Hi everyone, and welcome back to Airway First, a podcast from the Children's Airway First
Foundation. I'm your host, Rebecca St. James. My guest today is Dr. Brock Rondo, a general
dentist who has dedicated his practice to providing orthodontic, orthopedic, snoring,
and sleep apnea in TMJ services for his dental patients in London, Ontario, Canada. Dr. Rondo
treats many patients with orthodontic, snoring, and sleep apnea and TMJ problems. Through his work,
many of his patients are delighted when they are able to find a solution to their headaches,
earaches, neck aches, dizziness, fainting, pain behind the eyes, difficulties swallowing,
clicking, and jaw-locking issues. Dr. Rondo works closely with other healthcare providers to try and
resolve these problems for his patients. He believes that in most cases, when several
practitioners are working together, the results are always better for the patient. He has personally
trained more than 24,000 dentists over the course of his career. He is also the seminar creator and
author of Early Orthodontics, Treatment for Children. You can find out more about Dr. Rondo
at ortho-tmj.com. Now, let's jump into my interview with today's guest, Dr. Brock Rondo.
Okay, great. Thanks for being on the show, Dr. Rondo. I'm really excited to have you.
I'm really excited to be with you, too, Rebecca. I love doing these podcasts. I love educating
the public and also the dentists about what is possible and what I think they should be doing
for their younger patients as well as their older patients. So thanks again.
Yeah, yeah. Thank you. Yeah. And while you're pulling up the presentation,
I'm just going to let our listeners know that you are actually referred to as mentioned by
name during that episode with Linda Harris. And I'll make sure I link that episode in our show
notes for people that want to check that out. So, Rebecca, again, thank you for inviting me to
be on the program and show you a podcast. I'm very anxious to share my knowledge with mothers
and fathers and children and dentists. And of course, the presentation is the Airway Focus
Early Orthodontic Treatment for Children. I think dentists have to start treating the children
early because many orthodontists are not doing it. It's not part of the program of most orthodontic
programs and it's not taught in dental school. And when you say early, how early are you talking?
Age five. Well, I suppose we do tongue ties at birth. So that would be if you notice the tongue
tab and we don't normally see infants. The infants are usually seen by the pediatricians, but
but again, the earlier, the better do the tongue ties. But the earliest I started treatment is
usually around five years old. If I've got a patient that's fairly cooperative, I can help them with.
I usually put a fixed appliance in there rather than rule, although they're five years old.
Got it. It's a huge demand. Like in your practice, all these dentists have children,
75% of them have a malocclusion and they need help. So there I get started five. So and use
functional appliance. I'm going to show you some of the functional appliances tonight. So a lot of
people have never seen them before. So the first thing I tell anyone that takes my course, and I've
been teaching orthodontic course for 35 years, is when you have a constricted pallet, that the key
to health in my opinion is to develop the upper arch to normal. And the photo below, it's wide and
normal without surgery, just put a little appliance in there and notice how the pallet drops. See
that in the upper picture, the pallet's lower picture drop. So you're opening the nasal airway,
you're opening it horizontally and you're opening it vertically. And that converted many nasal
breathers to mouth breathers. And of course, a number of your lectures have talked about the
importance of nasal breathing over mouth breathing. Right. So functional appliance is the way we do it.
So if you have crooked teeth, it's usually because you got an air arch. And usually got an air
arch because you're mouth breathing. So you got to fix the cause of the problem, which is the mouth
breathing. Try to get them to be nasal breathing. But the way to fix that is to develop the upper
arch, expand the upper arch, and you're gonna open up the, change it from mouth breathing to nasal
breathing. So when a patient comes to most dentists and they see crooked teeth, they think extractions.
But someone who's been trained funxly say, no, no, use an appliance, make room for all the teeth,
and you don't have to extract. In North America, I found a lot of the orthodontists who fix braces
and clear liners and permanent dentition. I disagree with that completely. I want to treat
early. So what are the detrimental effects of airwaves? We're going to be talking about this all
night. But here are the three ways I think everybody should be thinking about expanding the airway.
And I think dentists have a huge role to play here, because we're the only ones that can put
appliances in and really affect the airway. Except if they're large tonsils, maybe they get the
tonsils out. But as far as the arch is concerned, and the bite is concerned, we're the only ones
that can do it. So the first thing, I'm going to show you a couple of arch development cases.
Then if the lower jaw is back, which it is in most class two cases, normally the mandible is correct,
the lower jaw is back, we have to bring it forward with a functional appliance to normal.
And I like to do that in mixed dentition. So when all the permanent teeth are up, you're only dealing
with crooked teeth and minor crooked teeth. The other thing that most people don't understand is
increasing the vertical dimension. If you have a deep overbite patient, most of them have deep
overbites and they have TMJ problems, and they also have airway problems. And the way most orthodontists
and most Invisalign people do is they intrude the incisors. And I'll show you a case where that's not
what you have to do. You have to extrude the posterior teeth, which most orthodontists and dentists
are not taught in dental school. Let's show you my first case, Josh, my six year old. So there is,
my key is you have enough room for the upper four permanent teeth, upper four permanent incisors,
the central incisors, the middle ones, and then the lateral incisors beside those.
If there's enough room for those, then we don't expand. If there's no room for those,
you have to expand. Look at the lower. You got two permanent incisors crossed over,
and the lateral incisors, baby teeth on either side. So there's no way there's room for those
upper and lower front teeth. So we have to expand upper and lower. And this is a trick I taught
Linda. She goes around now with all the cotton rolls, measuring everybody's palate. The cotton
roll standard cotton roll in the dental office is 37 millimeters. You want to make sure everybody's
at least 37 millimeters. So put that up there. It fits nicely between the motors like that.
You don't have to expand. But over here you do picture on the left. You don't expand,
then those side teeth or lateral incisors coming in the palate. So why would you wait till that
happens? Why wouldn't you expand and avoid that? It doesn't make sense to me. It doesn't make sense
to me why everyone's not trained in dental school. How to do this. And the ortho programs
should all be teaching this in graduate school. So there's a little appliance. It's called a
Schwartz appliance. It around says 9th, 335. And it's just a little appliance with a screw in the
middle and some clasp on the side to hold it in. And you just turn that screw twice a week. The
patient takes it out, turns the screw twice a week, puts it back in. They can get all kinds of
different colors in these functional appliances from the labs. You have to deal with a lab that
makes functional appliances. And if you go on my website, you'll see lots of labs that we work
with across the country in Canada and the US. There's the lower one, really small. Again,
you can see the key on the right hand side with the arrow. And you turn it towards the arrow and
take it out. So just turn it all the way, take it out, do that twice a week. And pretty soon,
you'll have room for the teeth. You can see in the lower now, you got lots of room. And in fact,
the two lower teeth that were crooked have almost straightened out. Because we've been expanding
the upper and lower painlessly, adjusting it twice a week, really easy. And you can see there's no
plastic between the teeth. It's really easy for them to eat and chew and everything else.
How long did that take? About five months.
Okay. You get about, you actually get about two millimeters a month. But sometimes they forget
to turn it. So anyway, okay. And see when you got a good strictly large like that, we have no room
for the tongue on the palate, right? And that's our big problem. So they're expanded seven millimeters.
So that'd be about maybe four or five months. And it's painless. I mean, and they can do it
very easily. Just take it out, turn it, put it back in. Anybody can do this. And any dentist
can be trained to this and any staff member can do this. So you can see now, look at the arch and
they're beautiful. I mean, we were 26. Wow. We developed at seven millimeters. And now we have
a beautiful arch and look, he never came back for treatment. So by making room for all the teeth,
maybe all his permanent teeth came in perfectly, he never needed treatment.
So that's a tremendous cough saving to the mother. Santa paid 7500 for braces. She probably paid me
2,500 and, and was over in seven months. No problem. I mean, it's just so easy. And the kids are very
cooperative. If they're not, we put a fixed appliance and I'll show you the next case. I used a fixed
appliance and there's the lower look at the difference in the size of the arch as you'll see in a minute.
So we found that if you look at the tongue, it's kind of covering over the back teeth a little bit
on the left hand diagram. And then when we expand, there's room for the tongue in the lower.
See the tongue is this and usually it comes farther forward than that. It's just, it makes a huge
difference when you make room for the tongue. It can come to its proper position. Well, usually it
should sit on the root for the mouth. Right. What a beautiful arch. Look at the difference in the
arches. Now, who do you think is going to speak better? The guy in the right, right? Who's going
to have, who's going to have less crowding? The guy in the right, who may not need any
extractions? The guy in the right after the expansion. And we just expanded seven millimeters.
It goes two millimeters a month, three or four months and we're there. Four months, I guess.
Yeah. Again, easier to speak and painless. So that's the arch is so easy.
And when they, when they have the ones that they can take out, do they take them out when they eat
or anything? Or do they just take all the time? Take them out for sports, take them out to clean
them. Okay. Got it. So they're very, very comfortable. And there we just let more teeth come in
and he's got two front teeth. He's happy. So I wrote a book, early orthodontic treatment for
children. You can, they can contact my office. It's actually coming up on Amazon soon too.
So it has 19 cases in there of functional appliances start to finish in color. It's
really a good book. We have a digitally or we have a paperback. Here's another guy who didn't
cooperate. And the mother makes that decision. The mother knows the child more than I do.
So I said to the mother, does he get a good cooperator or a bad cooperator? He's a bad
cooperator. We put a fixed appliance in. He can't take it out. His lower jaw was back a little bit.
And the neat thing is, and this happens with TMJ cases too, if you expand the upper arch
frequently, the lower jaw comes forward on its own, which fixed a lot of TMJ problems right
from the beginning. So these kids will never develop TMJ problems. The jaw comes forward
without surgery, without anything. So he's got clastum older, which means his lower jaw is back
too far, which we just showed. And there you can see there's no room for those side teeth, right?
Remember, you have to have room for the fore front teeth, for permanent incisors,
and there's no room. So you have to expand. So again, put the cotton roll in, see what you get,
30 millimeters, okay? We need expansion. We're going to have to expand him and give a chance for
all those permanent teeth to erupt. Poor cooperators. So we use a fixed appliance. It's called the
Transverse Transverse, but it's all kinds of fixed appliances you can use. You cement the bands on
the molars, you have the little lap springs on the side. And that four millimeters is the part you
measure. Because the coil spring on the left of that is full of springs and just pushes the,
pushes, pushes open and opens it up. And I'll show you.
So it opens up eight millimeters. So it gets about a millimeter a month,
four millimeters. You don't have any adjusting to do. The mother doesn't have to do anything.
He doesn't have to do anything. It's pretty small. It doesn't take much room up there. He's
teeth still touching and chew. He can talk and expands them from four to eight. So hopefully
to make room for those four front permanent teeth. And of course, we also did the lower,
because it was a little crowded in the lower. So if you're going to expand the upper and you haven't
got a cross bite, you also have to expand the lower. So he starts with five, he went to nine.
So we expanded the upper, I take four and five and the lower four or five. And pretty soon we're
going to have enough room for those teeth as painless. And which is really nice. The mother
hasn't do anything. She doesn't have to do anything. Just sit there and watch, watch it change,
which is good for us too. We don't have as much work to do. The appliance says the word.
We don't have. The other thing I read like about this is that my team, I've got nine of them,
can do most of the work. They call me Dr. Delegator. I'm really proud of my hands because I just walk
around and say, do this, do this, do this, do this. And they do it. It's fantastic. So here we are now,
of course, of course, mothers all want straight teeth, right? I'm into function. I'm into creating
a beautiful upper broad arch, opening up the airway, converting to nasal breathers. But mothers say,
no, no, I want some straight, straight front teeth. So we put the brackets on and a wire in there.
And we have to pinch that tube there in the middle where you see the circle. So it won't expand
anymore because we got what we want. And in three months, the teeth are straight. Now, if you were
into a Vizaline, you could put a Vizaline in there and straighten those teeth too if you wanted to,
if they didn't want any braces. But when you can fix it in three months, it's pretty fast.
So most times I'll put braces on. And we're going from 30 to 35. Now, remember,
he's 10 years old, so he'll develop on his own if he has proper function. So if he's not a mouth
breather, nasal breather, every time he swallows, his tongue will go on the roof of the mouth and
spread out that upper jaw. So he'll get to 38 on his own easy once we take those off. So it's a
great, it's so easy. I like it easy. And the mothers love this, they appreciate it. They've gone to
an orthodontist or somebody else or their general dentist and showed them this case. And the general
dentist said, well, I don't do ortho, go see the orthodontist. They go see the orthodontist,
the orthodontist, and I don't do early treatment. I prefer permanent dentition.
Well, if you leave that case on the left till the permanent teeth are up, you're going to be in a mess.
Yeah. You're going to be in a mess. There's no way you got room for all the teeth.
So we're fixing the airway and we're making room for all the teeth
and giving a beautiful broad smile. I mean, how can you miss? Can see why I'm always
excited about this. See why? Yeah. So remember, the roof of the mouth is the floor of the nose.
When you expand the upper arch, you're opening up the nasal airway. And that's really important.
There's no other way to do it unless you do surgery. So it's so easy to turn that screw
or to let those coil springs work by themselves. So again, the teeth all came in straight,
upper and lower. Easy, easy, easy. 10 months. Now, when we take those braces off,
those teeth are pretty crooked. I'd like to put something in to make sure they don't move.
So I put this little wire in and attach it to every single tooth and leave that in maybe for
six months. They can't see it. Then I'm guaranteed the mother's not going to get mad at me because
those teeth are not going to move. So everybody's happy. Now you can look at the case. Look,
the two, look at all the permanent teeth coming in now. All the permanent teeth are coming in.
It's beautiful. All I did was just expand upper and lower arches. There he is. Went from 30,
35. Probably a little more than that. So there he is. He's got crooked teeth. He's got straight
teeth. And then look, all his teeth came in almost beautifully. We did 85% of the problem
with two appliances that the mother didn't have to turn. I didn't have to turn. It just worked
by itself. So very, I mean, it saved their mother a lot of money and, you know, in general,
then they can spend money on other things. That's in the book too. Now, of course,
there's Julia Roberts. Absolutely gorgeous smile. Right. We try to have all the teeth
go to the right to the corner of the mouth of the kit. Now you can see her. She looks great.
Broad arch. He's not quite so broad, is he? He's got black corners at the side of his mouth. So
I never thought I wanted to call the royal family and ask him if he had extractions.
But his mother, Lady Di, had extractions. Lady Di, one of the most beautiful women in the world,
had her bicuspids taken out. But I guess years ago, that's what everybody did. The trend now,
today, is to try not to do that. But I'm still having orthodontists still do it, some of them.
So again, beautiful smile, not so nice. So here's one of my patients. I want you to look at her.
She's got the eye tooth on the lower left picture there is blocked right under the arch.
And notice how the other teeth are tipped in. The lower teeth tipped in, the upper teeth tipped in.
Okay. So I expanded her 10 millimeters on the top and the bottom 10. And that's what she ended
up like, beautiful arches. Look how the teeth are not tipped in anymore. They're straight up and down.
That's where they're supposed to be. And that's just an expander. That was just an expander,
12 millimeters. I didn't show it, but I showed the other expander. But here's what I want to show
you. It's so interesting. When you've got a constricted arch, look at that eye tooth on the
lower left side is blocked right out. I mean, I would think that a lot of orthodontists and maybe
general dentists would take out the first bicuspid behind the cuspid and then bring the cuspid back
into that space. And I guess if you're just looking at teeth and not the tongue and not the arch,
you might do that. But look what happened to me with her. I used two applies with her. This is a
fixed one with a call spring, very similar to the one I showed you before. And I got six millimeters
with that one. And then I got another six millimeters with this one. That's a removable
short supply. It's like it showed you the first case. And that's what she looks like,
look at her tongue. It actually fits in her mouth. Where that tongue doesn't. That tongue does not
fit. So the key to health and airways and breathing is to give everybody a proper size
upper and lower arch period. And the only ones that can do it are dentists. Card practice don't do
that. Medical doctors don't do that. For dentists do that. Oh, we're the only ones. And you've got
to learn functional appliances. You can't do that with braces. You can't do that with braces.
You can't expand an arch 10 millimeters with braces. You can get about three, but you can't
get 10. So tongue back, of course, you're closing the airway. Now what happens, this patient puts
on a little weight, gets a little older. Let's say she's story five, and she's put on a lot of weight.
And her tongue is back already. She lies there back. What's going to happen? She's gonna sleep
after me and snore and snoring. All the all the things. All the bad things you don't want. Yeah.
So if you treat her properly, you put her tongue there. That tongue's not going to go back.
That tongue's forward. That's what you want. You want those teeth? And those teeth are not tipped.
Everybody says, Oh, don't do this. You'll tip the teeth. Those teeth are not tipped. They're right
over the bone. So don't tell me that. I've been doing this for 35 years. Don't tell me they tip
because they don't. If they tipped, I know by now, wouldn't I? You would think, yeah. And I wouldn't
keep doing it. But that's, I mean, I love the fact the airways open. They can speak better.
They function better. They didn't have any extractions. It's just the way to go. So
look at the smile. Wow. Wow. Yeah, you can see right down the sides.
But look at the eyes on the left. She's smiling, but her eyes aren't smiling. It's got dark corners
at the side of her mouth. The one on the right, her eyes are sparkling. She's just, of course,
she fixed her hair. And of course, I got to put a picture of her wedding dress in here. I keep
forgetting, but I got to do that because she, and I thought I should have invited the wedding
because I think I had a part of him being found her irresistible and married her. And she's gorgeous.
Nice person too. Yeah. Oh, there she is. Brot smile. I just love it. So the idol trim is using
the oral appliance to move the lower jaw forward over the pharyngeal airway. So remember, if the
lower jaw is efficient, you got to bring the lower jaw forward. So look at that patient.
So here's how I get into this. So I took a course from an orthodontist 40 years ago,
and he told me to take out the bicuspids. Since I didn't know any better, I took out some bicuspids
for about three years. But then, like most of your listeners, I tried to get better and take
courses to see if I can improve my technique. Plus, I didn't like the look of the patient's
profile when I took out their teeth because their lips went back and their nose looked longer.
So if you look at her face, see that little crease under her lower lip?
That means her lower jaw is back. I also want you to look at her face how short it is. She's got a
short face. So I moved her jaw forward with a functional appliance and I brought her back
teeth up, which is what I told you to do to help the TMJ in the face. She's gorgeous. I mean, that
is gorgeous. I changed her completely. Her jaw was back 10 millimeters. Her mother thought she had
buck teeth. It wasn't buck teeth, lower jaw was back. Bring the lower jaw forward. Very simple.
Now, here's a good example of how it worked. Have a look at the airway on the left.
Have a look at the airway on the right. And that's what we're doing when we bring the jaw forward.
That's what we're doing where we're splints to bring the jaw forward. That's what we're doing
with oral appliances to prevent stories sleep apnea. That's what we're doing. We're opening the airway
and we're the only ones that can do it. We have to use appliances to do this. It amazes me. I mean,
dentistry should be at the top of the healthcare system. I don't want to knock medical doctors,
but they look at a lot of problems and they look at what the temporary solution is, not what the
cause was. And again, medical doctors are not trained at TMJ and dentists are not trained at
TMJ and 34% of the population have it. I mean, it's amazing. I'd be happy to go on sometime and
talk about TMJ if you want. Okay. So early treatment prevents sleep apnea. Remember, if you bring the
jaw forward, you're going to keep it forward. You're going to keep the tongue forward. It's open
the airway. So early orthodermic treatment prevents sleep apnea, makes the patients look
palier, better, healthier and prevents noise sleep apnea. I mean, there's no reason not to do this.
So I'm hoping that dentists who are not doing this will sign up for some courses because there's
lots of clinicians giving courses on this. Make sure it's functional appliances. Don't go over just
braces. Don't go over just the vizalign. You need to use functional appliances, but you're going to
change the bone. They're bone movers. Look at her. Look at the lower jaw, how far back it is.
Compare the upper jaw. She needs to have her lower jaw move forward. The bone has to come forward.
So functional appliances are bone braces and the vizalign are tooth movers. I want everybody to
use the bone movers in mixed dentition when the patient's act will be growing. And then when you
get to permanent dentition, I have no objection to putting on braces or vizalign to straighten that,
but don't try to do braces or in vizalign with the patient on the left. It will not work.
There's another patient and move to jaw forward. She looks so much better. The other thing with
this patient, her head uprighted. So a lot of patients have class two that have airway problems,
have forward head posture. But the minute I brought a jaw forward, look at her ear. Look at
the difference in the ear and the left and the right. Her head uprighted over the cervical spine,
which got rid of her neck problems. So I should send that letter to all the chiropractors in my
area and say, you got a problem with patients with neck problems? If they're jaws forward like that,
maybe you should send them to me and I can fix it. All these great ideas I have. So that little guy,
I mean, he looks great. Doesn't he? I mean, imagine if you've grown up to look like the guy on the left.
There's no way it would be as attractive looking and unfortunately in our world today,
having, if you're attractive, it does help. Doesn't hurt. So, and I think he looks so much
stronger, so much more masculine on the right. They did the left big difference. His mother was
quite happy. Now there's another patient who looks older, which patient looks older left.
Yeah. Left. She's nine months younger. See, I brought her jaw forward and made her face longer.
So you actually make people look younger. Maybe I should get one of these myself.
Yeah, you can see a difference in her chin underneath that under chin.
There's no crease under the one on the right. And so that means her whole jaws come forward
with a functional appliance. Now there's the booker out. So you can see the one, the picture on the
left. I'm showing that patient about a case that I've done like hers. But the one on the right,
I'm showing her in the book. That's her in the book and she's all excited.
She's got her picture. She's quite happy. So anyway, I've got all my certificates all over the
walls too. I hope the dentists are paying attention and patients too should look for those certificates.
The dentist is taking lots of continued education courses. You should get those up there. Go leave
them in the box in the house. You're listening to Airway First with today's guest, Dr. Brock Bondo.
You can find out more about the Children's Airway First Foundation and our mission to fix before
six on our website at childrensairwayfirst.org. The CAF website offers tons of great resources
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Then shoot us a note via our contact page on our website, or send us an email directly at infoat
childrensairwayfirst.org. As a reminder, this podcast and the opinions expressed here are not
a medical diagnosis. If you suspect your child might have an airway issue, contact your pediatric
airway dentist or pediatrician. And now let's jump back into my interview with today's guest,
Dr. Brock Brando.
Okay, another case. So, as you're eight years old, it's got headaches. So, I want to ask all the
dentists listening out there and all the mothers listening out there, what are you going to do
if your eight-year-old girl's got headaches? Where are you going to go? Are you going to go to your
medical doctor and get some pills? Are you going to go to chiropractorine again, adjustment?
Are you going to go to physiotherapists and work on the muscles? Or are you going to go to a dentist
who knows what he's doing? And remember, dentists are not trained to do this in dental school. It's
not fair. But we need to train ourselves. I mean, I think I'd like all the dentists to look
themselves in the mirror and say, why did I go in a dentistry? I learned to fix teeth and gums
in dental school. That's all. I never looked at a tonsil. I never looked at an arch. If it was
crowded, I said to the orthodontist, I didn't know what to do. The orthodontist says, take out the
bicuspid. They took him out. It wasn't my fault. Well, now it's time to get serious and start helping
the children near practice. Now, if you've got an orthodontist nearby that will do this the right way,
keep sending. You're losing a lot of money, but keep sending. Anyway, I think you're going to make
more money if you keep those kids in your practice and help them. And you'll feel better about your
practice. I love my practice out, Rebecca, because I've got a health-oriented practice.
But four new patients, two were referred by Linda. And it's just, I feel good about what I do. I'm
getting people healthy. And that's how I met Linda, of course. I mean, I helped her 30 years ago.
When she came in, she said, I got fibromyalgia. And I said, well, let me look it up. It was the
beginning of my career. And looked up the symptoms and they were very similar to TMJ symptoms. The
ring in the ears, the ear symptoms, the neck aches, the vertigo. Yeah. The head aches, the,
all, everything was the same. So I said, I don't know if I can treat fibromyalgia, but I think
I can treat your TMJ. I treated the TMJ and got rid of all her symptoms. So that's why she wrote the
book, Fibromyalgia and TMJ Connection. The only thing I'd recommend to the dentist, make sure
you read the book before your patient does. Because if the patient reads the book and comes
up, they're going to be telling you what's in the book. And if you don't know what's in the book,
you're at disadvantage. So I've read the book. That's a good book. So here's the patient with a
retronaviric underdeveloped jaw. Lower jaw is behind the upper jaw. Okay. Why would anybody
in their right mind want to extract teeth on the upper to fix this problem? And why would they want
to bring the upper teeth back by taking out the bicuspids and bringing six teeth back when the
problem is the lower jaw is the problem, not the upper jaw. So if the lower jaw is behind the upper
jaw for heaven's sakes, don't take out teeth on the upper, bring the lower jaw with a functional
appliance. But remember, orthodontists that aren't trained in this, when they see the patient as an
adult, they lean, if they don't use functional supply, they only have one way to do it.
Surgically move the jaw forward when they're 17 and put them in brace for two years or take out
the upper bicuspids and make the money now. Not good. No, I don't like either. I don't like either.
No. So there she is. So that so she's biting on, got a five millimeter over bite and a six millimeter
over jet. Everybody should make note of this. Every mother watching, every dentist watching,
that's a TMJ problem in the future. If you don't fix it, guaranteed. If that's a female over 20,
90% chance you'll have clicking jaws and TMJ problems. Why don't you fix it now?
Fix it now with a simple little appliance. So here she is, daily headaches. Mother brings her
home from school due to headaches and she sits, she sits at home in a dark room, you know, trying
to get better. Where's that mother going to go? She's going to go to a dentist in those ways doing
or she knows what she's doing. There are lots of good female dentists out there too.
Some dentists who knows what they're doing is going to be able to fix this patient
and they're the only ones that can fix this patient. So again, there's the upper arch too narrow.
The teeth are in, but if I put a cotton roll in there, it wouldn't fit.
The lower jaw doesn't look wider. Look at the tongue.
When it's a wide lower arch, look at the tongue sitting right there.
Just right at there. You can see it so clearly. I'm going to show you some tongue after this case
where we extract a T where there's no room for the tongue. Now that is called the twin block.
It looks like a pretty bulky appliance. First time I put that in there, I said, oh my God,
will anybody wear this? And there's a bled at the back because there's a lower block in an upper
block. It's called the twin block because if you try to move your lower jaw back,
it hits the block on the top and you can't go back. So they have no choice but to bite there.
And honestly, when I put that in, I wasn't sure it was going to work.
This is what Linda wore 30 years ago. I made her this. That's all I knew 30 years ago was to put
this in adults and children. And I remember taking her out for dinner one night because we got to be
friends because she was starting to send patients to me and she ate spaghetti wearing that. She
couldn't eat a steak wearing that, but she ate spaghetti wearing that. And it worked. Brought
her jaw forward and got rid of her problem. So there's the patient on the left with a lower jaw
back six millimeters. Here's the patient on the right and the lower jaw came forward. So there's
the upper part. We always have to put a screw in the upper to make the upper jaw wider because
when the lower jaw comes forward, if you don't make the upper jaw wider, you'll have a buck
across bite. You won't have a good bite. And there's the lower. Make sure we want the lower molars
to come up to fix the deep overbite. The two blocks fix the lower jaw being deficient and not
covering over the lower molars. Let's those lower molars come up and fix the deep overbite. Here's
a little video to show how it works. Two pieces, upper block, lower block. Make sure you have a
screw here and expand that arch. And that's how they fit together nicely. No problem. You can't
bite any other way. She bites any other way. Her teeth don't come together. So that's what she does.
So then the first thing you have to do is take that key that shows how to do it too,
turn that screw twice a week. Take it out of the mouth to do it though. Don't do it in the back.
Okay. And then grind the plastic and let the molars come up. Up they'll come. Sometimes
they can be inelastic, bring it up. Sometimes not. And look at that. Jaw forward, gorgeous.
Easy, easy, easy. And then put brace on it. The after is straight in the teeth. So
it's a non-surgical way to correct the problem. I've seen patients with the lower jaw deficient
go to an orthodontist who doesn't use these appliances or a genital dentist. I don't want
to pick an orthodontist, genital dentist. And they have to go for surgery to bring the jaw forward.
As I told you before, then they're in braces for two years from 17 to 19,
when they can be fixed in seven months with a functional appliance when they're
70, nine, 10, 11, 12. What a shame. And these functional appliances though can still be used
on adults, correct? They can. But I've made them much smaller now. And they're a little different,
but they can use them on adults. Yes. But the ones we have now are better. We've got some fixed ones
now for adults because adults and they're much smaller than that. So, okay. Good question.
So that's the twin block. Now that's what happens after three or four months. The jaw comes forward
and you can't push it back because the jaw is comfortable there and you can't push it back
and you got that open bite. So you have to, you have to bring those teeth up and fix that open bite.
So I'm not showing you how to do that because I was cutting the presentation down a little bit,
but there's a patient with an underdeveloped lower jaw and there's the patient with a straight
profile. The big thing is,
Look at her cheeks even. Wow.
It changes your whole, I mean, you're moving bone here.
You know, they're bone movers. So I just then I brought her teeth up and remember we opened the
airway. Now this, I haven't shown you this, but this is interesting because I mean on the,
on the photo on the left is the jaw too far back. So when the patient jaw is too far back as shown
in the picture, the condyle, the top of the jaw bone is also too far back and behind the condyle,
the top of the jaw bone and the ear are nerves and blood vessels. Look on the photo on the right
and see how thick the nerves and blood vessels are over there. And then when you move the jaw
forward, that's what you get. You get the, you're not compressing the nerves and blood vessels anymore
and you get rid of the pain. And also if you look on the left hand photo, there's a, they're pointing
to a disc. That's a little piece of cartilage or disc, which is in front of the jaw. So if the
patient's jaw is too far back and they open and close, they'll click and the clicking is the
jaw going on to the disc, but you don't want the disc to be there. You want the disc to be one of
the right hand side. We have moved the jaw forward and the disc is in perfect position on the top
of the condyle. And there's nerves and blood vessels are black there and there's no compression.
Now here's the problem, Rebecca. What do you think we were taught in dental school to do?
Push the condyle. That's right. We were taught to push it up and back under pressure and they're
still doing that because they went to dental school and they haven't learned anything different.
Right. If I did that, I would never practice. I wouldn't have any basis. The secret to Linda,
the secret to everybody is getting that jaw downward and forward away from the nerves and
blood vessels. I mean, it's so simple. It's ridiculous. That's why actual clients do that.
When you expand the upper arch, you bring the jaw down and forward. When you move the lower
jaw forward, you bring that jaw down and forward. When you correct the deep overbite, you bring
the jaw down and forward. Those three things I told you read the outset, you got to do.
So there she is at the end, all her teeth have come in. I did the functional blind,
then I did braces and moved the jaw from there to there and look at her face.
I mean, that's why you want to go to the office. Oh my goodness. Wow.
That's why you want to go to the office. Look at her eyes. Look at the difference
of headaches on the left and the bright happy little eyes on the right. I mean, no more headaches.
What do you think the mother thinks of me now? Oh, yeah. Oh yeah. What do you think the mother
will say if one of her friends says, we're just saying to your daughter for braces,
then a wreck had me. So you're going to have a heart. You're going to have a, and the other thing
that happens is that when she grows up, well, I've treated lots of, lots of mothers when they're
like 21, then they send their kids to me. So then I'm doing, I mean, the whole family's coming. So
it's great. But you want to feel good about what you do. I feel good. Then I helped her a lot.
Oh yeah. No more headaches. Yeah. And who else could fix them? Only a dentist. Only a dentist
whose functional appliances could fix that little girl. I don't know any other way to do it. Here
guys playing video games, little girl there too. So here's some of the reasons you think about
orthodoxy for children. Well, improve the overall health of the patient. Again, when we went to
dental school, they didn't mention health. They mentioned teeth and gums. Well, you ask them,
when you fix the gums, you'll improve the health of the patient. I shouldn't say that. And I guess
if you get rid of the cavities and everything else, you're, you're making the patient healthy too.
But this is different. This is the overall health of the whole patient. This is different.
Right. Right. Now I feel like that patient. That's my favorite patient in the world. She came in on
the left hand side, look at how narrow her jaw is. Look at the black corners. That's the same child.
That's the same patient. No. On the right. Oh, I thought you were showing examples. I didn't know
that. Wow. Same patient. Look at her smile. Yeah. Look at her smile. She came to me at 15 and said
I'm a model. I said, wow, are you ever? And look at the confidence. Look at the confidence. I mean,
four little girl on the left are making fun of her, calling her bucky beaver and
all kinds of dames and bad for her self-esteem. The minute I moved her jaw forward, nobody called
her bucky beaver. They all made, they said, wow, they just say, why, you look great. No, I mean,
that's a buck to each showing off a new smile. Now here's a guy that had his bicuspid teeth extracted
and memory toji ended up coming to my office for sleep apnea. Okay. So there he is. That's what
he looks like. So I always thought when I went to school that grinding was being caused by stress.
And I'm not saying that when you go through a divorce or a death in the family, I'm not saying
you're not under stress, but lately they found that most patients grind because they have to open
their airway. So they snore, they stop breathing, and then they have to take their lower jaw and
move it forward to open up their airway. And that would cause the grinding. So the term is actually
called sleep bruxism. So here he is. He had teeth extracted, but he had a lower jaw back too far.
He shouldn't have had extractions. You think that profile looks as good as some of the ones I've
been showing you? I don't think so. So when you extract bicuspids and you bring back the six front
teeth, lower jaws does not come forward and you end up with TMJ problems and snoring sleep apnea.
So these dentists that are paying attention to this lecture, please don't take a upper bicuspids
if the patient has a lower jaw deficient. And they're going to find they look carefully at those
patients, probably 95% of the patients that have the upper teeth extruding out the front
have a deficient lower jaw and not an upper teeth. That's the problem. It's the lower jaw, the problem.
And of course, they're grinding down. Look at the poor guy. He's 50 years old and his teeth look like he's 80.
So when he came to see me, I filled an initial form on him. He was diagnosed with severe sleep apnea.
I don't have time to really get into this tonight, but I'd love to spend a lot more time on it.
But let me give you some of the short deals on this. I don't like night guards.
Night guards are prescribed by every dentist in North America, every dentist in Europe,
every dentist in Asia that I've ever gone to. I've lectured all over the world. Everybody gets a
standard night guard to prevent grinding. It doesn't prevent grinding. It encourages it. So
you take the forward by cuss words out, you bring back the 4G to 6G, end up with jaw problems.
You retract the upper lip. The upper lip is back. His nose appears longer. Why would you want to do
that to somebody? He's a really good looking guy from the front. He's got a beautiful wife,
but he didn't look that good from the side. It's not a fault. He went to a really good orthodontist
he thought who took up by cuss. But remember, I did it 40 years ago too. Depends how you're trained,
but most of us have to retrain ourselves. We have to keep taking courses. I think your program
is very useful. I want to watch all the videos on there. Okay. So my cosmic tractions,
wear facets on the teeth, there's his tongue. Remember, he's had two 8 millimeter bicussments
taken out in the bottom, which is 16 millimeters at two structures. They shrunk his lower arch
by 16 millimeters and look at his tongue covering over the teeth. He'll also have scalping on the
tongue. He'll have marks on the tongue, which is an indication of sleep apnea. And that poor guy
has got severe sleep apnea. So he's running the risk of heart attacks, strokes, type two diabetes,
kidney problems, more cancer, Alzheimer's, dementia, loss of memory, all because maybe he had to
for a teeth taken out. That's not right. It's not right. Something's got to change. And of course,
the same thing is that's where you want the job. But if you take out teeth and pull the upper teeth
back and leave the lower jaw back, you end up with that. We talk again. Yeah. He was given a
night guard. The trouble is the night guard and moves the jaw back, not forward. Every single dentist
out there that has made a night guard, and I give you more slides normally, have the patient bite
down on their teeth naturally and see how much the lower jaw is back. It might be one or two
millimeters on average. Then put in the night guard and have the patient bite down again,
it'll go back way further. And we just showed you why you don't want the lower jaw back.
You know what the lower jaw back is? It closed the airway, causing a snoring, sleep apnea.
Right. You know what the lower jaw back is? It pushes the upper jaw too far up and back and
presses the nerves and blood vessels and causes TMJ problems. So you don't want to use this.
And all the dentists use this. Choose all over the world and it makes patients worse. I now have
350 cases documented in the last three or four years of patients that got worse wearing this night
guard. In fact, I've got patients who have locked on that one. So please dentist, if the patient is
clicking and you know the jaw is already too far back, don't make a night guard because the jaw
could lock. They should teach that dental school, but they don't. Too bad. We don't learn anything
about this dental school. Mine's blowing. That's entirely. Nothing about the TMJ. The American
dental association says one third of the population has TMJ problems. So why don't they teach it in
dental school then? It's ridiculous. It's nuts. Here's a study that shows the use of these splints
made the patients worse. The H.I. means that's how many times they're stopping breathing was increased
50% and the snoring was increased 40% more. So a patient comes in, they're not snoring.
They give more of these night guard and they start snoring 40% worse. So I think everyone should pay
attention to this. Every dentist listening to this should ask Lee for copies of this. My treatment
coordinator is Lee. She's head of Rondo seminar teaching courses, but we'd be happy to send
all the dentists, my TMJ health questionnaire. I'm going to show you in a minute and the app
we're sleeping to scale to see whether or not the patient has a possibility of having sleep apnea.
So I'll show you those now. There's the TMJ health questionnaire form. So it's really simple.
Look at the top. He says, his chief concerns snoring and all the yeses are bad and all the
no's are okay. He's saying chronic shoulder pain, back pain, grind to see the night.
Okay. So he's got some jaw problems. He's got back pain and shoulder pain. They can come for jaws
and he's grinding to see the night. If you look at the lower left hand corner, do you snore at night?
He says yes. Then look at the right hand corner at the bottom and says, have you had a sleep study?
Yes. Had been diagnosed with sleep apnea? He says yes. So this is a really good form
to kind of screen for jaw problems and snoring sleep apnea. Now this is amazing. In the October
of 2017, the American Dental Association, the board of whatever passed a resolution that all
dentists should screen patients for sleep disorders as part of their regular medical dental history.
Right. It's not being done. It's not being done. Not being taught in school. Not being followed up on.
They just passed this resolution and then just ignored it five years ago. They were on the right
track, but no follow through. Right. No follow. I should try and get some of my ADA members fired
up here and tell them to do something about this. I should work on Canada. So here's another form
which every dentist should have in his practice. Okay. Two questions I would ask the patient.
Do you snore at night? Number one, do you wake up refreshed? Not if they had a good sleep.
Did you wake up refreshed? And the answer will be let, no, I don't wake up refreshed. Okay.
Then once you fill this form, so it says zero, you'd never take those off. One is a slight chance
of dosing off to modern chance of dosing three high chance. So you ask the patient when you're
sitting and reading zero, one, two or three, the patient says zero. How about when you watch TV,
two, modern chance of dosing? How about sitting in a movie theater, two, modern chance of dosing?
How about a passenger car, two, modern chance of dosing? How about lying down to rest in the
afternoon and circumsets for a minute? You can probably tell from me, Rebecca, that I would never
sit down in the afternoon and rest a complete waste of time. I sleep at night and that's it.
Can you believe it, Rebecca? Sitting, talking to someone zero, but some people put down two or
three sitting after a life without alcohol. Some patients will stop at a stoplight and it's a three
minute stop sign or stop or light and they'll fall asleep. And the only wake up guy behind
the blows the horn. Oh, he's now this guy's wearing his seatbelt. I'm not sure showing any
pictures in seatbelt. It's a hose that goes over the nose, right? A big mask, right? Yeah.
Right. Yeah. Yeah. Talks to an air compressor on the floor. He's wearing a CPAP, which is supposed
to get rid of all sleep apnea snoring and he's still very sleepy. His neck size 18 inches. Anybody
over 17 inches snores in large tongue. He does have a large tongue, has no room in his mouth
for his tongue. I should change that. His tongue looks enlarged though, but it's really, it's the
it's the job being so small. So I won't go into this much. This is just how you diagnose sleep apnea.
But if you're stopping at the bottom there more than 30 times an hour, he gets to be
asleep. Okay. So we're almost done. I want to show you goes to the hospital and has a sleep study
done. And I know it's seriously bad because he's stopping breathing more than 30 times an hour.
He's not breathing 35 times an hour. Oh, my God. Bruxing open up his airway. So we started 30.
So he stopped breathing almost every two minutes. Every two minutes he stopped breathing
all night for his whole life, 50 years. And you wonder why he's not doing well health
wise. Right. I did go into his medical history. I should have put that up there. He's not doing
that well medically. Okay. Untreaty sleep apnea, you decrease your lifespan by 10 years. You increase
the risk of high blood pressure, heart attacks, strokes, type two diabetes, cancer, dementia,
and all that. You don't want any of those. Nobody wants those. And this is really interesting.
We're almost done. The risk factor for standard risk factor for getting a heart attack is one.
If you're overweight, it's seven. If you're hypertension, it's 7.8. Smoking is 11 and
OSA, obstructive sleep apnea is 23. Oh my gosh. I mean, this is serious. I mean, you've got to
do your podcast. They're so important that the dentist gets this information and the parents
get this information. And if there's anybody snoring or sleep apnea, you've got to get a sleep test
and you got to get them fixed. That's your cases. We always try to put them on CPAP,
but he couldn't wear a CPAP. He didn't like it. He kept taking it off. So we made an oral plan
so we fixed them. I'll show you. Okay. We're almost done there. So we put them in oral plans.
Now doesn't that look like the twin block? It's got that big dorsal mechanism coming up and there's
a block behind it. So his jaw can't go back. The jaw can't go back. So it keeps the jaw forward
and that's what prevents that. That opens the airway, right? Bring the jaw forward,
open the airway, take the teeth and move them back, close the airway, constrict the arch,
close the airway. We want to open the airway. That's what your whole, your whole theme is.
That's what you're all about. So that's how the appliance works. You can see the picture in the
top, the tongue is blocking the airway. On the bottom picture, you can see the jaw forward,
opens up the airway, gets rid of the snoring and the sleep apnea. So you want to open the
pharyngeal airway by bringing the jaw forward. So see what I said in the beginning, we use
functional appliances, bring the jaw forward. And then at those, we put a lower appliance in to
bring the jaw forward, open the airway. It's all about the airway. That's your whole, that's how
you started your whole organization or your, yeah. Yeah. So was that your idea to start it?
No, actually it wasn't. It was Candy and Brad Sparks idea to start it because of the journey
they went through with their daughter. That's wonderful. That's wonderful. Well, I think it's,
it's got to help a lot of people, a lot of Dennis and a lot of parents. That's our goal.
Yeah. We brought the jaw forward, prevented the grinding. Now we did a home sleep study. Now that's
my sleep study. I should have shown you the hospital sleep study. It was terrible. It was 16
wires all of you. So I do a home sleep. They sleep in their own bed. They can sleep there at their
own pillow. They got their own room. They got everything normal and we get a home sleep study,
which is more, it's more accurate than the hospital one. Okay. I got them down to 7.7 with the oral
appliance. I took them from 35 to 7.7. 7.7. I took them from severe to mild. His wife said,
snoring is purring like a cat. His wife likes cats. No sleep apnoes sleep apnea.
No sleep apnoe. Okay. Well, I think I better end it there. I've probably gone a little over
to him, but I've had a great pleasure to present tonight and I'm glad you were here
asking me, asking me lots of questions. Now I can answer questions if you want. I don't know
if we have time, but I'd be certainly happy to answer them or they can send you the questions
that I can answer them later, whatever you want to do. Yeah. I think that'd be phenomenal. I'll
just invite all our listeners now. If you have any questions, you can submit them through the
blog or email at info at childrensairingsfirst.org and I will make sure to get them to Dr. Ron
Ngo and we'll get them answered for you. That's wonderful. Well, Rebecca, again, thank you very
much for inviting me. Thank you for being on this was fantastic. Thank you for showing and sharing
all this. It was wonderful. Well, I thought, you know, I'd be rather than answer questions,
I thought they'd show you show and tell, right? Seeing is believing. There's no, you can't,
you can't question anything when you see the patients. You know, you can see the change in
their, in their lives, changing their self-esteem, changing their health. Basically, we're changing
their health, which is what's so good. That's why I love my practice. And that's why I was
I'm 81 today. Well, happy birthday. And I'm still cooking.
Because I don't want to stop. Yeah. I like, I've got a partner now who's I've trained for a year
and he's really good. And we might look for another partner so I can play more golf. But I work two
weeks a month and take two weeks off and go to the floor and play golf. So that's, that's what I do
now. So anyway, I was happy to be on and happy to talk in the future about sleep apnea or snoring
and TMD if you want, but you had Michael Kelwell. Yeah. It was fantastic. Yeah. Well,
thank you so much. I appreciate it. Good. Well, thank you for having me and I wish you good night.
Thank you too. Bye everybody. Bye bye. Thanks again to today's guest, Dr. Brock Rondo,
for sharing his medical insight and to each of you for listening to today's episode.
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