t draw attention to myself anymore, it doesn’t hurt and it is not a painful experience it is a pleasant experience, it has changed completely – I wake up headache free and I wake up with a loose jaw? My breathing for instance has sinuses even become more clear lie it helped me with the barbaric treatment plans from other doctors over the treatment course of 20 years had told me that it was my only hope. Then it will help you.
10. Hi I am Dianne Bede and this is my daughter Amber. So prior to the Vivos system I was dealing with migraines and they would happen pretty frequently bout a couple of times a month and so that was a concern and we acutely didn’t realize that the teeth in your mouth could do that. So she was in middle school and her teeth were a hot mess and none of them aligned, they had always told us that her jaw was very small and narrow. I am not exactly sure about all the problems it could have created long term just that they were covered enough about it that they really made a point to tell us about it. The bar across the roof of the mouth was the only thing. It sounded very invasive and not so fun so I was not a fan of it. When she would get a migraine it would come on pretty fast and she would end up getting sick to her stomach and just lying down. So initially when we went to see Dr. Korfeild we just went to get my teeth done and looking straight and nice and he was able to pinpoint my migraines as a problem that was ching from my teeth and jaw and all those things and so he really explained to us that it was a real possibility that my migraine could be decreased or even eliminated through the Vivos system. The reason we went with the Vivos system is less pain, more natural you don’t have to wear the appliance all the time. The way he explained it to me was that it was a lot more comfortable and esker to deal with and is not as apparent that you are going through such changes and it is a more natural way to move your jaw and the big thing for me was that the migraines that I was experiencing started to decrees in frequency and that was a big deal because it was difficult part of my life. The fact that they were decreasing in number was amazing. It was great. I love being able to not be able to take medication because it is kind of a never ending cycle when you are just kind of covering it up with medication and so the Vivos system allowed us a way to address the root cause and truly eliminate it, and it is just a more natural way to tap into your body’s strengths. I love my face now I mean it turned out amazing and that was largely because of the Vivos system, and the room that he developed allowed me to go straighten my teeth and do all the things that we wanted to do with it, so I mean it is great, I love it – it is such a great way to handle teeth problems as well as body health. I would just say that I am very thankful to the Vivos team for coming up with an innovative solution for a problem that a lot of people deal with. Thank you so much to the Vivo steam and I have referred so many people to this system because the benefits go far beyond dental health to who body health and things like that. My name is Lauren Johnson I am from Littleton, Colorado. Since I can remember I had a jaw ache to the point where I get headaches from the end of the day and it would pop every time spoke and it was not when I was just chewing or anything but it constantly popped. My muscles were constantly working more than they had to because my teeth were out of line. Dr. Korfeild was actually that one that kind of pin pointed it. He was the one who asked – like hey have you had jaw pain and I was like yeah because I thought it was normal because I had it for so long and I took x-rays and looked at my jaw and I felt it popping over time I talked. So he asked me if I had knee symptoms and I was like yes and then here is the solution the Vivos system. It is such a like a great way that made sense like my mouth should have always been that way and I get it – like it put my jaw in a position that it was supposed to be in became he said that it was so unaligned. After the first 3 days I saw that the Vivos system started to help I could notice it and I just felt my teeth in the back start to touch together which I didn’t know they weren’t touching until I felt them touching like I didn’t know they were in the wrong until I had them in the right place. I just felt more right and I don’t know if is am crazy here but it is helping me sleep because I was breathing through my nose more and I was kind of helping my nasal airway open up a little bit and so say I noticed a difference in the jaw pain like 3 to 4 weeks after using the Vivos system my jaw had to work less and my muscles had to like refinery relax and that is where it caused all the jaw pain because my muscles were trying to constancy pull my jaw shut but I couldn’t do that because my teeth were lined up, so when the Vivos system addressed that it pretty much went away. My jaw doesn’t pop anywhere and I was like this is great this is how I should have been feeling. The way I feel after I sleep – at first it was like I might have forgotten to put it in or I was too tired to put it in, I wake up so groggy. It is like night and day with this system, I am so grateful for the Vivos system and it was a great alternative to braces and I am a young professional I need to go to interviews I am trying to get into grad school and if I had braces on it would have just crashed my confidence and so it was a perfect alternative to braces and I think it had more of an impact than braces did just because it structured my mouth to where it should be and I kind of noticed with the Vivos system I kind of got cheekbones and cheekbones started popping which looked like my face is what it was supposed to be and should have been all along. I have to thank the makers of the Vivos system so much, like rely it saved me from years and years of pain for which I cannot say enough like no more headaches and it has just been awesome and honestly I tell my friends about it and I think everyone should check this out I think it is like changing.
11. Getting old was not actually about energy it is more about sleeping so that I have the amount of energy that is need to do these class with my dog. My name is Jeanette Hayward I live in Warrington, Oregon and I have been wearing the Vivos appliance for about 5 years. Not being able to sleep at night and nothing works in the daytime; I would wake up several times I couldn’t get comfortable. I was on my stomach, I would switch pillows and I must have a dozen pillows and nothing was helping. I was a teacher and I would tell my students that they could call me anytime when they had a question, and then I had to say oh you cannot call me past 9 o clock and then you can’t call me past 7 and finally I will help you after school and then I finally quit teaching so it definitely affected my life, so I was a dog trainer as a high school in my 20s and I had dogs and when they passed away I could not get any more because they retired more attention that I – than the energy I had to give. They put me on sleeping pills which I absolutely hated because I could not wake up in the morning I felt so groggy, the next thing that the doctors were saying was that I needed a sleep study and a CPAP machine. I can’t stand those. My husband had one at the time and it was like – no that is not going to happen to me. I think Dr. Klemp was the first dentist that asked me how I was sleeping at night, and when he looked at my mouth and looked to the ridges on my tongue which were another indication that I didn’t have enough of an airway in order to sleep at night and then he started asking me questions and then he said well I have something that could help you. Slowly after I got the Vivos because I did not get the energy all at once because my body had a lot to heal, and so the very first thing I did was get a dog – I got Gracie my oldest poodle and as it got my energy increased I was able to do things with her we started taking sit classes and we started going to different dog shows and then I thought I can even handle having puppies again and I bred Gracie and we have faith which is her daughter I don’t know anything about agility but it takes a lot of energy and i didn’t hesitate because I didn’t have any energy which would have definitely put the skids on anything like that and oh my goodness I am so grateful and I get to do things now that I would not have been able to do. My dogs and I have gone all over the pacific northwest and I could not have done it if I was not sleeping and the money that I spent is nothing compared to what I have gotten back and how I can enjoy life and enjoy a conversation with my friends where I do not have to say oh sorry it is 5 o clock and I am done for the day and I would not hesitate to do it again. I have a whole different life than I did, 10 years ago.
12. It has definitely changed our lives. The Vivos system has made him eat more foods, better foods healthier foods been able to give us some freedom of not having to prepare his foods and puree than and what have you. Is it not good? Yeah. My name is Julia Bangasser and this is my son Mathew Bangasser and he has spent a lot of time in the hospital when he was born which cause his pallet to be top pallet to be constricted so his top teeth did not match up to his bottom teeth and his chewing was not very effective. So we would puree everything in the blender and the food processor. The gagging was the big issue especially when he went to school and choking and gagging on his food we had quite a few incidents at home where we had to jump up and dig things out of his throat because he was chewing things that were too large and there was been quite a few incidents at school as well where they had to do the Heimlich on him. We knew that there were pallet spreaders out there and most of our dentists that we went to, did not want to put the permanent appliances in there and it cost too much heartache on Mathew and he was not able to handle it and there was one dentist that because of his jaw being behind his teeth, his front teeth being behind his bottom teeth. He wanted to break his jaw and rest it. Yeah that is when is said yeah no you are not doing that to my child. He said that was the only way to do it. We went to Dr. Korfeild and he recommended the Vivos system and we have used it ever since and we get great spreading of the pallet and now his top teeth are matching with his bottom teeth which makes his chewing very effective and the teeth itself are moving all into place without having to drag them into places we were able to move and they automatically moved on their own right into place where their molars are where they should be, the canines are coming down and stuff, so just by spreading it the teeth are moving to where it should be – oh the braces and stuff that would have been much more painful probably taken longer. If letting the body do what it does naturally not forcing the tooth in one direction or the other and letting the teeth move to where it should – it is the way it should happen I mean the human body does that. The Vivos system is making it easier and the movement he got was incredible and just to be able to eat on his own that was just a big issue with us and so now I know he can eat something in a restaurant with someone who is not his parents and not worrying about every chew. Now you are ching dude you are biting sandwiches you are chewing on your own the pre prep of the food is nothing anymore but the teeth move better more efficient and I think he talks clearer. Is the Vivos system comfortable? Yes. The Vivos system is comfortable for me. He has never really had any pain with it that he has told us about, he is very comfortable with it. Well I have been chewing better my mom says. It has been easier for you to chew? Yeah. Maybe some more complex food – maybe increasing the textures and stuff, and you have been able to chew and not gag on? Yeah things are falling into place. It is just a big improvement in our lives to be able to eat, normal food. (laughs) yes I would recommend Vivos. Why? Because it has really helped me a lot.
13. I was a 3 for sport athlete in high school. I played football, basketball, baseball and one of my coaches would call me the mouth breather because I couldn’t breathe out of my nose. Which is pretty funny now looking back on it because that is a big issue. You need oxygen in your blood and muscles to keep going and having the ability to breathe is very essential for that. When I was about 8 years old I started snoring, and my father had sleep apnea, and at the time I didn’t really know what that was or what that meant and I didn’t think anything of it but then eventually we ended up moving and our next-door neighbor was my dentist. And my dentist found out I was a snorer and my dad had sleep apnea and he had me come in and he immediately starts telling me about this appliance called the Vivos appliance. I got the upper piece first and I guess what the issue was, was the upper nasal passages weren’t bigger enough to be breathing out of and my lower jaw was too narrow so then I got the top one, kept working on that and then a few weeks later I got the bottom one and since then it has been probably about a year, a year and a half – breathing amazing actually. I used to not be able to run and just breathe out of my nose. This is something i did realize once I started being able to breathe out of my nose. Just relaxed and I wouldn’t – I had to keep my mouth open all the time so it’s great to be able to let my body do its normal thing and I think it actually just helped me relax in general as a person. My lower jaw was crowded and it was actually shaped in and that might – and my dentist told me that was also a major issue that I needed to deal with and luckily for me the lower portion of the device helped fix that. So not only am I breathing better but my teeth look better. So I can just breathe through my nose, I don’t snore anymore and even I am supposed to wear the appliance every night and if I forget a night her and there whatever it is fine, I still don’t snore of anything. I have less attention because I no longer have to keep my mouth open to be running sprinting, and I just feel more active and able to be active – oh and I highly recommend it. I have actually talked to some of my siblings about it, I have a couple of siblings that do snore and I have a couple of friends too during college that- they were snoring they were some of my roommates, and they were actually wondering about the device because they noticed that that I stopped snoring and I told them about it and they have actually been looking into it. I am 100 percent happy that I did this and I am thankful every day that I can breathe.
14. So starting my senior year of high school, I started getting really bad headaches I went to the doctor they told me it was tension headaches it was all sorts of migraine medicines went to a masus and starting drinking a lot of chamomile tea and all those things that were not helping it was just a lot of hit and miss, so I spent 4 years with horrible headaches until finally back in 09 my teeth here hurting so I went to Dr. Korfeild of epic dentistry and found out that I needed a root canal and it was during the process of the root canal that he found out my bite was off. Dr. Korfeild suggested the Vivos system as a way to expand my upper pallet in order to make my teeth actually align with each other, so I can actually close my mouth fully. so I guess you don’t really think about it you think when you have a headaches you need to go to the doctor and you don’t think about how your body is connected and that it was actually a bite tooth problem that was causing my headache and I didn’t even think about it and that is why I didn’t even go to the dentist to start with, and I spent 4 years thinking that was going to help mu problems and I was getting popping with my TMJ and so he was saying we need to do something to fix the bite which was going to solve all these problems, and he said if I expanded my upper pallet using the Vivos system that would help fix my jaw problems, and actually make all my headaches go away. I think I had the systems total for a year and a half and it was almost immediate that I could see a different in how my teeth were aligning with each other. Once the teeth were aligning my headaches slowly started going away and I right now it has been 5years since I had headaches. It drastically changed my life because I did not have to take pain meds every day and be concerned about what foods I was eating and whether it was going to hurt to chew so it made my life so much easier. The Vivos system helped to change my life, the fact that I was able to wake up every day and not worry about how painful my life or how painful my jaws are going to be or how soon I was going to have a headache, has vastly affected my life. The Vivo system has allowed me to feel more confident about myself and my face was always closing a little bit left and now it closes evenly and now it increases my happiness with just how my every day face is. I don’t snore at night anymore and that is something nice. i think it is easier to breathe every day the fact that I don’t mouth breathe as much as I used to is also a confidence booster I think. It made it so I can close my mouth fully so I can always have my mouth open which is kind of awkward so it made me more confident with who I am and how confident I was in terms of how I look and feel, and my advice is if you are getting headaches and migraines that it might not be a medical doctor problem, you should check out your dentist – it could be a jaw teeth problem, and the Vivos system could be an expert for you.
15. My name is Chandra, and I am a practicing herbalist and I have a shop here called wild roots, I have always been interested in health because of my health issues and I am interested in alternative and complementary care the store really was born out of that passion. I actually own it together with my husband Eric. Hi I am Eric I am the barista and like 3 years ago when we started the business we were working very hard 11 12 hours a day and I was especially exhausted because I had known I had suffered from sleep apnea my whole life and I knew I had to do something abbot it. Ever since I was a child I had experienced breathing problems, all throughout my 20s I had severe sleep apnea, complete exhaustion and I mean for the last 20 years of my life I suffered I wake up after 8 to 10 hours of sleep completely exhausted. You know this video should be more about me and my ability to sleep with someone who has sleep apnea and she has been snoring quite loudly and quite often. I had done some research and learned about epigenetic orthodontics and the work of Western A Price. I figured I would have to travel to a big city to have that done and then I figured out Dr. Griffin was right here in Panama City beach and I was able to go to her, and she did a sleep apnea test and I didn’t present with any of the typical other conditions that people with sleep apnea have. so we were both surprised when we found out that my test came back severe with my sleep apnea off the charts, so dr. Griffin recommended that I wear the Vivos appliance approximately 18 months to 24 months, I wear it every day approximately 15 18 hours a day. Well there had been drastic improvements in my life, within just a couple of weeks of using the appliance and hence I was able to breathe through both nostrils – something I couldn’t do my entire life. This was revolutionary, yeah she made it one morning and she said I can breathe through my nostrils again and I have not had that happen ever. I have been getting amazing sleep I wake up I feel rested, and one of the biggest changes in my life is that I don’t have to use the CPAP anymore I am just using the appliance for the remainder of my treatment. And I have actually started an exercise program which I was just not able to do before all the time. The difference is more at night you can just hear her breathe easier, her snoring was very loud and stopping it was almost like she stopped breathing and she would breathe and snore and when you hear someone laboring like that in their sleep t is worrisome, but now it is much quieter and you are able to just hear her out throughout the night. Yeah, I think it is an excellent thing that people should endure because it is noninvasive, I found the treatment to be very easy to incorporate in my daily life so I would definitely recommend it to you. She sleeps better, I sleep better. She has more energy, I don’t, but that is okay. Both my lower and upper jaw were extremely narrow and they widened the pallet and it gives more room in the sinus cavities and expands the jaw to a shape where it is supposed to be. Basically the appliance expands the jaw and just opens up the airway. I feel like I have more room in my mouth and it just feel different. I feel that it has pretty much made me feel excited about life again, I mean when you just get up in the morning and you have energy and you can do all the things that you want to do, that in itself is just like you have been given new life I know that sounds dramatic but it is true – now she makes me coffee and does laundry and- no way I still do that never mind. I am extremely grateful for the Vivos appliance it has really de stressed and changed my life. You know what they say happy wife happy life so I am grateful as well.
16. I am Scott Parnell, from Panama City Beach Florida and I love comparing with my boys and very involved in scouts. We camp usually at least once a month and if not more. At least once a month if note more. Living in Florida there are so many great places to be. Unfortunately we found that I was not enjoying my camping with my sons as much as I wanted to because I was always so tired. Way low on the energy level. I started realizing that I had an issue with my sleeping and my health. About 5 6 years ago I turned 40 and I did my initial 40 year checkup thing, and I finally realized that I know that I have been having breathing and sleeping issues but my doctor suggested i go see a specialist for it and we tried the CPAP for a while and that was not it- did not really work too well, I never got through full night of using it and I didn’t really see any improvements in my symptoms. So he referred me to Dr. Griffin and went through the process of a sleep study and getting kind of a baseline of where I was with my sleep apnea, so Dr. Griffin recommended I try the Vivos Device which really is just a small mouthpiece like retainer you have or if you have braces. Right after I started using it I noticed the changes, especially when I stopped snoring right away, my wife even the first night or second night it was great. Consistently if I forget to use it or put it in for some reason, I have to sleep on the couch. She’s like you have to put your mouthpiece in. it is very simple to wear and very easy to do and it just take as a little bit of familiarization to or like a retainer that you wear in your mouth or it is just like a piece of plastic that you pop right into your mouth and helps to do it immediately and just helps to keep you airway open, another great benefit of it is the fact that I can take it with you or travel. Camping is great for travel, I have one little piece that I use in the campsite in a place where there may or may not be power. I think the Vivos is a great piece I have recommended it to a lot of folks that I camp with, a lot of dads do have the CPAP and have wriggled up a marine battery with a power inverter in their tent and they are all night long with the CPAP before getting the Vivos I had a sleep study done at an actual sleep center where you have all the wires take all these readings of the numbers of the sleep apnea episodes that you have over a course of the evening as well as your snoring and then you wear the Vivos device for a specific amount of time and at the end you have another sleep study done and my sleep apnea episode is a fraction of what they were before. I think the Vivos device has benefitted me in my day to day life most importantly because the fact that I am not fallen asleep all the time I can sit and watch TV I can watch a movie with my wife I can work or do paperwork and not feel like I am very tired because I have gotten enough sleep and I think I am a better husband and father because I am more or less got a better attitude about things, camping is awesome I just got back from camping this weekend and it was beautiful and I was able to do pretty much anything I wanted to – it was quite phenomenal and it changed my life from how I can sleep and how I can carry on being active and then i don’t have to become encumbered by CPAP and I definitely recommend it to anyone.
17. My name is Sue Gordon I am from Littleton Colorado, I have been here since I was 7 years old, I go see Dr. John Korfeild and he asked me during the visit on time if I had issues during the night and if I was a mouth breather. He noticed that I had a hard time talking, and that there was not enough room in my mouth so he wanted to broaden my mouth open and more room for my tongue and then he introduced me to this Vivos system and told me what it would do and open my jaw and my tongue would lay at the bottom of my mouth and have an esker time talking and being able to sleep tonight breathe through my nose and not through my mouth. He had me open up my mouth and he had a mirror and he said look and see how your tongue doesn’t fit at the bottom of your mouth, your tongue is cupped whereas it should be flat and be able to move around whereas mine didn’t. I noticed that my tongue did kind of collapse at the bottom of my jaw and in the morning when I wake up my tongue would be dry and almost stuck at the bottom of my jaw – it was hard to get used to having something hard in my mouth but after I wore it for a about a month then I noticed that I was being able to breathe through my nose at night and I can tell that my jaw has gotten wider and I do breathe through my nose and my tongue was pretty flat and when I come for the checkup Dr. John noticed that my speech has improved and that I am not biting my lounge in a small area. My jaw was a u shape when I had brace over time and it moved to a v shape so what he is doing is that he is doing it back again and my tongue can lay there and be there instead of being cupped and breathing through my nose and I noticed I had a slight, my nose was off a little bit and m nostrils were the same size and he noticed that it started to clear itself up but that is the biggest high I noticed is that I can breathe through my nose. My speech has corrected itself. I can tell from pictures of me in the past and now where my jaw has squared out more vs. being more narrow and confined it is now flat and my face is now more out, which then allows the lounge to play flat – my teeth are starting to go back to where they were. I think the breathing is very important I think I sleep better at night, I think it is more implant to have a restful sleep than I had before. When I wake up in the morning my tongue is not dry and stuck to the bottom of my mouth, as far as the nose breathing I think that it is also a calming thing, having done Yoga in the past, I know that when you breathe in through your nose, it has more of a calming effect and as skeptical as I am about it as I was, I am glad I did it.
INTERESTED IN LEARNING MORE ABOUT TREATMENT FOR SNORING, AND OBSTRUCTIVE SLEEP APNEA?
Contact the team at Nirvana Dental in Leominster, MA to discuss your options. Our team is here and ready to ensure you have the best possible care and attention for your smile—and more! The office is conveniently located in the community at 285 Central Street and accepts new and established patients and families who call (978) 704-8788 for an appointment.
How do you fix Sleep Apnea?
Do you snore excessively? Do you suffer from day time fatigue? Do you wake during the night with shortness of breath? You may suffer from the life threatening sleep disorder known as sleep apnea. About 1 in every 15 Americans suffer from sleep apnea, and it is a problem that many don’t even realize that they might have. But what does this have to do with dentistry? Because sleep apnea is caused by an airway obstruction, the disorder can be treated through the Thornton Adjustable Positioner or the TAP appliance is one of the more popular ways to treat sleep apnea. When the jaw bone is lax the tongue and soft tissue obstruct the airway the TAP appliance advances the jaw bone allowing the air to flow freely and making sleep more restful throughout the night. If you think you might suffer from sleep apnea, talk to your dentist today about possible treatment options.