We have put this page up because a provider or a parent looking into this work deserves to know three things before they go any further: what the framework actually claims, how someone is trained to deliver it, and where the evidence runs out.

Those are fair questions. This is our attempt to answer them plainly.

Neurofunctional Dental Medicine proposes that oral and airway dysfunction involves six interdependent systems: structure, muscle function, fascial restriction, the oral-brainstem input circuit across cranial nerves V, VII, IX, X and XII, autonomic regulation output, and cellular vitality.

The framework grew out of a pattern seen over years of practice. Patients complete structural and myofunctional treatment appropriately, everything is done correctly, and they still do not achieve full functional recovery. Rather than attributing that to compliance or to provider skill, NFDM asks whether the systems that were never assessed might be the ones still holding the pattern in place.

We want to be careful about what the six-system model is. It is the way we organize assessment and treatment planning, and we believe it is the right way to sort what is known from what is still proposed. It is not a claim that six independent systems have each been separately proven. Some of these systems rest on primary experimental literature. Others rest on mechanism, anatomy, and clinical observation. Our published references say which is which, entry by entry.

ALF Therapy supports improvements in functional capacity, yet does not claim to cure anything. It promotes a more ideal environment for the body to heal itself.

The assessments have names, a sequence, and a scoring method, and they are taught the same way to every provider.

POST-IT is administered at initial assessment, at insertion, at every adjustment or titration visit, and at final records — always at the start of the appointment, before any intervention.

STOP is a subjective test of pain, scored on an absolute three-level scale at defined palpation sites.

SWITCH is a four-step within-visit sequence, performed on both sides, in both teeth-apart and teeth-together positions, before and after a therapeutic intervention.

Starfish identifies retained primitive reflexes.

ACORN is the infant assessment instrument.

CARE — Careful Assessment, Restriction Evaluation — names the reasoning that runs through all of it. Two distinct stages, not synonyms. Careful Assessment is the patient's function. Restriction Evaluation is the restriction itself, and whether it is reducible: densification responds, mature adhesion does not.

Readiness for structural change is scored before it is attempted. Red means reflexes are unintegrated and the brain-body connection is not established; structural change waits. Yellow means reflexes integrate with appliance support or after adjustment, laser, or manual therapy. Green means they integrate with and without support.

We do not publish the full technique. It is highly tactile and experiential, it cannot be transmitted accurately in writing, and published instructions invite self-training by people who have never had their hands checked. That is a deliberate decision and we are willing to defend it.

There are two pathways and a combined credential.

Pathway One — Dental Device Therapy. The ALF Evolution course, hands-on, 21 AGD PACE credit hours. Requires an active dental license. Ten documented cases for Certified, twenty-five for Advanced Certified. Examination is administered online under independent proctoring.

Pathway Two — Laser-Assisted Neuromodulation. The RestOralase course, 18 AGD PACE credit hours, preceded by a required virtual session carrying the didactic content so that in-person time is spent on hands-on work and live patient assessment. OraLase is the foundation, RestOralase the advanced application, BabyLase the infant application for ages 0 to 2 — carried as a rider with its own examination and ten documented infant cases. Ten documented cases for Certified, fifty for Advanced Certified. Open to dental, medical, physical therapy, chiropractic, and speech-language pathology licensees where state scope permits Class 4 non-ablative laser therapy. Documented laser safety training and access to a qualifying platform are required.

 Dual Certification is conferred on providers holding both. It is recognized as the combination, with no separate course or examination.

Advanced Certified requires two years held at Certified. Certification is current for two years; renewal requires ten hours of relevant continuing education and confirmation of active licensure.

Providers trained elsewhere are welcome, and enter the same sequence as everyone else. Documented prior training plus examination and cases is a recognized route.

This is a training credential. It is not specialty recognition, it is not board certification, and it is not a substitute for licensure. We say that on the pathways page too, because it matters more than it flatters.

Instructors are appointed per pathway and per course, after holding Advanced Certified for a year and completing a sequence of observing, assisting, co-teaching, and teaching under observation.

Two limits are absolute. Instructors cannot confer certification, and instructors cannot appoint other instructors. Faculty complete annual calibration on STOP, SWITCH, and ACORN scoring.

We built this tier deliberately. Uncontrolled instructor proliferation is how a method drifts away from itself, and the only reliable protection is a bottleneck that everyone passes through.

Every reference we publish carries its publication type — primary study, review, hypothesis paper, animal study, case report, simulation. A reader should not have to open a paper to learn that it is a review.

Some specific limits we hold ourselves to:

• The mechanobiology of cranial sutures characterizes the force parameters within which light-wire cyclic appliances are designed to work. It does not by itself demonstrate what any particular appliance delivers. Quantifying that is part of our research agenda, not a claim we make in advance.
• Translingual neurostimulation research establishes that afferent input at the tongue reaches the brainstem and produces measurable functional change at a distance. It uses electrical stimulation, measures gait and balance rather than oral function, and is prescribed alongside structured exercise. A different device. The same nerve. We cite it for the principle and never for equivalence.
• The published literature on photobiomodulation in neonates and children is small, was not conducted at the wavelength we use, and measured wound healing rather than neurological or functional outcome. What it supports is that this therapy has been applied in small clinical series without reported adverse events. That is an absence of a safety signal. It is not an efficacy claim and we do not make one.
• Expansion with an ALF is real and, with proper case selection and design, results in growing children can be excellent. What differs from conventional expansion is mechanism rather than capability — the appliance permits the natural forces of the swallow to generate the force. Because of that, expansion is contingent on swallow function. In older patients and in patients with a compromised swallow it should never be promised, and we do not teach it that way.

A framework that cannot be wrong is not a framework. Two of ours are stated as predictions with the conditions that would defeat them.

Tongue posture. A controlled study found that instructed tongue-on-palate posture raised muscle activity under the chin and lowered heart rate variability. That is the cost of effort, and we take it seriously. Our position is that the tongue should want to go to the palate rather than be held there — and we predict that a reflexive posture achieved after restriction is released will separate from the instructed condition on two channels at once: low suprahyoid activity with preserved or improved heart rate variability. If reflexive posture produces the same signature as instructed posture, the distinction we draw is wrong. 

That study has not been done. We are working on it.

SWITCH. We hold that the assessment detects a real change in motor output. It is internal to our own framework, which means it requires validation against instruments that do not share our assumptions — instrumented force capture rather than an examiner's judgment, and convergent measures such as suprahyoid EMG and heart rate variability. Reproducibility and inter-rater reliability are the first questions we are asking, not the last.

Outcomes are collected with published, validated instruments rather than our own impressions: PedsQL, PSQ-SRBD, SDSC, DVSS, SDQ, PedMIDAS, Rome IV and Bristol, and NOSE, alongside goal attainment scaling and a daily diary. Our own clinical measures are recorded as exploratory.

 Outcomes in the NFDM protocol are collected using published, validated instruments rather than in-house measures. These instruments are copyrighted by their developers and are not distributed by The Synergy Academy. Certified providers obtain them directly from the source below, under whatever license terms the developer requires. Where an instrument is free for a given use, the developer says so; where a license or fee applies, that is between the provider and the copyright holder. 

The Synergy Academy supports their providers with access to the following forms for documentation of treatment baseline and progress:: 

• The Goal Attainment Scaling worksheet
• The NFDM daily diary
• The global change item
• The NFDM clinical measures form
• The POST-IT, STOP, SWITCH, Starfish and ACORN recording forms

 These are our own forms, not licensed instruments. They are provided to certified providers as part of course materials, and to clinicians participating in the NFDM research program. Others may request them at admin@thesynergy.academy. 

We are working toward standardization deliberately, and it is worth saying why.

When every provider assesses differently, no two results can be compared, and a field ends up with a great many confident clinicians and very little accumulated knowledge. Standardizing the assessments, the scoring, and the timepoints is what makes it possible to ask whether something worked — and to answer honestly when it did not.

That is the point of the case requirements in our certification pathways, and of collecting outcomes with published instruments rather than our own impressions. We would rather find out than assume.

Patients are the reason for it. Better questions asked consistently over time are what eventually turn into better care, and we would rather build toward that slowly and be able to show our work than move faster and have nothing to show.

Case requirements in the certification pathways are structured to feed this work, which means the providers we train are the people who will eventually test the framework.

The Synergy Academy sets and maintains the framework. Our provider community advances it — and through the research network, will be what validates it.

The ALF appliance and the OraLase sequence were originated by Dr. Darick Nordstrom. That is stated plainly and without qualification wherever the work appears.

NFDM, RestOralase, BabyLase and NINJA are Dr. Tenholder's.

ALF education has been inconsistent and fractured over the years, and that fracture produced real problems. 

NFDM is our answer to it — a standardized curriculum, published indications, a credentialing pathway, and a research program.

 We are honoring  our roots while growing our wings.

The Synergy Academy, LLC holds federal trademark registrations for OraLase, BabyLase, RestOralase and ALF (both logo and use of word).  The Synergy Academy is a commercial education provider. Anyone reading our clinical claims should know that.

We think the correct response to a commercial interest is not to pretend it away, but to publish the evidence, label it accurately, state the limits, and be specific about what would prove us wrong. That is what the rest of this websiteis for.

Our verified literature references, with publication type stated for every entry, are found using the button below

Registration and course information: thesynergy.academy · admin@thesynergy.academy

Reviewed August 2026.