Splint Orthopaedic Myofunctional Appliance

At the Wholistic Dental Surgery, Dr. Joseph Da Cruz has spent many years of research, refining and collaborating to develop an innovative Mandibular Growth Device that integrates Splint, Orthopaedic, and Myofunctional Appliance (SOMA) therapy into one phase of treatment. The SOMA uses a multifaceted approach to treating TMJ pain and dysfunction, growth and development, sleep, neck issues and much more.

The SOMA treatment involves gentle expansion of bony structures in the upper palate without creating pain. This produces major improvements in facial patterns and straightens teeth, while pacifying the nervous system by dampening down the sympathetic overdrive. Through its design, the SOMA avoids fight-back of facial muscles produced by regular appliances, which in turn aids orthodontic correction with great efficiency. By reducing muscle fight-back, the SOMA can effectively decompress the Temporo-Mandibular Joint (TMJ) into a stable comfortable position to also provide immediate relief of Temporo-Mandibular Dysfunction (TMD) in a lot of cases, but more difficult cases need time & follow up. A thorough investigation is needed in the beginning. There are primary, secondary and tertiary cases where primary are the easiest and tertiary is the most difficult. Due consideration is always taken.

The benefits produced by the SOMA are far more than just orthodontic and facial. The SOMA has helped relieve different types of chronic pain, respiratory problems, TMD, neck/spine problems and immune system conditions. There is a hypothetical possibility that the pituitary gland and pituitary thyroid adrenal axis functions improve when the cranium is widened. In addition, the SOMA improves airway space, thus improving swallowing, speech, eating, breathing, and sleeping.

There is a common problem found in standard fixed and removable dental appliances. The issue with standard appliances are that they lock the maxillary sutures and teeth. If the cranial sutures are jammed, they inhibit the Cranial Respiratory Impulse (CRI). The CRI is the continuous pulsation in the cranium whose strength is essential for optimum health.

The SOMA creates sufficient retention without jamming the cranial sutures. The SOMA prevents strain on the CRI and relaxes the muscles of mastication. When the muscles of mastication are relaxed, muscle fight-back does not occur around the bones of the face and jaw. This is when cranial release occurs. This enables teeth to be orthodontically moved faster without relapsing. While of course it takes time to bring about bony changes. One of the most interesting aspects of the SOMA is that as soon as the brain perceives the correct realigning pressure, there is an immediate reduction in stress, sympathetic nervous system overactivity, an enhancement and balancing of the cranial respiratory impulse, opening of the nasal passages and relief of many muscle tensions.

The SOMA was initially developed for treating TMD, however, the TMD would not resolve satisfactory without also treating the malocclusion. An orthopaedic approach was incorporated into the treatment process as a second component. Unfortunately this was not sufficient, a third component needed to be addressed, this was tongue positioning. Thus successful treatment could not be achieved unless proper stable jaw positioning was established with a sound cranial base. When these three components of treatment were addressed, that is TMD, orthopaedic and a stable Jaw position (tongue position), the results were highly satisfactory in a short period of time. The SOMA address all three components of treatment to provide rapid, effective and stable TMD treatment. Consequently this approach produced beneficial side effects of reduced headaches, migraines, posture pain and sleep disordered breathing. This highly effective treatment is simple, intuitive and a stable treatment option for any dentist with a background knowledge in TMD. The occlusal balance is also a critical part of the SOMA methodology.

Dr. Joseph Da Cruz credits Dr. John Diamond ( for his assistance in designing the SOMA appliance and sharing knowledge on kinesiology and osteopathy. Collaborative work between Dr. Joseph Da Cruz and Dr. John Diamond revealed that realignment of the cranial bones and forward positioning of the lower jaw are key factors that need to be addressed when dealing with the alignment of teeth. If the cranial structure and architecture are not corrected, then the superficial realignment will collapse.

By integrating splint therapy, orthopaedic, and myofunctional treatment, the SOMA can help in the realignment process of the cranial base thus establishing a sound dental architecture from which teeth can be aligned and remain stable.

For a prefect cosmetic result, aligners can be use in the final phase of treatment.

The SOMA is currently available through VTS Dental Labs only ( and to be issued through a SOMA qualified dentist.