1 00:00:00,000 --> 00:00:15,680 Hi, 2 00:00:15,680 --> 00:00:33,440 Hi everyone, and welcome back to Airway First, the podcast from the Children's Airway First 3 00:00:33,440 --> 00:00:34,440 Foundation. 4 00:00:34,440 --> 00:00:38,360 I'm your host, Rebecca St. James. 5 00:00:38,360 --> 00:00:43,640 My guest today is Courtney Robertson, a dedicated registered dental hygienist with over 11 years 6 00:00:43,640 --> 00:00:46,440 of experience. 7 00:00:46,440 --> 00:00:52,280 In recent years, she's honed her expertise in oral-facial myofunctional therapy, a passion 8 00:00:52,280 --> 00:00:57,920 she pursued in her hometown of Ottawa, Ontario, where she has proudly established one of the 9 00:00:57,920 --> 00:01:03,440 pioneering independent myofunctional therapy practices in the city. 10 00:01:03,440 --> 00:01:08,760 Her journey into myofunctional therapy is deeply personal, as both she and her children 11 00:01:08,760 --> 00:01:14,120 have faced their own challenges with airway and myofunctional issues. 12 00:01:14,120 --> 00:01:19,360 It's this personal connection that fuels her commitment to helping others overcome similar 13 00:01:19,360 --> 00:01:22,000 obstacles. 14 00:01:22,000 --> 00:01:26,640 From her base in Ottawa, Courtney's had the privilege of virtually assisting patients 15 00:01:26,640 --> 00:01:32,120 across Canada, the United States, the UK, and Australia. 16 00:01:32,120 --> 00:01:38,840 Additionally, she does maintain an in-person clinic for her local patients in Ottawa. 17 00:01:38,840 --> 00:01:43,840 She collaborates closely with airway-focused dentists and orthodontists, working with both 18 00:01:43,840 --> 00:01:46,560 children and adults. 19 00:01:46,560 --> 00:01:51,560 Her particular passion lies in fostering children's airway health and guiding optimal 20 00:01:51,560 --> 00:01:56,680 jaw development to ensure a brighter, healthier future. 21 00:01:56,680 --> 00:02:02,400 You can find out more about Courtney at archwaymyo.com. 22 00:02:02,400 --> 00:02:06,560 And now let's jump into my interview with today's guest, Courtney Robertson. 23 00:02:06,560 --> 00:02:10,000 I thank you so much for joining us today, Courtney. 24 00:02:10,000 --> 00:02:12,960 Thank you for having me. 25 00:02:12,960 --> 00:02:17,440 I love what you're doing with the Children's Airway First Foundation. 26 00:02:17,440 --> 00:02:23,640 I think it's so great that you're bringing so much awareness to airway health and myofunctional 27 00:02:23,640 --> 00:02:25,160 issues in kids. 28 00:02:25,160 --> 00:02:30,840 A lot of parents don't know where to go, so it's a nice resource to direct them to. 29 00:02:30,840 --> 00:02:31,840 Thank you so much. 30 00:02:31,840 --> 00:02:32,840 I appreciate that. 31 00:02:32,840 --> 00:02:36,840 Yeah, that's our goal is just to get the information out there and try to support parents 32 00:02:36,840 --> 00:02:38,280 any way we can. 33 00:02:38,280 --> 00:02:40,840 So thank you for that. 34 00:02:40,840 --> 00:02:47,320 So let's go ahead and start our conversation with just a little bit more about you and 35 00:02:47,320 --> 00:02:49,200 your journey. 36 00:02:49,200 --> 00:02:54,600 So for anyone that hasn't already read your blogs, I know you do explain it on your blog. 37 00:02:54,600 --> 00:02:59,200 Let's just go ahead and talk about what it was that drew you into the profession of myofunctional 38 00:02:59,200 --> 00:03:00,200 therapy. 39 00:03:00,200 --> 00:03:01,200 Yes. 40 00:03:01,200 --> 00:03:02,200 Okay. 41 00:03:02,200 --> 00:03:05,800 So I am a registered dental hygienist. 42 00:03:05,800 --> 00:03:13,240 I've been now a dental hygienist for over 11 years, and I'm based in Ontario, Canada, 43 00:03:13,240 --> 00:03:19,520 and I'm not sure what the dental hygiene training is like everywhere, but I know for myself 44 00:03:19,520 --> 00:03:26,720 I did not learn about airway issues, sleep, very much about tongue ties or myofunctional 45 00:03:26,720 --> 00:03:30,600 therapy in my hygiene training. 46 00:03:30,600 --> 00:03:32,360 So I feel like I went through a lot of my... 47 00:03:32,360 --> 00:03:33,760 We hear that a lot. 48 00:03:33,760 --> 00:03:35,520 Yes, yeah. 49 00:03:35,520 --> 00:03:39,960 I'm hoping that that's starting to change, and I'm hearing that that's starting to change, 50 00:03:39,960 --> 00:03:41,480 which is really great. 51 00:03:41,480 --> 00:03:47,960 But I was seven, eight years into my career of dental hygiene in a pretty busy and modern 52 00:03:47,960 --> 00:03:53,520 practice without really knowing much about this. 53 00:03:53,520 --> 00:03:59,880 So I first learned about myofunctional therapy when I was on maternity leave with my second 54 00:03:59,880 --> 00:04:01,760 child. 55 00:04:01,760 --> 00:04:03,520 So my daughter, she's now four. 56 00:04:03,520 --> 00:04:11,960 So back in 2019, I was listening to podcasts on my walks, and I came across a dental hygiene 57 00:04:11,960 --> 00:04:17,320 podcast episode, and the speaker was Sarah Hornsby. 58 00:04:17,320 --> 00:04:23,760 She's a well-known myofunctional therapist in this field, and it was a four-part series, 59 00:04:23,760 --> 00:04:31,680 I remember, because I listened to it so many times, and it just totally opened up my world 60 00:04:31,680 --> 00:04:35,600 to myofunctional therapy. 61 00:04:35,600 --> 00:04:42,840 And initially, I was thinking about my own kids, my baby at the time and my toddler at 62 00:04:42,840 --> 00:04:47,840 the time, my toddler especially, was showing a lot of he still wasn't sleeping through 63 00:04:47,840 --> 00:04:54,960 the 90s, and we had a really difficult breastfeeding journey and all of that. 64 00:04:54,960 --> 00:05:01,880 So looking at helping them and then realizing, oh my gosh, myself as an adult, I am still 65 00:05:01,880 --> 00:05:07,520 suffering from all of these issues and discovered I had a tongue tie that I never knew about, 66 00:05:07,520 --> 00:05:12,080 which seemed kind of embarrassing as a dental hygienist that I felt like I did a lot of 67 00:05:12,080 --> 00:05:14,880 continuing education. 68 00:05:14,880 --> 00:05:18,960 So it really started with a personal journey. 69 00:05:18,960 --> 00:05:22,560 I took in all the free content that I could. 70 00:05:22,560 --> 00:05:31,560 I ended up enrolling in Sarah Hornsby's myo-metre program and treating myself and family first, 71 00:05:31,560 --> 00:05:40,480 but then I, you know, it's been such a positive thing for myself and my family that I founded 72 00:05:40,480 --> 00:05:46,120 my independent myofunctional therapy practice in 2021. 73 00:05:46,120 --> 00:05:54,600 I think I'm one of the first independent myo practices in Ottawa where I live. 74 00:05:54,600 --> 00:06:02,200 But I have treated patients from across Canada, the United States, the UK, and Australia so 75 00:06:02,200 --> 00:06:10,920 far just because I do have, you know, a virtual practice as well that helps me reach more 76 00:06:10,920 --> 00:06:11,920 people. 77 00:06:11,920 --> 00:06:14,160 Which I really love. 78 00:06:14,160 --> 00:06:19,000 That was one of the things that drew me to you when I first ran into you on Instagram 79 00:06:19,000 --> 00:06:22,080 and then started digging around a little bit more. 80 00:06:22,080 --> 00:06:28,000 I haven't seen another solely virtual practice out there. 81 00:06:28,000 --> 00:06:33,200 And one of the things I do love is you can reach so many more people this way. 82 00:06:33,200 --> 00:06:38,000 So what is it like doing it virtually, you know, as a parent, you know, what should I 83 00:06:38,000 --> 00:06:39,000 expect? 84 00:06:39,000 --> 00:06:41,560 I bring my child to you. 85 00:06:41,560 --> 00:06:47,400 What is that like as a virtual relationship versus, you know, if I were to take my child 86 00:06:47,400 --> 00:06:49,000 to you in person? 87 00:06:49,000 --> 00:06:53,080 Well, so things have evolved over time. 88 00:06:53,080 --> 00:06:59,040 So in the last two years, I mean, when I started, there was, it was COVID times first of all. 89 00:06:59,040 --> 00:07:06,720 So I'm trying to do my job with all of the PPE and everything was not really realistic. 90 00:07:06,720 --> 00:07:13,400 Also not so long ago, it doesn't sound very long ago, but two years ago, there was a lot 91 00:07:13,400 --> 00:07:15,400 less awareness in my area. 92 00:07:15,400 --> 00:07:17,880 So I was getting less local referral. 93 00:07:17,880 --> 00:07:20,560 There was less awareness in our area. 94 00:07:20,560 --> 00:07:27,800 So it was more natural for me to start online and have more reach and use social media to 95 00:07:27,800 --> 00:07:29,840 grow my practice. 96 00:07:29,840 --> 00:07:35,320 So I did get really comfortable with the online stuff. 97 00:07:35,320 --> 00:07:43,120 Usually what I'll do when I work with someone solely online is I'll send them intake forms, 98 00:07:43,120 --> 00:07:47,280 a request for photo uploads. 99 00:07:47,280 --> 00:07:54,600 So I send them a template that I use to get certain views that I need. 100 00:07:54,600 --> 00:08:01,800 And then we'll do a video parent consult first to kind of go over the intake. 101 00:08:01,800 --> 00:08:06,720 I help to connect the dots for them on some of the symptoms that they're seeing. 102 00:08:06,720 --> 00:08:12,560 And we review the photos together and I share some things that I see through my unique lens 103 00:08:12,560 --> 00:08:16,920 of, you know, signs of red flags in those photos. 104 00:08:16,920 --> 00:08:21,480 And if we feel like it's the right fit, we'll do a video functional assessment where we 105 00:08:21,480 --> 00:08:24,960 keep it light and fun for the child. 106 00:08:24,960 --> 00:08:30,200 I really only need to be able to see from the collarbones up when I'm doing an oral 107 00:08:30,200 --> 00:08:35,240 facial myofunctional assessment. 108 00:08:35,240 --> 00:08:40,320 Now mind you, things like I said, have evolved over time and the awareness has grown quite 109 00:08:40,320 --> 00:08:41,320 a bit. 110 00:08:41,320 --> 00:08:48,160 I have lots of amazing referral partners and I've built a really good network in my area. 111 00:08:48,160 --> 00:08:54,240 So I do now have an in-person space, which if you can do it, if you can get a myofunctional 112 00:08:54,240 --> 00:09:01,560 therapist locally for children, especially I'd say even under 10 years old, in person 113 00:09:01,560 --> 00:09:05,640 can be, you know, really great. 114 00:09:05,640 --> 00:09:08,520 There's more than you can do. 115 00:09:08,520 --> 00:09:13,160 It's because I think that I'm able to be a little bit more interactive with the child 116 00:09:13,160 --> 00:09:15,520 and, you know, we can keep them moving. 117 00:09:15,520 --> 00:09:18,080 We can do more games and things like that. 118 00:09:18,080 --> 00:09:24,760 There are some limitations to online, but I have adapted my online practice as well for 119 00:09:24,760 --> 00:09:28,520 those that just aren't closed. 120 00:09:28,520 --> 00:09:33,440 And I love that you do that because one of the things, pardon me, that we hear a lot 121 00:09:33,440 --> 00:09:41,280 from our parents help me find support, you know, and it's heartbreaking for someone like 122 00:09:41,280 --> 00:09:46,040 me, when I get these emails, there is no myofunctional therapy available in my area. 123 00:09:46,040 --> 00:09:49,560 There isn't an airway centric dentist in my area. 124 00:09:49,560 --> 00:09:54,920 So the fact that you have been able to adapt your practice to actually help a child virtually 125 00:09:54,920 --> 00:09:55,920 is amazing. 126 00:09:55,920 --> 00:10:02,400 Yes, yeah, it's been a work in progress, but we have some fun. 127 00:10:02,400 --> 00:10:05,160 We try to keep it really interactive. 128 00:10:05,160 --> 00:10:09,960 I have some different things that I share on my screen with them to make it a bit of a 129 00:10:09,960 --> 00:10:10,960 game. 130 00:10:10,960 --> 00:10:12,360 We use some fun timers. 131 00:10:12,360 --> 00:10:19,720 I call them fun timers for them to kind of will compete against each other to see who's 132 00:10:19,720 --> 00:10:25,840 going to win watching these little races, but then also doing our therapy exercises at the 133 00:10:25,840 --> 00:10:26,840 same time. 134 00:10:26,840 --> 00:10:32,880 So I've learned even just doing these things on my own children that, you know, we need 135 00:10:32,880 --> 00:10:37,880 to keep it fun and we need to have it play based for the smaller kids, which is which 136 00:10:37,880 --> 00:10:39,360 is big, right? 137 00:10:39,360 --> 00:10:45,120 Do you have to keep their their engagement through through the whole whole session? 138 00:10:45,120 --> 00:10:46,600 Yeah. 139 00:10:46,600 --> 00:10:51,200 On your website, and I will put a link to this in our show notes. 140 00:10:51,200 --> 00:10:57,120 You have a blog where you talk about the shrinking jaw line and that's something we've talked 141 00:10:57,120 --> 00:11:00,840 about on our show several times. 142 00:11:00,840 --> 00:11:02,560 You know, we talked about it with Dr. Boyd. 143 00:11:02,560 --> 00:11:06,360 We've talked about it with Dr. McIntosh. 144 00:11:06,360 --> 00:11:10,880 It's becoming a little more mainstream in the conversation that people are becoming aware 145 00:11:10,880 --> 00:11:15,680 that yes, over the last hundred years, everything is shrinking and let's not pull out teeth. 146 00:11:15,680 --> 00:11:19,200 Let's take a step back and kind of reset. 147 00:11:19,200 --> 00:11:23,320 But as a parent, when you hear that for the first time, that's a little overwhelming. 148 00:11:23,320 --> 00:11:24,680 That's kind of scary. 149 00:11:24,680 --> 00:11:33,080 So how do you approach it with parents for the first time when they hear this and maybe 150 00:11:33,080 --> 00:11:37,360 they've already had a child that's had some teeth pulled or they've had retractive braces? 151 00:11:37,360 --> 00:11:41,840 How do you approach it so that it doesn't completely, for lack of a graceful way to 152 00:11:41,840 --> 00:11:43,720 say this, flip out the parent? 153 00:11:43,720 --> 00:11:47,000 Oh my gosh, you know, I've damaged my child because we've all gone through this. 154 00:11:47,000 --> 00:11:49,360 So how do you approach that? 155 00:11:49,360 --> 00:11:57,320 Well, it's, you know, as a parent myself, I know how overwhelming that it can feel. 156 00:11:57,320 --> 00:12:03,960 So I approach it carefully because I know that there's a lot of like mom or parent guilt 157 00:12:03,960 --> 00:12:05,520 that comes along with that. 158 00:12:05,520 --> 00:12:11,200 When, you know, there were things that you just didn't know. 159 00:12:11,200 --> 00:12:17,120 And while it's so interesting, all of the anthropology and the history of, you know, 160 00:12:17,120 --> 00:12:22,480 our changes, there's just so much information that we can share with parents. 161 00:12:22,480 --> 00:12:26,280 So a lot of times I will share resources with them. 162 00:12:26,280 --> 00:12:31,560 So I won't overload them with too much information all at once. 163 00:12:31,560 --> 00:12:37,760 I think that that's something that I've learned over time is that I can't just give so much 164 00:12:37,760 --> 00:12:44,080 information right off the bat because it's hard for them to take it all in and we all 165 00:12:44,080 --> 00:12:46,560 need some time to reflect on it. 166 00:12:46,560 --> 00:12:48,360 So I'll give them reading material. 167 00:12:48,360 --> 00:12:53,240 I'll direct them to these different podcast episodes with the experts like Kevin Boyd 168 00:12:53,240 --> 00:12:57,200 who are speaking about all of these things. 169 00:12:57,200 --> 00:13:02,440 But I think most importantly, just breaking it down into bite-sized pieces. 170 00:13:02,440 --> 00:13:05,400 Okay, where are we now? 171 00:13:05,400 --> 00:13:06,560 And what can we do? 172 00:13:06,560 --> 00:13:10,560 What are some easy steps that we can do right off the bat? 173 00:13:10,560 --> 00:13:15,560 And I'll create kind of a roadmap for them and have them know that I'm there with them 174 00:13:15,560 --> 00:13:17,240 throughout the whole thing. 175 00:13:17,240 --> 00:13:22,000 As a myofunctional therapist, I think a lot of us refer to ourselves kind of as a traffic 176 00:13:22,000 --> 00:13:29,240 director where we help the parents advocate for their children and we help them to know, 177 00:13:29,240 --> 00:13:31,120 you know, we're not just doing the therapy. 178 00:13:31,120 --> 00:13:35,640 We're also connecting them with other professionals that can help with these different pieces 179 00:13:35,640 --> 00:13:36,640 of the puzzle. 180 00:13:36,640 --> 00:13:42,720 So I think that's been an important part of my practice is meeting the parents where 181 00:13:42,720 --> 00:13:47,120 they're at and helping them to move forward in some way. 182 00:13:47,120 --> 00:13:49,040 Yeah, absolutely. 183 00:13:49,040 --> 00:13:50,640 So many things I could respond to you there. 184 00:13:50,640 --> 00:13:55,840 I mean, first off, I say this, I swear, every episode we should change the name to you don't 185 00:13:55,840 --> 00:14:00,960 know what you don't know because that's the first thing that I always have to tell parents 186 00:14:00,960 --> 00:14:01,960 when they contact us. 187 00:14:01,960 --> 00:14:02,960 It's okay. 188 00:14:02,960 --> 00:14:03,960 You didn't know. 189 00:14:03,960 --> 00:14:06,240 You know, I went through that whole mom guilt myself. 190 00:14:06,240 --> 00:14:07,240 I didn't know. 191 00:14:07,240 --> 00:14:10,600 I look at my two daughters and think, oh, I kind of missed the mark there, but you course 192 00:14:10,600 --> 00:14:11,600 correct. 193 00:14:11,600 --> 00:14:16,440 And so many physicians and dentists that we've had on the show, same thing. 194 00:14:16,440 --> 00:14:17,440 They weren't taught. 195 00:14:17,440 --> 00:14:18,760 So we're all kind of in the same boat. 196 00:14:18,760 --> 00:14:20,120 You know, let's turn the ship. 197 00:14:20,120 --> 00:14:21,160 Let's course correct. 198 00:14:21,160 --> 00:14:26,560 So and we have talked about this a little bit more. 199 00:14:26,560 --> 00:14:31,240 How does for those that haven't heard this before, how does myofunctional therapy help 200 00:14:31,240 --> 00:14:34,560 a child and their development and their jaw growth? 201 00:14:34,560 --> 00:14:35,560 Yeah. 202 00:14:35,560 --> 00:14:40,400 So I know you've had some other myofunctional therapists on the show too. 203 00:14:40,400 --> 00:14:47,160 But I guess, you know, hearing them from different ways of explanation are always helpful. 204 00:14:47,160 --> 00:14:48,160 Absolutely. 205 00:14:48,160 --> 00:14:55,760 So one of the things that I often tell parents is that our ultimate focus with myofunctional 206 00:14:55,760 --> 00:15:00,320 therapy is to achieve correct oral rest posture. 207 00:15:00,320 --> 00:15:07,720 And what that means is we want children and adults, all of us to have our tongue in the 208 00:15:07,720 --> 00:15:08,720 right place. 209 00:15:08,720 --> 00:15:15,040 So we want the tip middle back of the tongue to rest sealed to the roof of the mouth with 210 00:15:15,040 --> 00:15:21,360 the mouth closed, lips sealed, and breathing through the nose. 211 00:15:21,360 --> 00:15:29,440 Now in achieving those goals, in having proper rest posture, there's a lot of connections 212 00:15:29,440 --> 00:15:30,440 to that. 213 00:15:30,440 --> 00:15:35,680 So when the tongue is resting in the right place, it helps to open the upper airway for 214 00:15:35,680 --> 00:15:39,480 a clearer space to breathe through. 215 00:15:39,480 --> 00:15:43,440 So and that translates also into nighttime. 216 00:15:43,440 --> 00:15:49,080 So that's where myofunctional therapy can help us to breathe better and in turn sleep 217 00:15:49,080 --> 00:15:50,080 better. 218 00:15:50,080 --> 00:15:56,920 And we know how important that optimal breathing and sleep is, especially for a developing 219 00:15:56,920 --> 00:15:57,920 child. 220 00:15:57,920 --> 00:16:03,880 But the tongue also resting in the roof of the mouth and exerting pressure on the roof 221 00:16:03,880 --> 00:16:10,120 of the mouth during those really important developmental stages helps to guide the way 222 00:16:10,120 --> 00:16:13,040 that the upper jaw grows. 223 00:16:13,040 --> 00:16:18,960 So our tongue exerting pressure on the roof of the mouth provides that internal support 224 00:16:18,960 --> 00:16:22,240 for children. 225 00:16:22,240 --> 00:16:27,800 Primaric before I would say before the age of eight is the most key time for that. 226 00:16:27,800 --> 00:16:31,760 And the bones are still soft and easy to manipulate. 227 00:16:31,760 --> 00:16:36,960 So when the tongue is in the right place, it will guide the palate to grow wide, flat, 228 00:16:36,960 --> 00:17:06,760 and forward and fit all of the teeth. 229 00:17:06,760 --> 00:17:18,280 You're listening to Airway First, the podcast from the Children's Airway First Foundation. 230 00:17:18,280 --> 00:17:27,120 You can find out more about CAF and our mission to fix before six on our website at childrensairwayfirst.org. 231 00:17:27,120 --> 00:17:32,920 The CAF website offers tons of great resources for both parents and medical professionals. 232 00:17:32,920 --> 00:17:37,360 In our Parents Portal and Clinicians Corner, you can find educational and informational 233 00:17:37,360 --> 00:17:43,480 content including videos, blogs, our recommended reading list, comprehensive medical research, 234 00:17:43,480 --> 00:17:49,600 podcasts, events, parent support, and educational opportunities. 235 00:17:49,600 --> 00:17:54,160 Parents are also encouraged to join the Airway Huddle, our Facebook support group which was 236 00:17:54,160 --> 00:17:58,400 created for parents of children with airway and sleep related issues. 237 00:17:58,400 --> 00:18:07,200 You can access the Airway Huddle support group at facebook.com backslashgroups backslashairwayhuddle. 238 00:18:07,200 --> 00:18:09,720 Are you interested in being a guest on the show? 239 00:18:09,720 --> 00:18:14,920 Then shoot us a note via the contacts page on our website or send us an email directly 240 00:18:14,920 --> 00:18:19,440 at infoatchildrensairwayfirst.org. 241 00:18:19,440 --> 00:18:24,720 As a reminder, this podcast and the opinions expressed here are not a medical diagnosis. 242 00:18:24,720 --> 00:18:29,560 If you suspect your child might have an airway issue, contact your pediatric airway dentist 243 00:18:29,560 --> 00:18:31,600 or pediatrician. 244 00:18:31,600 --> 00:18:51,720 And now let's jump back into today's podcast. 245 00:18:51,720 --> 00:19:04,360 But another thing that we don't often think about as dental professionals is that a wide 246 00:19:04,360 --> 00:19:11,160 enough jaw, a wide enough palate is also going to fit the tongue. 247 00:19:11,160 --> 00:19:16,240 And then when the mouth is closed at rest, it's also stimulating the lower jaw to grow 248 00:19:16,240 --> 00:19:22,800 forward away from the upper airway and set them up for a clear airway space and airway 249 00:19:22,800 --> 00:19:25,440 structures into adulthood. 250 00:19:25,440 --> 00:19:32,160 So when we are prioritizing these things early on, we are setting our children up to have 251 00:19:32,160 --> 00:19:38,080 better breathing and better sleep and overall health into adulthood. 252 00:19:38,080 --> 00:19:44,480 So there are a lot of connections there, but it really comes down to, you know, our breathing, 253 00:19:44,480 --> 00:19:48,160 our sleep, and our craniofacial development. 254 00:19:48,160 --> 00:19:49,160 Right. 255 00:19:49,160 --> 00:19:54,520 And you mentioned this, if you sleep well and breathe well, then they're going to have 256 00:19:54,520 --> 00:20:00,360 better motor functions, better brain activity as well, because otherwise it can impact all 257 00:20:00,360 --> 00:20:02,960 of that and their behavior, right? 258 00:20:02,960 --> 00:20:05,080 Yes, exactly. 259 00:20:05,080 --> 00:20:11,160 And we see this often, you know, we'll see children that are not breathing well during 260 00:20:11,160 --> 00:20:17,320 sleep and their body is just in this chronic state of fight or flight, even when they're 261 00:20:17,320 --> 00:20:22,760 sleeping when they should be in a pure sympathetic state where they're resting, digesting and 262 00:20:22,760 --> 00:20:25,320 their body is repairing itself. 263 00:20:25,320 --> 00:20:31,800 So if they aren't getting into that restorative sleep, we're going to see the effects during 264 00:20:31,800 --> 00:20:32,800 the daytime. 265 00:20:32,800 --> 00:20:40,400 We can't expect a sleep deprived child to perform at their highest level if they're not 266 00:20:40,400 --> 00:20:43,000 breathing well and not sleeping well. 267 00:20:43,000 --> 00:20:44,000 Absolutely. 268 00:20:44,000 --> 00:20:50,000 And you also mentioned the tongue, having enough space for it. 269 00:20:50,000 --> 00:20:54,680 And for those who haven't read the six foot tiger, we'll put the link to that in here, 270 00:20:54,680 --> 00:21:02,840 but maybe we could talk about that a little bit, because is it accurate to say that sometimes 271 00:21:02,840 --> 00:21:04,920 we hear about, oh, that child has a big tongue? 272 00:21:04,920 --> 00:21:09,800 Well, perhaps it's not that they have a large tongue, it's that their mouth has not been 273 00:21:09,800 --> 00:21:10,800 formed correctly. 274 00:21:10,800 --> 00:21:11,800 Yes, exactly. 275 00:21:11,800 --> 00:21:21,440 I would say a vast majority of the time that it's actually that the jaws are too small 276 00:21:21,440 --> 00:21:27,320 to house the tongue, not that the tongue is too big for the mouth. 277 00:21:27,320 --> 00:21:34,160 So as I discussed that the tongue, when it's in the right place, it's exerting pressure 278 00:21:34,160 --> 00:21:42,240 on the palate and guiding healthy jaw development and creating that space as they get older. 279 00:21:42,240 --> 00:21:46,640 The opposite is going to have a negative effect on the jaw development. 280 00:21:46,640 --> 00:21:54,080 So if the tongue is not resting in the correct place, maybe because of a tongue tie, restricting 281 00:21:54,080 --> 00:21:59,720 the tongue's mobility, or maybe because of low muscle tone or chronic mouth breathing, 282 00:21:59,720 --> 00:22:04,440 when the tongue is resting low, there's no internal support telling the roof of the mouth 283 00:22:04,440 --> 00:22:05,760 how to grow. 284 00:22:05,760 --> 00:22:11,800 So a lot of times these kids, and most of the time they'll experience a downward growth 285 00:22:11,800 --> 00:22:16,760 where the ridges that support the teeth grow downward, and it'll give the appearance of 286 00:22:16,760 --> 00:22:20,040 a high-involved palate. 287 00:22:20,040 --> 00:22:26,400 We'll see crooked teeth, no space for the teeth, but also when we see no space for the 288 00:22:26,400 --> 00:22:29,600 teeth, we know there's no space for the tongue. 289 00:22:29,600 --> 00:22:35,760 And that's going to put them into more of this vicious cycle where now they don't have 290 00:22:35,760 --> 00:22:40,880 enough tongue space, and it's even more likely that the tongue is going to obstruct the airway 291 00:22:40,880 --> 00:22:42,280 during sleep. 292 00:22:42,280 --> 00:22:49,200 And as a parent, because we've talked about some of the symptoms before, and I'll put 293 00:22:49,200 --> 00:22:59,360 them in our show notes, but how could we check or what are some of the things we could look 294 00:22:59,360 --> 00:23:03,880 for to identify a possible tongue tie in our children? 295 00:23:03,880 --> 00:23:08,840 I mean, I know if your child doesn't lisp, for example, but they're going about their 296 00:23:08,840 --> 00:23:13,480 everyday lives and everything seems okay, and then you come to find out 10, 20 years 297 00:23:13,480 --> 00:23:15,240 later they have a tongue tie. 298 00:23:15,240 --> 00:23:20,040 So is there anything as a parent we can do to look to try to spot it for ourselves and 299 00:23:20,040 --> 00:23:23,400 maybe think, oh, you might, so I need to take you in? 300 00:23:23,400 --> 00:23:28,200 Yeah, there's a lot of connections with our tongue. 301 00:23:28,200 --> 00:23:34,600 I'll first say that our tongue needs full range of motion. 302 00:23:34,600 --> 00:23:39,840 It may seem kind of silly why we would focus so much on tongue mobility and our tongue's 303 00:23:39,840 --> 00:23:40,840 role. 304 00:23:40,840 --> 00:23:49,000 But I would argue that our tongue's function is, it's involved in every vital aspect of 305 00:23:49,000 --> 00:23:53,040 our survival and day-to-day life as a human being. 306 00:23:53,040 --> 00:23:58,920 Our tongue is composed of 16 muscles and the way that it functions impacts the way that 307 00:23:58,920 --> 00:24:04,760 we do and swallow and sleep, the way that we breathe, the way that we sleep, and in 308 00:24:04,760 --> 00:24:06,760 the way that our jaws develop. 309 00:24:06,760 --> 00:24:13,000 So there's a lot of ways that, you know, there's a lot of little clues that can tell us when 310 00:24:13,000 --> 00:24:17,880 the tongue doesn't have its full range of motion because it's not going to be able to 311 00:24:17,880 --> 00:24:23,280 do all of those jobs without compensating. 312 00:24:23,280 --> 00:24:30,600 So you know, if we start kind of early on in infancy or we think back to our child's 313 00:24:30,600 --> 00:24:37,400 infancy, there may have been some breastfeeding challenges, but not always. 314 00:24:37,400 --> 00:24:43,760 Sometimes kids get really good at compensating or sometimes maybe breastfeeding was not something 315 00:24:43,760 --> 00:24:45,640 that was a fit for our family. 316 00:24:45,640 --> 00:24:53,760 So there was bottle feeding and we weren't identifying the issues with the suck and swallow. 317 00:24:53,760 --> 00:24:58,640 But I know for my own child, I breastfed. 318 00:24:58,640 --> 00:25:03,720 It was something that, you know, I was determined to do, but it was never comfortable. 319 00:25:03,720 --> 00:25:06,560 There was pain with nursing. 320 00:25:06,560 --> 00:25:14,240 There was a lot of reflux, you know, frequent waking in the night that now I would attribute 321 00:25:14,240 --> 00:25:17,400 to it. 322 00:25:17,400 --> 00:25:23,280 And then, you know, sometimes we'll see, you know, in a little bit older, if we look into 323 00:25:23,280 --> 00:25:28,680 like our toddlers, did they have issues transitioning to solid foods? 324 00:25:28,680 --> 00:25:31,280 Did they have a really strong gag reflex? 325 00:25:31,280 --> 00:25:37,200 That could tell us that maybe their tongue wasn't very efficient at, you know, lateralizing 326 00:25:37,200 --> 00:25:45,280 the food and swallowing and it was presenting as, you know, difficulty transitioning or gagging. 327 00:25:45,280 --> 00:25:53,080 I've also seen children that will compensate for their tongue tie by oral habits like sucking 328 00:25:53,080 --> 00:25:55,080 their thumb. 329 00:25:55,080 --> 00:26:01,160 So we know that if the tongue isn't able to rest in the roof of the mouth, it's not stimulating 330 00:26:01,160 --> 00:26:02,160 the vagus nerve. 331 00:26:02,160 --> 00:26:07,200 There's some nerve endings in the roof of the mouth that help to regulate our nervous 332 00:26:07,200 --> 00:26:08,200 system. 333 00:26:08,200 --> 00:26:12,040 So some kids are really clever and they'll use their thumb. 334 00:26:12,040 --> 00:26:14,320 They'll suck their thumb. 335 00:26:14,320 --> 00:26:19,280 Sucking the thumb could also be helping them to open their airway when the tongue tie is 336 00:26:19,280 --> 00:26:23,960 holding their tongue partially in their airway. 337 00:26:23,960 --> 00:26:30,680 Now as they get older, so I kind of, I guess I kind of started with infancy. 338 00:26:30,680 --> 00:26:37,000 Sometimes we will see challenges with speech sounds, especially like the R's and the L's 339 00:26:37,000 --> 00:26:41,320 and the S's and the Z's. 340 00:26:41,320 --> 00:26:47,160 And again, it depends on how a child compensates with their tongue tie. 341 00:26:47,160 --> 00:26:54,680 So sometimes that's not something that's immediately something that we'll think about. 342 00:26:54,680 --> 00:26:59,840 And then when we look at sleep, so there's certain signs that our tongue isn't resting 343 00:26:59,840 --> 00:27:02,840 in the right place. 344 00:27:02,840 --> 00:27:06,760 And again, that could come down to a tongue tie. 345 00:27:06,760 --> 00:27:12,760 If we see a mouth breathing or hear snoring, that could tell us that something is narrowing 346 00:27:12,760 --> 00:27:13,760 the airway. 347 00:27:13,760 --> 00:27:17,600 That could potentially be a tongue tie. 348 00:27:17,600 --> 00:27:22,920 Teeth grinding, your teeth grinding a lot at night that we now know is a protective 349 00:27:22,920 --> 00:27:28,280 mechanism of our body to help us open the airway during sleep. 350 00:27:28,280 --> 00:27:33,480 And I do find that a lot of the children that are grinding their teeth will end up having 351 00:27:33,480 --> 00:27:40,920 this underlying tongue tie that was causing their tongue to obstruct the airway. 352 00:27:40,920 --> 00:27:49,280 So there's a lot of different things that we can look at that could give us some clues. 353 00:27:49,280 --> 00:27:55,680 And as an adult, if we were missed as a child and somehow we've gone through everyday life 354 00:27:55,680 --> 00:28:01,360 and everything is fine, but all of a sudden you start hearing these symptoms and you think 355 00:28:01,360 --> 00:28:03,720 I have that, I have that, I have that. 356 00:28:03,720 --> 00:28:07,440 Is it too late to have a tongue tie released as an adult? 357 00:28:07,440 --> 00:28:12,840 No, it's not too late as an adult to have a tongue tie release. 358 00:28:12,840 --> 00:28:20,960 I had a tongue tie release done in my twenties and it was life changing for me. 359 00:28:20,960 --> 00:28:27,400 So if you are an adult and you're realizing, oh my gosh, I'm a clincher, I'm a grinder, 360 00:28:27,400 --> 00:28:33,640 I've got all these sleep problems, it's worth consulting with a myofunctional therapist 361 00:28:33,640 --> 00:28:40,960 or an airway focused dentist to have a look and assess because it's never too late to 362 00:28:40,960 --> 00:28:48,040 get your tongue tie released and notice benefits from it. 363 00:28:48,040 --> 00:28:50,520 And I want to read this because I don't want to get this wrong. 364 00:28:50,520 --> 00:28:54,120 I saw this on your website, which I'll put the link for. 365 00:28:54,120 --> 00:29:01,400 You have a post and in there you say dysfunction of the muscles can be the root cause of many 366 00:29:01,400 --> 00:29:06,280 issues such as poor facial growth. 367 00:29:06,280 --> 00:29:10,880 So if you would just kind of elaborate to help us understand a little bit more about 368 00:29:10,880 --> 00:29:15,200 this, what dysfunction of the muscles are you talking about specifically? 369 00:29:15,200 --> 00:29:24,120 Yeah, so we talked about what's functional and what's normal when we're talking about 370 00:29:24,120 --> 00:29:25,760 like the oral facial muscles. 371 00:29:25,760 --> 00:29:31,280 So like I said, tongue up, lips closed, breathing through the nose. 372 00:29:31,280 --> 00:29:35,960 We also want to be swarming correctly with the tongue exerting upward pressure on the 373 00:29:35,960 --> 00:29:37,960 palate. 374 00:29:37,960 --> 00:29:41,680 Now what's dysfunctional is anything outside of that. 375 00:29:41,680 --> 00:29:47,800 So mouth breathing, for example, is dysfunctional. 376 00:29:47,800 --> 00:29:52,120 And when we're chronically mouth breathing, we're underusing the muscles of the face and 377 00:29:52,120 --> 00:29:53,120 the mouth. 378 00:29:53,120 --> 00:29:58,880 So we'll have some low muscle tone in the tongue and the muscles in the upper airway 379 00:29:58,880 --> 00:30:00,440 and the face. 380 00:30:00,440 --> 00:30:04,160 So low muscle tone is dysfunctional. 381 00:30:04,160 --> 00:30:09,440 We may have a dysfunctional swallow pattern because of that low tone or restriction of 382 00:30:09,440 --> 00:30:16,480 the tongue, which presents as a tongue thrust or a reverse swallow pattern. 383 00:30:16,480 --> 00:30:21,080 Having the tongue resting low in the mouth and not against the roof of the mouth, that's 384 00:30:21,080 --> 00:30:24,640 also dysfunctional. 385 00:30:24,640 --> 00:30:33,240 Now if the muscles of our face and our mouth are not working properly, that can result in 386 00:30:33,240 --> 00:30:35,240 poor facial growth. 387 00:30:35,240 --> 00:30:40,640 Because as I said, if the tongue isn't acting as that scaffolding in the roof of the mouth, 388 00:30:40,640 --> 00:30:48,600 we will experience, we won't experience our jaws growing to their full lunatic potential. 389 00:30:48,600 --> 00:30:55,600 And then the underdevelopment of the jaws can lead to all kinds of things like poor sleep, 390 00:30:55,600 --> 00:30:56,600 poor breathing. 391 00:30:56,600 --> 00:31:04,360 You're more likely to experience sinus issues because your nasal volume may be decreased. 392 00:31:04,360 --> 00:31:12,040 So there's a lot of things that can come back to poor facial growth and even before the 393 00:31:12,040 --> 00:31:15,720 poor facial growth, in the poor muscle function. 394 00:31:15,720 --> 00:31:16,720 Okay. 395 00:31:16,720 --> 00:31:19,720 All right. 396 00:31:19,720 --> 00:31:26,400 And another thing, you actually have one of my favorite quotes on your website by Maya 397 00:31:26,400 --> 00:31:27,400 Angelou. 398 00:31:27,400 --> 00:31:32,920 When you know better, you do better, which I think is a huge mantra for all of us now 399 00:31:32,920 --> 00:31:38,280 as we're starting to really understand what's going on and how we can impact it and how 400 00:31:38,280 --> 00:31:46,040 we can save the children of this generation so that they don't end up like us. 401 00:31:46,040 --> 00:31:53,480 How do you implement this in your own airway journey now and your own practice? 402 00:31:53,480 --> 00:31:56,920 So it's also one of my favorite quotes. 403 00:31:56,920 --> 00:32:03,720 And I say this to parents all the time, but I tell myself this too, because when I found 404 00:32:03,720 --> 00:32:07,800 out about all of this, I had a newborn and a toddler. 405 00:32:07,800 --> 00:32:13,360 And my toddler definitely went through more challenges because of that because I didn't 406 00:32:13,360 --> 00:32:16,720 know what I didn't know. 407 00:32:16,720 --> 00:32:22,800 So I just kind of use this to encourage parents and adults who are going through this journey 408 00:32:22,800 --> 00:32:33,200 that it doesn't matter what you did in the past or what maybe negative habits that you 409 00:32:33,200 --> 00:32:37,960 may have had in the past or things that didn't support your child's journey. 410 00:32:37,960 --> 00:32:45,040 We need to start where we're at and not be hard on ourselves and just move forward and 411 00:32:45,040 --> 00:32:49,520 then continue to share this information with other people so that they can start the journey 412 00:32:49,520 --> 00:32:51,960 earlier too. 413 00:32:51,960 --> 00:32:58,680 So for myself as an adult, it is a little bit more of a challenging journey than it 414 00:32:58,680 --> 00:33:00,800 is for kids. 415 00:33:00,800 --> 00:33:03,640 Because in kids, we can work with their growth patterns. 416 00:33:03,640 --> 00:33:08,560 It's easier for us to get structural changes in children and they just adapt so much more 417 00:33:08,560 --> 00:33:10,200 quickly. 418 00:33:10,200 --> 00:33:15,400 For myself as an adult, I mean, I've done the myofunctional therapy. 419 00:33:15,400 --> 00:33:17,800 I do all the nasal hygiene. 420 00:33:17,800 --> 00:33:20,800 I've had my tongue tie released. 421 00:33:20,800 --> 00:33:25,080 But I know that my jaws are still too narrow. 422 00:33:25,080 --> 00:33:29,720 And that's kind of eventually going to be the next thing. 423 00:33:29,720 --> 00:33:36,240 But I try not to be too hard on myself for what I didn't know before and just trying 424 00:33:36,240 --> 00:33:38,360 to manage my hygiene control now. 425 00:33:38,360 --> 00:33:42,720 And I think that's a great way to approach it 100%. 426 00:33:42,720 --> 00:33:47,240 So typically at the end of every episode, I like to turn the floor back over to our 427 00:33:47,240 --> 00:33:51,520 guests because you guys are the experts. 428 00:33:51,520 --> 00:33:57,080 What is a final thought that you would like to leave with our parents or any medical professionals 429 00:33:57,080 --> 00:33:59,600 in our audience? 430 00:33:59,600 --> 00:34:07,880 I think for parents, the best advice that I can give is that you don't have to go out 431 00:34:07,880 --> 00:34:17,640 it alone when you learn all of this information, try to align yourself or partner up with a 432 00:34:17,640 --> 00:34:24,000 myofunctional therapist or an airway focused dentist that have dedicated all of this time 433 00:34:24,000 --> 00:34:26,240 to learning. 434 00:34:26,240 --> 00:34:31,960 Because even for us, it takes a long time to get comfortable with this information and 435 00:34:31,960 --> 00:34:38,720 change our mindset around airway health and myofunctional therapy and all of that. 436 00:34:38,720 --> 00:34:45,760 So there are a lot of people out there like myself that have devoted so much time to learning 437 00:34:45,760 --> 00:34:51,640 and building networks that you don't have to be by yourself in it. 438 00:34:51,640 --> 00:34:58,640 If you find somebody to work with and consult with, there is a lot of help out there. 439 00:34:58,640 --> 00:35:02,480 You just need to find the right people. 440 00:35:02,480 --> 00:35:08,720 And then for the dental, medical professionals that may be listening or just getting started 441 00:35:08,720 --> 00:35:19,320 into all of this, I think it's such an important thing to learn about. 442 00:35:19,320 --> 00:35:25,640 Once you discover this whole other world of airway stuff, you feel like a beginner again 443 00:35:25,640 --> 00:35:29,960 and it takes time to put all of the pieces together. 444 00:35:29,960 --> 00:35:36,120 So again, finding mentorship was a huge thing for me. 445 00:35:36,120 --> 00:35:42,920 And just always going back to community because that's what's going to help you to connect 446 00:35:42,920 --> 00:35:49,360 the dots and see the life changing results in your patients that just are going to be 447 00:35:49,360 --> 00:35:55,880 so much more fulfilling than constantly putting, you know, band-aids on symptoms. 448 00:35:55,880 --> 00:35:56,880 Agreed. 449 00:35:56,880 --> 00:36:01,720 Thank you so much for being on today, Courtney, and sharing all of this amazing information. 450 00:36:01,720 --> 00:36:03,640 I appreciate it. 451 00:36:03,640 --> 00:36:05,640 Thank you so much for having me. 452 00:36:05,640 --> 00:36:07,440 It's been great chatting. 453 00:36:07,440 --> 00:36:10,880 Thank you. 454 00:36:10,880 --> 00:36:15,760 Thanks again to today's guest, Courtney Robertson, for sharing her medical insight and to each 455 00:36:15,760 --> 00:36:19,440 of you for listening to today's episode. 456 00:36:19,440 --> 00:36:22,600 If you're new to our podcast, please don't forget to subscribe. 457 00:36:22,600 --> 00:36:26,720 And if you enjoyed today's episode, leave us a review or comment telling us about what 458 00:36:26,720 --> 00:36:29,240 you enjoyed the most. 459 00:36:29,240 --> 00:36:33,120 You can stay connected with the Children's Airway First Foundation by following us on 460 00:36:33,120 --> 00:36:38,720 Instagram, Facebook, X, LinkedIn, and YouTube. 461 00:36:38,720 --> 00:36:44,960 Parents can also join us via our Facebook support group, the Airway Huddle app. 462 00:36:44,960 --> 00:36:54,240 You can find tons of great content for parents and medical professionals on our Parents Portal 463 00:36:54,240 --> 00:37:00,280 and Clinicians Corner on our website at childrensairwayfirst.org. 464 00:37:00,280 --> 00:37:04,440 If you'd like to be a guest or have an idea for an upcoming episode, shoot us a note via 465 00:37:04,440 --> 00:37:12,960 the contact page on our website or send us an email directly at infoadchildrensairwayfirst.org. 466 00:37:12,960 --> 00:37:17,560 And finally, thanks to all the parents and medical professionals out there that are working 467 00:37:17,560 --> 00:37:21,880 to help make the lives of kids around the globe just a little bit better. 468 00:37:21,880 --> 00:37:43,800 Take care, stay safe, and happy breathing everyone.