Hi everyone, and welcome to another video.
Hi everyone, and welcome back to Airway First, the podcast from the Children's Airway First Foundation.
I'm your host, Rebecca St. James.
My guest today is Kelly Rubio, an Arizona native and U.S. Army veteran with a heartfelt commitment to pediatric care since 1996.
From her two locations in the Phoenix Valley, she works with patients both in-person as well as via telehealth.
As a licensed dental hygienist, she specializes in myofunctional therapy and as a certified botego breathing practitioner.
Kelly stays at the forefront of her field through ongoing training, holding a qualification in oral facial myology.
What sets Kelly apart is not just her expertise, but also the genuine connection she forms with each of her patients.
Her passion for oral facial myology is driven by the meaningful relationship she's built along the way.
You can find out more about Kelly at MyMyOMyHealth.com.
And now let's jump into today's episode with Kelly Rubio.
All righty, thank you so much for joining me today, Kelly. I appreciate it so much.
Thanks for having me.
Absolutely.
So before we get started, I would like to just start from a place that kind of levels setting.
If you wouldn't mind just sharing a little bit about your own airway journey and how you landed where you are now.
Well, anybody that follows me knows kind of where I come from and why I'm here and my purpose.
But for those who don't know me, I am a licensed dental hygienist and have focused specifically working in high volume pediatric practices for over 20 years in dentistry.
And so you see, you know, 50 to 100 patients a day, and you're seeing lots of mouths and you're seeing lots of oral defensiveness.
And over the years, I was noticing mouths were getting smaller, tonsils were getting bigger, dark circles under the eyes were becoming more of the norm.
Behavioral issues and we're having to modify behavior and pediatric dentistry. It's kind of like psychology and dental interventions at the same time when you're working with Pete.
So I noticed that that was a characteristic. And so I had an experience with my nephew where I witnessed apnoic events.
And that kind of got me alarmed and why, why is he, you know, stopping breathing in his sleep, why is his lips turning blue. And then it lead me into a rabbit hole of researching and talking to my boss at the time about, you know, what, what we could do, what we could look for.
And then I searched and this term came up called myofunctional therapy. And I noticed that there was several offerings for courses and that my licensure would allow me to sit in and have this additional training.
And that in the course, it was just light bulbs and fireworks and oh my gosh, this is me, this is my family, you know, I had a brother that died of SIDS and I witnessed that and, you know, all of the things I have brothers that struggle severely with sleep and addiction and mental health and all the things
that my kids couldn't breastfeed. I struggled my whole life with sleep, breathing disorder, anxiety, I had no surgery, I had tonsils out, you name it. And so, you know, my experiences are heavy and I wear them and that's how I see and those are my lenses that I see our patients through.
And so, I want to be that person that's advocating for you for your family I don't want anybody to be the mom that, you know, I felt like helpless and couldn't breastfeed and didn't have the support.
And that child that's growing up anxious and nightmares every night and being scared and shy and, you know, you name it so that's why I'm here, and that's my purpose and I feel like this is my calling and so I left clinical dentistry, and probably five years
and just solely dedicate myself to opening this practice because there wasn't a lot of those in the Valley and now it's like it's really blown up where Phoenix has grown incredibly. And so we have seen a big shift in those providers that are focused more on
the way and it makes me so happy that we have support out here and I have referring providers to refer to and it's just been such a shift in the last five years and so our practice also incorporates different scopes and different lenses so occupational
practice and speech therapist and dental professionals so we all come together to look at these individuals through different lenses but also through a foundation of that functional and airway lens.
I love that and I love the cross functional we are such huge advocates for that and I love seeing it in action.
Yeah, it's.
Yeah, I was just going to say it's definitely become where you see the pivotal points and some practices are solely focusing on what they can do.
And you know nobody else can join in and it's disheartening so that's another point of view is we definitely want to work more together and collaborate more as a unit because at the end of the day we're all here to help people.
Absolutely.
That's that's exactly what it is.
Yeah.
And I'm going to just kind of let parents know before we really dig in here there are a couple of videos that they really struck me when I saw you in them so I will be putting those links in the podcast notes and encouraging parents to check those out so
you know over over the last couple of years we've talked to quite a few myofunctional therapists and I think for the most part parents really understand what the goal is you know what you do what treatments are offered so we're not going to focus a lot on that today I'll put some links to some of the
more popular ones in our notes with you because of the things I've heard I would really like to focus a lot on mental health and children and how sleep and breathing play a role in.
Yeah, yeah it's what the more and more I find the connections between sleep, breathing, and how well our brain works and how well we respond to the world is astounding that this isn't part of risk assessments and well checks and exams especially with what's going on in the world
right now we're seeing a huge problem for lack of a better term and caring for these people that need more support and are struggling a lot with mental health and it doesn't just start when we become an adult and get our first job.
It starts when we're young and we're sitting in kindergarten class and we're shy and we're anxious because we're not getting a lot of sleep at night, and we're not able to sit and focus and we're not able to sit and read and focus on the connection with our brains and learning because our brain isn't getting
what it needs night after night. And then, you know, I feel like there's a lot of propensity to push these kids into looking into stimulants and being diagnosed with ADHD and there's a lot of teachers that I love teachers and a lot of my family members my sister is a teacher
but it shouldn't be a diagnosis from education professional and you know there's there's so many different needs for so many different kids but if you look at the foundation of it is how is our brain reacting to our breath that we're taking in and out and how is our brain reacting to the quality of sleep that we got the previous night.
Right. So when we're seeing these kids present with these issues with the, you know, inattention and focus issues and memory issues and, you know, emotional regulation.
There definitely needs to be a conversation about what referrals to put in place. And in my research, seeing that there has been something in place for pediatric well exams but there's, you know, I can link it here to if people are interested but there is.
Probably, there was a big, a big article about pediatricians and, you know, needing to screen for sleep disorder breathing and using snoring as a diagnostic marker. And in about 1000 of those surveyed from 1000 electric,
electronic medical record charts, only a third of those were asked or screened for sleep concerns at the well checks. No, it's a standardization through American Academy of Pediatrics.
So, you know, if 1000 kids are coming in and only a third of them are getting asked what their sleep quality looks like, we're missing a ton of kids and this isn't, you know, this is 1000 charts.
So how many kids are we really missing out on.
And really what this article and this research is showing that the pediatricians don't find that there's enough time, and they don't have enough tools to know what the next step is in the referral process or what to do about it.
So, you know, that alone is saying a lot. And I know that's a big hurdle for a lot of professionals is what's the process because there is no protocol.
Right. Right. And that's what I was going to ask about is there are so many, you know, because you and I know because we're in this field, so many conferences and webinars around, you know, we work with Airway Health Solutions and they have training.
Yeah.
But these are for dental providers and pediatricians and my own functional therapist that are already out there.
Right.
And we still have to pull in the hygienists and and honestly, you do have to educate the teachers and the educators because they're on the front lines with these children and we have to tackle parents and that's the part we work on.
How are we missing this though in the medical realm if all of this is out there and the science is not new.
How are we missing it? That's a great question. I think we all ask that. I don't think we really know exactly what the answer is, but my in my opinion and this is my opinion is, you know, we all have experienced, you know, the short changes in medical in the medical world.
We've all been in that exam room where we're waiting two hours for a doctor. We've all been, you know, mishandled in regards to like referring and the referral process and billing like we've seen it. We've all experienced it.
And so that's the spillover. That's the spillover that continuity of care. And so where I feel that there's some value in is, is really these, these parents are amazing and you know this, you know, putting all this information out this out for the parents.
And they're hungry for this information.
Absolutely, because they know parents when something's wrong with their kid, they will travel the world and back to find out answers to help their children. And so absolutely, the more advocacy that we have, the more that questions get answered, the more education we put out there for them, like this organization, which I applaud you guys is that's where we're going to have more standardization and integrating more in that medical and dental model of protocols
and risk assessments because we're asking for that. And I think there needs to be more advocacy for sure.
The other thing that I can see is, you know, we, looking at the, the model of education with these, you know, pediatric residents and dentistry and in medicine.
There is a lot of discussion on, on sleep. I don't think there's specific training and not to my knowledge. If anybody else knows if this is actually discussed in, in school or the training or the education, I know they talk about tonsillin, adenoid enlargement being
causation and a huge risk factor for sleep disorder breathing. But then if you look more at the research, it's not effective in stopping sleep apnea or improving sleep quality greatly. It's, I want to say 69 to 70%. It doesn't, it doesn't have that response that the surgery is wanting to do.
I am a product of that. I had that surgery when I was little and I don't remember my sleep ever getting better. So, you know, there's a lot to say with that and that's, if that's been the answer for the referring, the referring protocol when a child comes in and the parents
are talking about their sleep. It's, it's not the right model. So what can we do to educate these dental and medical practices and when I go out and I encourage every medical and dental professional that wants to know about airway and sleep, find a
dental therapist in your area and I hate to say that because that's what I represent but honestly we do so much above and beyond in regards to researching and finding out more information and then being almost like a tour guide of what needs to happen next and who to connect with.
And because a lot of us don't have that, you know, insurance model and that medical model, we are spending a lot of hours with the boots on the ground and calling offices and inviting ourselves in to educate these, these offices about what it looks like for airway and sleep
and everything disorders so that would be awesome if you're if you're wanting to know more connect to the myofunctional therapist or somebody in airway dentist or somebody that's willing to because we love talking about this to come into your office and educate you on what you can do to help your patients and support your patients.
Yeah, and I love the way that you called it a tour guide I've also heard that you know, the other one that I liked is you really are the lunchpin because the if you just put a pin in you it goes off to everyone you're the one that connects everybody.
There's not a lot of myofunctional therapist I know it's still up and coming in. Not everybody can I've heard you you speak to this not everybody can train to become a myofunctional therapist so just take a step for it's kind of a side step but yeah who qualifies to even go through this training.
So it's important to say that there's no exact organization that's that's in charge of organizing and reigning us in if you will. So, there's there's lots of offerings and training and even more so now.
And my avenue that I took was through the international organization of oral facial myology the I am. And under that organization. At the time I took my course was licensed dental hygienists and speech language pathologist I know they have opened it up to also some acceptance of pts and ot's which I feel that's super valuable because
the more eyes the better these pts pts are seeing this in action they're seeing this every day they're treating people with TMD they're treating kids with sensory concerns and feeding concerns so I think it's super valuable to have them also learn about airway and oral
function and oral facial function. There are some other course courses that you can take through different organizations I mean there's so many out there I really can't keep track of yeah yeah and so I would love to see more organization within the field and you know more standardization.
Music
You're listening to airway first with today's guest Kelly Rubio.
You can find out more about the Children's Airway First Foundation and our mission to fix before six on our website at children's airwayfirst.org. The CAF website offers tons of great resources for both parents and medical professionals.
Visit our parents portal, clinicians corner, resource center and video library to see for yourself. We also encourage parents to join the airway huddle our Facebook support group which was created for parents of children with airway and sleep related issues.
You can access the airway huddle support group at facebook.com backslash groups backslash airway huddle. 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 today's episode.
That would be great.
I want to come back a little bit because we talked before we started taping we were talking a little bit about mental health.
We both have had our own journey with that. We both have had our own airway journey and we've had it as parents.
Before we really get into this, this is the point where I will tell parents just take that mom guilt. Let's just put it to the side. Check it.
You don't know what you didn't know. You did the best you could. Here's where we are now. Let's move forward.
Because we all wrestle with it once we find all this out.
It's really digging into mental health. It's surprising for a lot of parents to realize sleep and airway can really impact these littles when they're teeny teeny.
As a parent, what are you looking for outside of just snoring? What are some of the other signs? What's the right way?
What's the right discussion that opens it in a productive way?
I think when you're talking about younger kids, you definitely want to keep an eye on anything that's out of the norm. When I say that, that's a broad term.
But moms and parents know their child and they know what's normal for their child and they know what's... This doesn't feel right.
When you have a kid that's becoming more dysregulated throughout the day. For example, they are becoming more angry or they're becoming more physical with their siblings or peers.
There's more outbursts, more outbreaks, more breakdowns. We've all had that toddler who throws themselves on the floor because they didn't get the candy and the candy out at the grocery store.
But is that happening more and more and more? Are you having a hard time calming them down when you go to do homework after school?
Or is it more frequent than not where we're not able to get through a homework session without a complete fight? Do you dread doing that?
Does your child dread doing their homework? Is your child dread going to school? So those are all things that you want to look into.
Are they isolating themselves? Are they anxious? I spoke a little bit with you about my family history and I remember my brother would throw up every morning before school.
He has sleep breathing disorder and so anxiety, emotional dysregulation, more frequent breakdowns, tantrums. I see it more like 4 or 5.
4 or 5, 6 is where I see...
Because when it starts?
When I talk to parents, that's kind of like the collective age that I'm hearing. I've noticed it happening more at those ages. I just had an adult client in last week and she said that when she was younger, she was brought to psychiatrist after psychiatrist about possibly having schizophrenia.
And because she had such a swing in her moods and behaviors and focusing, then that makes me super sad because think of the medication that they use to regulate that.
And I mean, that's the question, the next question the physicians should ask is, what does this child's sleep quality look like? And so as a parent, when you bring your child in, if your first course of action is to bring them into the pediatrician, like I said, they should be asking about the sleep.
And they're mostly what their protocol is, is ask about snoring and mouth open posture. So definitely discuss that with your pediatrician and then ask for a referral.
And that referral could look like seeing an ear, nose and throat doctor. It could look like seeing an allergist because we have to make sure that the way that they get oxygen to the brain is open and available and ready to do so.
Sure, that makes sense.
That's the anatomy of the nose, the pathology and the structure supporting that. So if your course of action isn't going to lead you pediatrician to ear, nose and throat doctor, then it's best to search for a dentist in your area that is, that's a pediatric dentist or an airway trained dentist that can help guide you and kind of point you in the
direction of what routes and what steps you can take. And then like I said, going back to oral facial myologist or myofunctional therapist, there's a lot that you can consult with over even virtually if you don't have close access to care.
So that therapist can do some research or get with colleagues that are in different locations and try to put a team together for you and your family to really get down to the root cause of what's going on.
And that, you just totally set up transition perfectly there. That's really what we're talking about too is get to the root cause because so much of medicine and again, not their fault.
Right.
And the doctors too, right? They were taught what they were taught and they're doing the best they can, but it's all reactionary. It's what we see this. Let's treat this symptom and treat this symptom and really it's this paradigm shift that we need to have of let's talk about the root cause.
Why are you having that symptom? Let's back all the way up and see what it is. Yeah. How do we change that mindset?
Well, I think I, this is a plug for Peter Atea's book outlive and I just listened to that and it's great and I follow him and he's got a lot of great points and he looks at medicine differently.
And he's a doctor that specializes in longevity. And he talks a lot about medicine 2.0, which is the traditional model what we're seeing and what medicine 3.0 could look like is more of a prevention model.
And so that's interesting to me because in dentistry, we're all about prevention. And when there's that crossover in medicine, I think there's a lot to learn from each other.
And so us advocating as a whole as a group in the public setting as parents, as family members, and asking, well, why does my child, you know, asking your provider that question will get them to think about it and we'll get them to research it and we'll get them
to find out how can I provide these answers and a treatment protocol for these families and patients. And so it goes back to saying like we're going to have to make some noise about what we want and what we're needing to get back down to is root cause.
This root cause treatment and not just putting band-aids or treating the problems that we're seeing. And so advocating, advocating, advocating. And once again, if more of us can get into these offices, and you know, we also have to tread lightly, because if they're not willing to hear it, they're not willing to hear it,
but it's not going away. It's definitely going to be talked more and more about and we're seeing more mouth tape on the market and you know, it's the and the straw that strengthens your tongue. So there's more of that awareness in our general population now more so than there's ever been.
So there we're going to kind of infiltrate these providers with, hey, we need to find out a little bit more of the why. So let's do it.
Yeah. Yeah. And we call it arming the the airway mama bears to give them the information and let them go ask questions. And, you know, we just have to push it through. So, you know, when it when it comes to this transition, you know, where do you see
it for lack of a better, I don't know what to label it airway and sleep medicine. Where do you see it in the next 1020 years just because the changes we've made the last five.
We love to see a model where dentistry and medicine crossover in regards to airway support. And so pediatricians and dentists are local. And a lot of them are I know working in a pediatric office we had pediatric pediatric offices that we worked with a lot and we worked with their staff so if we're,
we're co treating these families, you know, for lack of a better word co treating them meaning pediatrician sees them in office for concern say a two year old mouth opens, snoring at night, hot and sweaty all night, waking up multiple times.
And lots of tantrums lots of meltdowns all of the things and parents go to pediatrician pediatrician has somebody local that they know they can connect with and say, I don't know all the things but everything you're saying is checking off some alarms to me that we should
take care of the people or this more, and then making sure that this child has that dental home. And the dental home has risk assessment tools that they're looking at in regards to the structure of this child's mouth, the proximity of the primary teeth.
And, you know, they can also look at the oral structures with a visual exam, and see if there's enlargement in the tonsils much, I think much better than no no shade to pediatricians but we know how to get in the mouth and we know how to get in the mouth and getting out.
You know, looking at tonsils looking up the nose can we see inflammation swelling of the turbinate tissue. Are we seeing Venus pulling our dark circles under the eyes and the crossover of using more support to get more answers and then having that protocol that referral in place in that process.
Yeah, that's fabulous and kind of to your point it's when you everybody has their lane they have their expertise and we're not saying, you know, don't get out of your lane.
Right. That is your expertise but we're seeing is is their way you can put the lanes together so we're driving stronger together in the same direction.
And support support.
Yeah, which when you're when you're in, you know, healthcare and you're a provider and you are kind of on your own. That's that's that's something that kind of weighs heavily on that provider to do.
Sure.
And you have support and you have somebody you can call and somebody you can bounce things off with the more eyes the more brains, the better for everybody. Yeah, absolutely. And for any of our providers that are listening and I'm also going to put links to two conferences in particular for
2024 that you may want to check out that actually there's three because they is all about collaboration. Yeah, you know, there's the airway Palooza.
And then there's the CDC sleep conference and then of course collaboration here. So those are all ones that we highly recommend and promote. And again, like you said, it's all about collaboration.
Because then you can better support the child.
And those conferences are great. And when you go and you're sitting next to PTs and dentists and physicians and chiropractors, like, you feel like, Oh, I do have support. I'm not alone on this little island out here, you know, promoting health wellness root cause airway.
And so, you know, that's it's a it's a good place to go to really give yourself that almost that recognition that you need you need to have that motivation if you will, like, because it's it's a field.
It's a lot. Not a lot of people know, you know, that what's it called the water cooler talk of of my own airway.
Right, right, right. But we're working on it. We're trying. Yeah, we're trying. Absolutely.
So at the end of every podcast, I always like to hand it back over to our guests because, you know, y'all are the experts and and give you the final thought or message or take away for our parent audience.
So I would definitely want to empower our families and our parents by advocating for themselves and their kids. And also as a mom that struggled extremely with my mental health after I had kids and before.
Don't be afraid to ask for help and don't be afraid to ask for help for yourself.
Oh, yeah. When you're when you have littles of that art sleeping, you're not sleeping either. Your hormones are going to be in balance. You just had a baby or you know, you're you're kind of getting yourself back.
You're still breastfeeding. So give yourself that support that you need to be in the right place to make those decisions for your family or your kids.
So that's my my biggest takeaway is mom support yourself, love yourself, give yourself what you need. And then be an advocate for your kids, which I know you will be, but don't stop asking those great questions and don't stop asking the why and getting to the root cause.
That was just so well said and thank you for saying that because as moms, we forget it's not a martyr thing. You just forget you get so focused.
And you need to have that you need I always tell like I'm going to give you permission. It's okay. Like you kind of have to hear you know it intellectually, but you kind of have to hear it.
It's like, give me permission. Give me permission.
Yep. Yeah, absolutely. Thank you so much.
Of course, of course.
Thanks again to today's guests Kelly Rubio for spending time with us on the podcast and to each of you for listening to today's episode.
You can stay connected with Children's Airway First Foundation by following us on Instagram, Facebook, X, LinkedIn, and YouTube.
Don't forget to subscribe to the Airway First podcast on your favorite podcasting platform so you won't miss an upcoming episode.
If you'd like to be a guest or have an idea for an upcoming show, shoot us a note via the contacts page on our website or send us an email directly at infoatchildrensairwayfirst.org.
Today's episode was written and directed by Rebecca St. James, video editing and promotion by Ryan Drawn and guest outreach by Christy Bochinkian.
Finally, thanks to all the parents and medical professionals out there that are working hard to help make the lives of kids around the globe just a little bit better.
Take care, stay safe, and happy breathing everyone.