S8_E76 DR Hilary Pada Transcript



Rebekah: [00:00:00] Awesome. Thank you so much for joining me this afternoon, Hillary. I appreciate you being here.  

Hilary: Thank you for having me. I appreciate being asked to be here.  

Rebekah: Of course, of course. And before we dig in, because I'll just tell parents now, we have a lot to talk about. This is, I'm really excited about this conversation. 

We were talking a little bit beforehand and I'd like to dig back into that painting behind you.  

Hilary: Ah, but it's just,  

Rebekah: it is wicked cool. I love that .  

Hilary: It is cool, isn't it? I know. Yeah. I fell in love with this painting at a coffee shop in Vancouver about four hours away from where I live. I was down with my daughter and a friend, going to a show at the Queen Elizabeth Theater, and we'd gone to a coffee shop and this guy had mm-Hmm. 

Taking his x rays from his different body parts and had kind of day of the dead painted them up and his way of kind of working with where his health was at. and,we ended up while I'm at the Queen Elizabeth theater in this awesome presentation, I'm negotiating purchasing with him this whole time [00:01:00] because we're going to be leaving town after the show. 

So, what's. Very important about this as well as it being dental x rays and kind of funky and colorful and beautiful is that it was missing a pre molar. So a pre molar, these are your pre molars. These are your molars. This premolar was actually missing, and the guy, part of his grief with this was that he was missing that tooth. 

He's also really worn his teeth down.  

there's probably a reason why that tooth had fractured and then had to be removed. But, yeah, I loved it so much, and it was just such a beautiful piece, and so he and I figured out a way for me to keep it. Get it from him, purchase it and an agreeable price. 

And then when I brought it back home, a long time, I wanted to have this happen, but my daughter ended up painting back in this premolar and doing her own cool,designs on it. And so like many of the providers that you've talked to on this airway [00:02:00] podcast, like our focus is on growing. the jaws to fit the teeth, right? 

And so, although this person did not have the space for it, our goal is to keep remolars and to keep teeth in the jaws. So I just thought it was a really great metaphor too, for this work is the like, yeah. So thank you. I just  

Rebekah: think that's, yeah, I just think that is really, really cool. And I love the story. 

It really speaks to me. it makes sense why it found you, the art found you. There was a reason.  

Hilary: Yeah, totally. Yeah. I love that. Harry Potter book four with the Vancouver symphony. They were doing like the symphonic,whatever it's called, like when they have the copy of how the symphony is played throughout the movie and yeah, that's the movie. 

And I was so awesome. So I  

Rebekah: love this kind of thing. They're fun. They're fun. Yeah. Yeah. Okay. So now that we know about the cool painting. and, it was important and listeners probably going, what are they doing? It actually speaks to you and a lot of things we're going to talk [00:03:00] about, which is another reason I just really wanted to bring it up. 

It was so appropriate. So let's start our conversation by talking about your personal journey into oral myofunctional cranial guided dental care and airway and leadership. So where did this start for you and, who inspired you to get you toward the path you're on now?  

Hilary: Yeah, 

my first exposure to this work happened. So I had practiced general dentistry for about 20 years and was leaving general practice for a couple of reasons. 1 is I had been in a car accident. I had a lot of, sort of chronic pain associated with the postures of dentistry. It was the right timing in terms of practice. 

Um,practice timing to transition to work that I had been doing at BC Cancer. So I've been working as a dentist at BC Cancer as a consultant for 25 years. And I thought, I'm going to go there, expand the scope of care that we provide, [00:04:00] and just really kind of settle into, Less intense of a business like practice life and focus on care at BC Cancer. 

And so I had already registered. I, a lot of my career has been spent with the Coyce Centre in Seattle, which is an incredible place for postgraduate. You've interviewed previous Coyce graduates and mentors in Seattle. That's been a really big home for me, dentally, personally, professionally, and, I was signed up for Dr. 

Doug Thompson, in 2018, had started, teaching the first wellness week, which was integrative oral medicine and, It was a pretty mind blowing week. It was five days. They did our, we were doing continuous like glucose monitoring throughout the day. We were learning aboutsymptoms and signs in the body of systemic health that are connected to oral health. 

Many of those have become normalized now over the past, five days. six years. So it wouldn't be a [00:05:00] surprise for people to understand that inflammation in the mouth isn't, indicates inflammation in the body. We know the connection of our microbiome in the mouth and our nasal passages to our digestive tract. 

So those things were kind of new in 2018 and it was kind of right now they've become almost normal. and But what was mind blowing at the time was how much information he was giving to us and how beautifully he taught. And, on the, like the last day of five days, and I, I was kind of thinking, I was looking at how I'd bring this into the cancer agency. 

would I be looking at microbiome and restoration of microbiome in patients who've gone through a lot of cancer care? Would I be,I wasn't totally sure and I started really thinking about the, the impact of dry mouth, from cancer therapies. And so my focus was kind of like in that. 

And then last day of the course, the fifth day, your mind's almost full and this It's part comes in about my oral myofunctional therapy and there's a condition in dentistry [00:06:00] called a class two where the upper jaw is further ahead of the bottom jaw. And I could even show you a model because I have it right here, my daughter. 

So the upper jaw is ahead of the bottom jaw. And what we learn in dentistry is when you see this, you're going to need ortho, right? Small job, wait till all the, wait till all the baby teeth fall out and then start doing braces. Maybe they'll need surgery to bring the jaw forward in the, in the future. 

What he starts showing is these pictures of these class twos. are growing and breathing and learning to swallow differently, having releases of tethered oral tissues. And they're, not there, they grow into normal conditions. So I have my youngest daughter, Pooh, This is her, this is what she looked like. 

And so I'm in this situation where I'd been waiting and waiting, but I'd finally convinced a colleague to put braces on her. And I was [00:07:00] like, let's just get going. Cause she's having all these problems breathing. She was,we're a pretty active family. She was cross country skiing and she was starting to need to use an inhaler. 

she'd had, if I back up, she was always, she had all kinds of little problems from birth. She was more of a struggle to breastfeed. She was way more upset. She had colic. She would, we had like croup with her where, there's a couple of times where we're like, we need to go to the hospital, we go outside. 

And then as soon as she got in the cold air, her breathing would settle and be like, okay, we Maybe she's okay. And then, just sort of all these little things and, her little, her little butt crack was crooked. Like when I was like, Oh, that's so cute. I had no idea that the pelvis was crooked. 

And so, yeah, so anyways, fast forward to,on one day on Terry Fox day, she ended up having such a breathing attack. We ended up going to the hospital. They put her on a big, cute little puffer with a teddy bear on it and whatever for kids. But she's, I was like, Oh [00:08:00] my gosh, I have a child that's going to need an inhaler now. 

I wouldn't have imagined. And so she moved through athletics. We kept kind of like. Yeah, having inhaler dealing with it and trying and so, she became really involved with cross country skiing at a pretty high level and it was to the point where she couldn't even practice without you needing an inhaler, let alone, race. 

And, so. She was in these braces and, but I talked to my colleague in three months before I went to this course. I talked to my colleague into getting braces on. One thing that had happened, which I did not even clue into, was that a little spot became painful for her behind her two top front teeth. 

It's common in dentistry to have what we call popcorn emergencies. So somebody has popcorn, approximately two weeks later, when one of those husks that's exactly the shape of a tooth gets underneath, sticks under the gums, gets jammed, [00:09:00] and it can be really painful. So I was like, oh, she must have some sticks. 

Gotta be a popcorn emergency, right? it's this big Thing that was sore and looked like almost necrotic. And I knew nothing about lip ties, tongue ties, tethered oral tissues, restrictions, like that was all for me, the realm of a periodontist or. Some like it wasn't even things that we were talking about. 

There was nothing we learned about in school It was just like so anyway what had happened. I brought her in the Clinton into my clinic She had these braces on and I checked for popcorn couldn't find anything went in to freeze it up thinking it's got to be deeper like I couldn't because it was brown and dying and Puffed up and she was in so much pain because that's a very painful place to free. 

Yeah I There's nothing underneath it. Sodidn't really know what to do. It went away. I'm at this course learning about the possibility [00:10:00] that breathing, tethered oral tissues, class two occlusions could actually be managed at an earlier age.and they show these cases growing. And I'm thinking I've put my daughter in braces. 

And I just think that perhaps that was. her papilla, like her midline of her upper lip, actually the teeth were brought together where she had this spacing, the teeth were brought together across this and it got crushed. The papilla and the frenum was so strong, it actually got crushed and was necrosing and dying. 

And that's what black and purple was. And so I'm starting to think all of these things that I'm learning during this course are things that she's struggled with. 

The interesting thing was I had the same setup. I had a class to occlusion. My teeth stuck out. I had braces, headgear. I had bed [00:11:00] wet till I was eight years old. I had all kinds of sleep issues, anxiety, sleepwalking, sleep talking. Wow.  

Rebekah: You had all the signs.  

Hilary: Oh, I had it all. Holy  

Rebekah: smokes.  

Hilary: My mom actually did some little like hypnosis move with someone when I was about eight where they worked with pressure points in my hand to stop me from bedwetting and that to teach me to get up and go to the bathroom at night. 

yeah, troubles breathing, all of it, narrow jaw. And I diligently wore my headgear and I, so anyways, I just thought it was a genetic inevitability that my daughter was going to get it. Needing braces and I just wanted them to start as soon as possible because I was starting to hear inklings from other courses about getting started sooner, but I didn't know what that meant by getting started sooner. 

I thought that was just get started sooner with what we know. So, I'm sitting with a colleague from Europe at this course. And on the break I said to him, I'm like, have you heard anything about this? Like this, like I've just put my daughter, I'm showing him these pictures. I'm like, I just put my [00:12:00] daughter into braces and I'm like, I feel like now she maybe could have grown and he's looking at me like, and you have a license to print and like, you don't know anything, what are they teaching you in Canada? 

Well, no, I like, that's the thing. We  

Rebekah: have heard that from some of the biggest names in the world that y'all just weren't taught this. So, I mean, everyone is kind of having these moments. Yes,  

Hilary: and then he's I have an entire floor in my clinic. That'sdesignated to this kind of work. 

You should come and visit. So I'm like, okay, so I don't want to visit him and fear and then I just started going. Okay. So then also what happened is, I was working out of A lab of a totally dear and respected, friends and colleagues that wanted to have a dental clinic inside their lab. And so we were like, okay, maybe between the cancer agency and this, I can be doing something that's, helpful for the lab and then have a space to do some clinical [00:13:00] work with them. 

And then COVID hit and The whole, all the regulations of kind of non dental, like, how do you work having patients seen in a clinic that isn't owned by a dentist? That's so there was some logistical issues that we need to front, plus the idea of COVID and bringing them being very concerned about bringing patients into a lab and because like,people I'm like negative pressure and doing all this stuff for air circulation, ventilation, how, what they did. 

So it was like, we just kind of stopped everything. And I just poured in, I was scheduled to go down to the Breathe Institute in California to meet Dr. Zaghi, because someone had said, if your daughter needs a release, You need to train with Dr. Zaghi. So I find him sign up and I'm supposed to head down there in April of 2020. 

So then, you know, it's so incredible. I  

Rebekah: mean,  

Hilary: Of course it's canceled and they're such an incredible.them probably, I [00:14:00] mean, within five weeks, they have full online course ready to go. And it was like the first zoom course that I checked. So this was mind blowing and incredible. And it was like, it's just such a beautiful place to be putting energy during COVID. 

And then I just, all these online courses started popping, right? Like a lot of these people that you've interviewed before, like Barry Raphael and, and. People that were on this path and had these mentors near them and they're like, this is the time for us to get your old slides from the seventies onto zoom and help you on PowerPoint. 

You didn't make these courses happen because we have time. Going really deep into a whole bunch of courses with, yeah, so I said, took online courses with Barry Raphael and studying with Gavin James, who's a big ALF provider. And then I started, taking my own functional courses and from my own functional therapists. 

Who were offering them online and then more stuff with the breathe Institute and my own masterminds and meeting and like really my mentor community became speech [00:15:00] language pathologist dental hygienist who'd become oral myofunctional therapistsor myofunctional therapists coming from other realms, but usually from dental hygiene, like osteopaths craniosacral therapists and the entities. 

And that's really been my mentorship group, aside from dentists doing ALF provisions. So I've taken like online and in person courses from every ALF provider that's out there.  

Rebekah: And it's amazing too, because it is such this collaborative kind of, full view that you have taken. I mean, could you ever have imagined coming out of dental school knowing this is where you would end up? 

These are the courses you would focus on.  

Hilary: Totally. totally. And that, yeah, it was a hard conversation, but so then the other thing that happened is I was at the Coyce Centre, and it was one of the last courses that I mentored. And Dr. Coyce, John Coyce, the director of the centre, came up with this book called Jaws by Sandra Kahn. 

Rebekah: Yeah. It's back  

Hilary: here.  

Rebekah: Yeah,  

Hilary: the epidemic under your nose and [00:16:00] I'm like, Oh my gosh, this is so important. And so. I got the book, of course, in order to, you know, whatever you ordered, like 11 copies, because you're like, I need to give this to everybody that I know. Exactly. Yeah, we  

Rebekah: did this. I think everybody does that, right? 

We did that with Breathe. We did that with the, yes.  

Hilary: Close your mouth, right? And gas. Yeah. Like you just want everybody to read them. Then you realize, okay, I'm probably spending hundreds of dollars a week on books that I want other people to read. And then I'm not sure if they're reading them. So maybe I'll just recommend the books. 

Slow it down. Right. You're at the grocery  

Rebekah: store. Here, look, you need to read this. I hate you. See  

Hilary: the kid with the dark circle. could I just show you this book?  

Rebekah: I always feel so bad cause I'm always 50, 50. Do I go give you my card and say, please go check out and the people we work with, cause I'm not a doctor, but Hey. 

Or do I just sit there quietly and go, yeah, that's always such a hard  

Hilary: choice. Airports are hard,  

Rebekah: right? 

Hilary: So, [00:17:00] anyway, what else is hard is starting into this conversation with colleagues, right? Yeah, my daughter's embraces. I'm like, okay. I'm not convinced that what she needs is braces now. I feel like we need to do some combination of stuff. Like she needs their breathing. Let me look at her tether and so, and reading the jaws book. 

And so, that was an awkward conversation and the outcome was, you know what, I don't think that there's really any science to this. And I think we should just take the braces off and you're on your own. And that was like, Ooh,Cause this was like, It was early on. Yeah, it was early on. It was early on for me. 

I was looking to him for like us kind of going on this journey together and he made it really clear that I was on and on my own and that was hard personally. Again, we're still in a freaking pandemic. You're feeling alone and you're thinking that it's getting more. I left private practice. So then the other really, really unearthing part of this was that I'm working at the BC Cancer Agency. 

So the only patients I'm [00:18:00] seeing. Or BC cancer. So I get all super fired up about, my course with,Dr. Zaghi at the Breathe Institute, right? And being able to diagnose tongue tie and understanding tongue range of motion ratio, right? The TRMR grading scale that is so clear and so great to use and inform with movements. 

As we can very quickly tell if somebody's got a tongue tie. Functional tongue tie. And, so, so, I, I, start thinking, well, you know what? Every Thursday, we're still working with the cancer agency. We've got, Every protocol of barriers and we're over wrapped and whatever, but I'm still going to NCP because we're keeping the cancer agency running. 

I thought, I'll just start looking at tongue, range of motion ratio in these people and, use my mind that way. And yeah, so starting May of 2020. and I've worked every week at BC Cancer since then, and I see on average, like I just work for the morning there, so I see on average maybe five or six patients. 

I started [00:19:00] testing tongue range of motion ratio, and the statistic is very, very, very high. I've done since, I can describe to you, I ended up going through wanting to design a study to be. Helpful. First of all, integrate. Maybe we can help again with the whole dry mouth, the most breathing was in with me. 

We were going to do a lip taping intervention. And I had another colleague who was on board to do the intervention, the testing, the radiation oncologists were like, no, this isn't a good enough study. and, But what I ended up doing is a database, the statistics are basically over, it's 96 percent of the patients that we see there, have a grade four tongue range of motion ratio. 

So the patients that we see in the dental department at BC Cancer are,of all, tumor groups, except maybe the torso. So we see the obvious, head and [00:20:00] neck, radiation group. So anyone with a tumor that's going to receive radiation above the hyoid bone here, we look at anyone who's going to go on to a bisphosphonate medication, which is meant to support tumor, tumor, So, it actually stops tumor growth in bone. 

So it stops bone remodeling, and the eating of the bone from tumor groups. So, things like prostate, breast, and then, multiple myeloma and any of the lymphomas and leukemias, blood disc heresias that are going to head into stem cell transplants. We need to clear that they have no infections in their mouth or that we don't have concerns about where they're headed. 

So it's a pretty broad spectrum of patients that we see there.  

Rebekah: Yeah.  

Hilary: Head and neck tumors and so, yeah, it's this crazy high incidence of  

Rebekah: and are these functional meaning they're going through their everyday lives just or I mean, what degrees are the as far as, we know that it's impacting their airway or it's restricting. 

Hilary: Yeah, it's interesting, right? You start looking at and so [00:21:00] the study that we've done and the data is just coming out now. and again, like Dr. Zaghi's trained us well in, in science and scientific investigation. So, in order to eliminate, or diminish as much as possible investigator bias to make sure that I'm not just saying that this is what it is. 

We've got photographs doing the TRMR. And then I have a panoramic x ray that shows, what the setup is of the teeth, the joints, and you can see the nose and the sinuses and the stylohyoid ligaments, which we could get into to talk about, which would be interesting.but these, I've got colleagues who are also affiliates of the Breed Institute who are now, we've received permission to send the data to them, and they're concurring on the diagnoses of about 20 different findings that I have, to make sure that Yeah, we've alleviated the investigator bias. 

We were going to do a hundred patients, but the goal was to say, if by 50, the results were so clear that we didn't need to keep going because we know statistical significance [00:22:00] happens at 30. I thought it's a nice number because people can make their own percentages.  

Rebekah: Sure. Sure. Yeah.  

Hilary: But you know, it just wasn't even worth it. 

Like by 50, it  

Rebekah: was just slammed down.  

Hilary: It's so clear. Yeah.  

Rebekah: And out of curiosity, just because of conversations, we've had like with Dr. Sandra Kahn and others. Yeah. When you're looking at these panoramics, and you've seen the nose.  

Hilary: Yeah,  

Rebekah: how many actual triangles are you seeing versus you can tell it's been impacted. 

Hilary: Yeah, so again, all that data will be coming out and my colleagues will be concurring but deviation is like, it's very, very, very high, like we're talking about 80%. The biggest finding is elevation of the lower anterior mandible. For the 6 lower anterior teeth. So we see that the attachment of a tongue tie is to the, bottom jaw, pull of that tongue tie, especially ones that when we see this Eiffel Tower. 

So, when you see [00:23:00] a, we can put a photo in right here of a baby, even with an Eiffel Tower, to know that they're going to then grow up and see these pictures,the pull of the tongue tie on the lower anterior mandible. Yeah. So that was actually another uncomfortable conversation I had with the orthodontist because I, the encouragement when you start learning from some of these amazing mentors is to say, what's the diagnosis. 

Like I get that you've got these clinical signs and symptoms, but we've. We've actually been kind of taught that the signs and symptoms are the diagnosis,  

Rebekah: right? Instead of let's get to the root. And what's  

Hilary: the diagnosis that's led to these signs and symptoms? So we've kind of been taught that a diagnosis It's elevated, is super eruption of the lower six front teeth. 

And like the diagnosis is a hundred percent overbite where you don't even see the bottom teeth because the top teeth come out a hundred percent over them, [00:24:00] but that's not the diagnosis. Like the diagnosis is that there's an oral restriction that's pulled like the diagnosis is a grade four tongue. Right. 

Right. Right. Right. That's everything else is the symptoms of overdeveloped. Yeah. So actually, and that  

Rebekah: is just, and that's a change too, right? I mean, in science anyway, that's in science, it's always changing and evolving, but now this is just a different way to, I mean, you really have to think about it. 

Hilary: Yeah, when I first started learning this and was doing these webinars, to start building community here of what we were learning, and I discussed this lower anterior six teeth being elevated, someone sent me a screenshot of this book, Think Like a Monk, and they wrote, Think Like a Monk, because if you look, that's exactly what we're talking about. 

Rebekah: Oh my goodness. Bottom  

Hilary: front, six teeth, right?  

Rebekah: Yep.  

Hilary: So . Okay.  

Rebekah: Anyway, but it's like we were talking about before, and we have said this on other episodes, [00:25:00] once you know it Yeah. And you know what you're looking for. It's everywhere.  

Hilary: I see it. It's everywhere.  

Rebekah: Everywhere can see it. Granted, at this point, I mostly look at kids because that's what we do, but that's what doing  

Hilary: Yeah. 

Rebekah: I see it in adults.  

Hilary: .  

Rebekah: I go out places with friends, people that don't know what I do, and we start talking about it with adults. And all of a sudden they're like, wait, wait, wait, I snore. I do this, I do this. And it's do you want me to tell you? Yeah. Go talk to your doctor. Hey, your chin's kind of retreated. 

Hilary: Yeah. So I love that you said that because it brings me to one of the phrases that I say all the time, which is we're all just grown up babies. We're all just grown up babies and actually, we had a really exciting meeting in Cleveland this spring and I know some of the people, Kevin Boyd that you've interviewed and some of the people that are like in the books, right? 

Like in Breathe, they're in like, they're, they've been in this and They are there and they're so passionate about this and Brazil is pretty advanced in what they're doing, their legislature [00:26:00] assessment so Mariana Piera Giving a presentation in Cleveland and there were six of us that were like right up there. 

Rebekah: Mariana is phenomenal. Yeah. Is  

Hilary: she? Have you interviewed her?  

Rebekah: I actually have interviewed and met her in person. She works very closely with Dr. Boyd. He's on our board. And I got the opportunity to meet her because she was speaking at the SEC sleep conference in Houston in April.  

Hilary: Okay. And  

Rebekah: I met her. 

Hilary: Yeah. She  

Rebekah: is outstanding. She's outstanding.  

Hilary: So you would have seen her research to show that occlusion exists at birth, right?  

Rebekah: Yes.  

Hilary: Yeah. You start to go, So if the discussion is that the realm of who's deciding whether or not a tongue tie matters or a lip tie or whatever's creating the dysfunction, even a cheek tie, if the realm is not supposed to be a dentist. 

Because we're not supposed to treat preventively. So say, we're not thinking about these elevated lower anterior [00:27:00] 6 teeth, which are going to be an issue later. And the orthodontist is going to be trying to intrude them, which is 1 of the major struggles of orthodontics is intruding lower anterior teeth. 

of course, you're fighting the force that's put them up in the 1st place, but say, we're you know,the defense always may be from like, if someone feels that it's the realm of an IBCLC or an SLP or someone to say, it's really, you should only treat if it's going to improve breastfeeding, right? 

Like it's all about the baby being able to have proper breastfeeding. But really what Mariana has shown is that Occlusion already exists at birth. We know that the baby started to suck when they were like four weeks in utero and they're swallowing by 12 weeks.  

Rebekah: They've adjusted  

Hilary: doing this for a long time, even when they're born. 

So their patterns, their neuromuscular patterns, if that tethering is there and has not had that apoptosis cells to [00:28:00] break it away and become a really functional swallow. We're already seeing malocclusions at birth. And I love the research that she's done to be able to show that. So I've started adding that into our testing and you can only do it when the babies rest and almost asleep. 

You can't do it once they're awake. but you're testing to look and see, and she's got beautiful documentation of the fact  

Rebekah: that she's got a great video of it. Yeah. Which I think we've used before. Yeah.  

Hilary: Which  

Rebekah: is funny too because,and it is just, I guess I'll segue into this because we touched on it funny enough in conversations that day after the day that she had spoken at the conference. 

It was three days and that New York Times article just will never leave the conversation at this point.  

Hilary: Yeah.  

Rebekah: And it was discussed in that article and it was interesting to hear, I'd love your perspective, but to hear their perspectives on. That article is about very different people. Here's what we're doing. 

Here's why. Here's the research. No, it doesn't always [00:29:00] have to be. These are the cases we would say leave it and why but Here's why you do it. Mm hmm. How do you approach that and discuss that with patients when you see it and you're recommending it and they say oh, well I read this article  

Hilary: Yeah. 

so 

Rebekah: You  

Hilary: know what I've started to say? I've started to say. I was in general dentistry for 20 years and I had a really full successful practice that had been closed to new patients for a long time. 

I made a lot more money doing that than I'll ever make doing this. And if I really wanted to make money, I'd be prepping veneers and putting in implants. It's very lucrative, especially when you're good and it's needed. And this work is nowhere near. Nowhere near the remuneration for the effort for the daggers you get in your back for the fights that you have to fight Like nobody questions whether an implant is a good idea or not. 

It's accepted in [00:30:00] dentistry, right? It doesn't mean it's gonna be done. Well, it doesn't mean that all of the criteria like there's so much to know about implants It's easy Well, it's easy to not do veneers well, but they're not criticized as a technique for treating what a missing tooth or teeth that look like they could look better or be shaped better versus  

Rebekah: something that can help your brains, your functions, depression, ADHD, long term things down the road. 

Like Dementia,  

Hilary: which brings me back to your question. We were talking about the study at BC Cancer and the data will be coming, but you were asking me if they had other, if they'd been living well or if they had other,  

Rebekah: yeah, if it was quote functional  

Hilary: medical histories, like reflux medication is a very common finding in. 

Not only our society, but in cancer patients, depression, [00:31:00] anxiety, CPAP, diagnosed or undiagnosed sleep apnea. And then there's the stuff that we're not really recognizing, right? Like when you start to get into, if you know how to ask probing questions with them. But the, the big thing is you just take a cotton roll, like a cotton roll in dentistry. 

Yep. Maybe you're aware of this test, right? 38 millimeters. Yeah. Between their two molars, like it never, I've never ever seen a cotton roll that fits in one of my cancer patients. That's a hundred percent of the patients have neuromaxillis.  

Rebekah: And I will thank Dr. Moralia and Dr. Bill Harrell for that. That's the only reason I know of that. 

That's where I learned it.  

Hilary: Cheap, free and diagnostic. So yeah. So then we know. Okay. So. The data right now is somewhere between 4 and 12 percent of Tung Thai reported at birth in whatever form, method, whatever the literature is that shows that. And I'm not saying Tung Thai causes cancer. What I'm saying is that the people who I am seeing in the [00:32:00] dental clinic BC cancer have like a majority highest grades. 

of tongue of the highest grade of tongue type grade for tongue tie. And it is, it's interesting to me learning that when there is a fascial restriction. And compensations need to happen through life. So say there's a fascial restriction on a cheek, but it doesn't get to soften away by proper function because there's also a fascial restriction on the tongue. 

So if the tongue tie, the tethered oral tissue of the tongue is tight, You start needing compensations of using your cheeks to swallow. It's more effort. You've got the restrictions that we know are connected in the frontal plane of fashion all the way down. Yep. So this tension persists through life in function. 

So then it looks really bad too. Not only is it. Is it obviously it's like thick and white and like it's, like these are [00:33:00] not just like fresh little ties like we're seeing in these babies, like they're, they've been through a life of compensation. So, yeah, so it's, the patient, what I was going to say is that, these patients end up, their medical histories are pretty revealing. 

And, I used to play this game. Kind of game with myself where we take this panoramic film that in one, like one dimension lays out a three dimensional skull in a picture. And I would look at it and I would just guess things about their health or their history based on looking, at say where on their temporomandibular joints or if their sinuses were pneumatized or they lost teeth or their teeth are worn, like in this x ray, guess stuff. 

Now, I'm like, Yeah, too bad about their tongue tie, right? everybody's got this elevated lower anterior teeth. And this is interesting too, because going through school and helping even volunteering at this, like the place where we train certified dental assistants here in Kelowna at our college, like they [00:34:00] always have dentists come in and supervise the training and they're learning. 

One of the things you teach an assistant is to make it so that the occlusion, like the bite is straight across, right? So you don't want to have them going up. Or down, like you want to have it straight, but I can remember thinking to myself, Oh, there's just whether it's through practice or whatever, people aren't quite getting it straight. 

But you know what I actually realized is it's a very common thing to see this elevated lower anterior teeth. You're not going to get a panoramic film to not show. It's not there. We just had it. And so even if those teeth are worn down so that they're almost the same height as the bottom teeth, there's a lot of elevation that's a big signal. 

So that's become a really big, a really big sign for me and, I, now I play the game of I look at their, I look at their calcified stylohyoid ligaments, which we know is the connection from, the mastoid down to our sternum in this. And like that, the, I don't know if you've [00:35:00] interviewed anybody that's talking about the incidence of that, but it's huge. 

And we're seeing it in kids, We're seeing it in little kids on CBCG scans, these calcified, and And you send off in order to get both a second opinion to be testing your own clinical skills, making sure you're not missing like missing pathology in these things. But also they, you can get them to report on different findings that you don't want to maybe be spending time figuring out in your own measurements or whatever. 

They always write back and they say calcified stylohyde ligaments, which are a non incidental finding. And I'm like, How could they be doing this?  

Rebekah: I'm telling you. Send that to Bill Harrell. Go ahead. You are not going to get that response from that man.  

Hilary: Yeah. So. And I have to  

Rebekah: say because of, him and others that I've interviewed, it's been so exciting for me,cause I just got a new dentist because my other one didn't have this and didn't talk about these things to walk in and they went in to do all of my films and they walked me in and it's, that's a CBCT and they're looking at me like. 

Yeah. Weirdo. Yeah. How do you know [00:36:00] that? And I got so excited. I'm like, and are you going to be doing this and this and this thing? And I see. And she's yeah, like some kind of a groupie. But all of a sudden that was the first time I thought, yeah, okay, someone's going to look at all that because I know I have an issue and someone's going to look at it and it just, it changes your perspective and it changed. 

My dialogue with my provider,  

Hilary: right?  

Rebekah: Never have I walked into a dental provider and had these conversations, but  

Hilary: yeah,  

Rebekah: it's, it is life changing because you can  

Hilary: open  

Rebekah: the door to these conversations and then you start getting the treatment.  

Hilary: Yeah,  

Rebekah: it's night and day,  

Hilary: which is super interesting because this moves us into the group that I was telling you about the AIA, the Athletic Academy. 

So this is a beautiful group of a collaboration of two occupational therapists, Mike Kentrell, James Anderson, and Alice Lam is a dentist. Again, super highly trained, right? She's been through Panky and Dawson and Spear and like all these big schools of dentistry. [00:37:00] And, They teamed up also with a neurological optometrist, Heidi Weiss. 

So the four of them are working this group they've called Applied Integration Academy, and their big thing is grounding, compression, and they call their work respiratory neurodontics. And so this has been a pretty cool and again, like mind blowing side of seeing the connection and testing the body and the body's movements and then envision and gate and then seeing how it works. 

The appliances we work with, ALF and Allure, Splint, and Breathing and teaching how to breathe can end up unravelling scoliosis and that you can actually see scoliosis in the tongue, right? And so now, it's funny, I had a friend send me a picture on a text one day and she [00:38:00] was, I was like, just wrote her like, how are you doing? 

And she's oh, I'm at the hospital with my daughter. They're really, they've done I don't know, I can't remember how many she said they can't get. Blood because they can't get a vein and she's here because her tonsils were bleeding and we're worried about her and, So I said, can you just send me a picture of like her opening her mouth so I can see back to her tonsils and she sends me this picture of all this blood dripping out of all these places where they can't get it in together being and they're trying to test what's going on. 

and so now I'm so ruined because not only can I not go to an airport, like you're saying, and see these kids with the dark eyes and the mouth. People with the elevated lower anterior teeth when they smile at you and you're like, oh, I feel you're suffering. I feel you.  

Rebekah: You see, you see the gap and I'm going, oh,  

Hilary: you want to just be able  

Rebekah: to ask people  

Hilary: about their vacation in Hawaii, but really you're like, and when you get back, could you call  

Rebekah: your dentist? 

Yeah.  

Hilary: So anyway, but so she sends me this picture and the picture shows, okay. A tongue that's pale, a [00:39:00] uvula that's deviated, the tongue has got a coated dorsal surface, the tonsils are enlarged, and then she sends me the picture of her arm, and I'm basically like, She has a non functional swallow. 

She has scoliosis of her spine. She's got her vagal tone is not matched by looking at her uvula. She's got low iron because her tissues are all really pale. And she's breathing through her mouth because her vessels are so small. So I have such low trigger pressure from having such a low CO2 percentages that they can't get in to get a vessel because they're not pumped up plump vessels. 

And so she's Oh my God, how can you see all that? I think it's frustrating to be able to see all this, but yeah. So,  

Rebekah: yeah. Yeah. And that's, I think one of the things that we do hear, from the clinician side over and over is this frustration. I mean, okay, first of all, This is the only time I thought I'd ever say this, but kudos for COVID for taking us down because clearly [00:40:00] that gave y'all time to really dig in. 

And I do think, I never thought about it before, but after hearing you talk about it, when you look at the timeline, because I constantly hear in 2017 and 2018 we did blah, blah, blah. So it was just hitting then and lockdown, everybody had time to study and gather and share. And.  

Hilary: Yeah. I  

Rebekah: really think that is why it has launched it into the stratosphere. 

So hold on for that  

Hilary: plus the book breath. So it's not published right before it's it was a perfect storm,  

Rebekah: right? For this hall to just hit the stage  

Hilary: and favorite quotes, I had, do you know Derek Nordstrom? Have you interviewed? Oh, we know Derek Nordstrom. yeah. Yeah, so he says my like 45 years in this work is for this time in the world right now, right? 

Like we're an epidemic of inflammatory conditions of, [00:41:00] neuro, like the loss of neural Input, reflexes, speech, IQs, IQs, the ability depressions charts. Oh my gosh. Depression. Autism spectrum disorders. A DHD. Yeah, like inflammatory mediated diseases. Allergies. like. All of these syndromes, right? 

And he's like, yeah, if we can just get conversion, true conversion, not training, but conversion to a functional swallow, we can get the neurotransmitters on board. We can start to bridge the little gaps, the breaks in development that haven't been there because of whatever reason and the. Cost that will show up in our fascia, in our immune systems, in our nervous systems and in our society. 

So yeah, it's funny. Our staff had a really like us [00:42:00] coming round to that whole thing where our mission is just providing collaborative care to support the journey of conversion to a functional swallow that and knowing that the resilience that we need. arises when we develop a functional swallow and we start to develop those neurotransmitters, right? 

We get the dopamine, we get the serotonin. So the, the kid that went from thumb sucking to finger chewing, to clothing chewing, to hair chewing, to picking their skin, to tattoos, to and every link cutting, like just looking for dopamine, right? Yeah. And it's just, and it's all sitting right here. 

It's  

Rebekah: right here. And I think it's so, I don't know, I don't want to minimize it because to me it's so easy. I think, I've been around Boyd way too long when you talk about passion, I mean, that man just  

Hilary: right in the  

Rebekah: [00:43:00] pond just eats and breathes this and it's infectious. And so maybe that's why to me, it just seems so simple. 

I've read much and I've talked to some people and it's, to me, it's obvious, right? Kill the silo. We're done with the silo. We have to be collaborative. But. I realize that simplifying things because just the way everything is set up around the globe and blah, blah, blah, but  

Hilary: totally and on every level. Yes. 

Like  

Rebekah: it's insurance  

Hilary: remuneration, understanding schools of teaching of these silos.  

It's every level.  

Rebekah: and I'm seeing what I think will get us there. What gives me hope is because I'm seeing. I call them little factions. I don't know. I've read too many like divergent and things like that, but these little factions all over, clinicians that y'all are gathering and you're creating these little microcosms of sharing and knowledge and collaboration and like with your collab CO2 [00:44:00] elaborative approach. 

I love that. That is so cool. So I mean, I think it, my, my gut says that's how we're going to, one of the ways, right? Cause it's going to take several months to move this, but.how do you. Foster that and grow that in this kind of environment.  

Hilary: I got to tell you, it's challenging. And I also feel a certain amount of, I don't know, maybe guilty passion in terms of that because I also have. 

When we talk about, say, my continued journey through this, I realized that I couldn't just work at the cancer agency. In fact, I was feeling very depressed about what had used to be kind of my, it was like, I'm going to love this. I love going to the cancer agency. You know what I loved about it? I love that patients feel like I'm on their team because I'm in the hospital. 

I'm in the public health care system. I'm not that, Dentists. That's just out there being greedy [00:45:00] and making money by having a private clinic and having a business. And I have to  

Rebekah: come see you every six months and I hate  

Hilary: you. And I don't, and I don't want to pay you for what I already hate. Anyway, yeah, it's like I'm on their team and I had a lot of knowledge and I could be empathetic, but I could just be there for them and then help them. 

And then most of what they needed there was free as well. So it's like this good feeling. Yeah. Yeah. It went from that and leaving private practice to going, all I can see now is tongue ties. Every single one of these patients has the 20 check mark marks of long term compensations in the body from a non functional swallow and tongue tie. 

They are in a system that is funding all this care and like we're still treating end stage disease even if we think we're getting it early because we really need it. They had this when they were a baby. I was going to  

Rebekah: [00:46:00] say, we're still treating the symptoms instead of backing it up. Yep.  

Hilary: So I started going oh my God, what have I done? 

Now I have no ability to make an impact. Now I'm basically treating end stage disease when I've learned that what I need to do is treat babies. I couldn't bring babies into that lab that I was working with and then we're trying to figure out how to even see people. That's not the place for breastfeeding moms. 

Plus, I'm trying to figure out how to do all that work. So then I start renting a clinic from another colleague. And then I ended up committing to creating another clinic of my own. So I went from having simplified everything to making everything way more complicated, getting pretty, sad about what I was seeing in the, My cancer patients and what I felt my ability was to do to now help them trying to design this study that I thought was going to be helpful and getting all these awesome people on board to do it. 

Like we said, Patrick McKeown and these colleagues and Dr Zaghi and it was [00:47:00] like, and then it became that it was not going to be possible to do this study at our agency. And then, yeah. Letting kind of those people down and the time they put in and the effort and the kindness And then being like, oh my gosh, okay now I really have to do this and I have to do this kind of for the fact that I Like let down this whole group, but it was very hard and then to goand keep myself Learning and growing in this and then taking mentorship in baby release courses from all these good people around Figure it out yourself and what ones need to be done. 

What ones not need to be done? What are they saying about my nebular tendon in, marina raccobato's courses? What are we learning about who should we be doing mandibular tendon in babies? Is it reactive? Is it compensatory? Is that a place to treat? Do we do lower lip? I mean, upper lip and tongue are already controversial. 

What about buckles? When we have an osteopath and a craniosacral therapist, what Coming in hold. And then what's that feeling like in our community? And then I have [00:48:00] a release provider, not too far from me, who'd had some like discomfort with the medical system on his own and was like on his own path to figure out where he's willing to let this all in. 

Meanwhile, you're super highly criticized by everybody that's doing everything. You're just trying to learn to do a good job with it. And you really care, right? Right. Right.and you're trying to do this all through a pandemic and and build a clinic and then, so  

Rebekah: it's a lot, it is a lot, but you know what, I don't think that research you've let anybody down from my opinion, because for me, again, this is an outsider for me. 

I'm that kind of person that's going to see that and grab it and gobble it up and go, there you go. There's another example of if we fix it now.  

Hilary: Yeah, this  

Rebekah: is what we're avoiding. So  

Hilary: totally. And I guess what I mean is I let the initial study that we worked for a year to build where we were going to do an intervention where we were going to teach cancer patients mouth tape and actually be doing a metric on improvement of symptoms [00:49:00] of xerostomia, dry mouth, and maybe even mucositis based on having a drier mouth. 

And it was an intervention. And having it be an intervention made it a more complicated study. So what I mean by letting those down is that people put a lot of time, a lot of energy. Patrick McKeown even made videos for our cancer patients to describe how to breathe, how to mouth tape. Like it was like, it was kind of, it was very, that was very sad. 

So that's why I feel like  

Rebekah: that. What  

Hilary: I wanted to say is that, when we talk about, like the silos and bringing people together, what I do feel like is I feel like. Where I'm at now is again, Derek Nordstrom said, we're on the cutting edge of not cutting by using photobiomodulation at an advanced level with like optogenetics and neural reprogramming with the oralase and babylase that we use with the 1064 laser. 

Rebekah: Yeah, let's talk a little bit about that. We have not. We haven't dug into that at all on this [00:50:00] program.  

Hilary: So let's talk about this. And what I wanted to say is that I feel like I do not want to be critical of a single colleague of mine that is not using this technology. That is not my intention. But what I do feel like is my passion, my seeing my connecting the dots and my wanting to sincerely help may have had me do more Aggressive clinical releases than I would do now. 

For sure. It happened for sure. I maybe given anyone who had an argument to say, oh, there are two or whatever, maybe there was a case where I was. So where I'm at now, this many years into having done releases, I'm using two modalities. So I always do non surgical releases first with baby lays or oral lays. 

So this technology, it's again, Dr. Nordstrom, who's been. spearhead of this [00:51:00] amazing techniques. And yeah, so the, there's a laser that has a 1064 wavelength and the beauty of this length, it's a collimated laser. it's able to penetrate without creating heat at the surface, but it has four impacts. you basically, you can feel it. 

It feels kind of like sunlight on your skin. You follow a very specific protocol that reaches six of the 12 cranial nerves. So there is a neurological reset that happens with this. You have, We test reflexes beforehand. So in an infant, for example, we're looking to see if their eyes can track straight ahead and gain on make eye contact with us. 

We're watching for signs of like divergent or convergent eyes. And as soon as we see that in a baby, we'll say to the parent, do you sometimes notice that the way the eye weavers are moving? Yeah, but they said that's no problem or they'll grow it or whatever, but what we know is that there's neurological input to the eyes, right? 

The optic nerve. And so we can affect that with this protocol. we [00:52:00] test palmar grasp to make sure if you put your finger in the baby's palm, that their fingers close over your hand. We test lateralization of the tongue. So we put our finger over here and over here. And the tongue should follow it. We do what's called a heart shape touch. 

So I make a heart like this on the baby's face and it should have them. I want you to then put your finger in their mouth and start sucking. So she'll elicit a suck reflex.and then we also test for, startle reflex. So you're holding the baby and you should be able to go and just drop it and it'll go right and put its hands out. 

So those are all reflexes that would be normal intact reflexes that we want for a newbie. Baby Lays, or Oral Ays, or use of this 1064 laser as a non surgical release modality goes in to the tissues, and it has an impact cellularly, so it gets right into the [00:53:00] mitochondria of our cells. So, if we were to go science back to, like, 

So like a flower or a plant gathers sunlight and it gives it the energy it needs to grow. This 1064 wavelength that Dr. Nordstrom has worked with goes right into our cells and into our mitochondria. And it's delivering a, the form of energy to ourselves. So repair. Inflammation, growth, it's like another gap that's been missed is filled. 

So we talk about that, right? starting at four weeks is that suck swallowing by 12 weeks all through in utero and now the baby's born, whatever gaps haven't been met, whatever's not happening in those reflexes, we can start to bring them on board by getting into the cells with energy and ATP. So that's, it's beautiful. 

It's like really help. It's like a human becoming a plant. It works in the fascia. So our fascia, as you would know, is collagen, [00:54:00] this magical, beautiful web of interconnectedness, that's got all these different planes of fascia throughout the body. It's made of collagen web and there's liquid inside it of hyaluronic acid. 

So the hyaluronic acid becomes thickened or gelatinous. So trauma of compensations, trauma of medication involvements of injury of whether it's physical, emotional, like a childbirth of needing to have interventions in order to have childbirth happen. All of those start to impact the fluidity of the hyaluronic acid in our fascia, and so fascia can get stuck. 

So fascia, we know it only stretches 3%, right? You can't stretch fascia, but you can make it glide. by making the liquid that may have gotten [00:55:00] sticky or gelatinous or even starting to become crystalline by liquefying it and making it make the fascia glide. Okay. And I, we can put images. I'll have it like after showing. 

Okay. What the tethered oral tissue looks like before using the non surgical release modality of this 1064 laser, and then what it looks like immediately afterwards. And the coolest thing is. We make these, we make sure that the baby is totally online in their midline, neurologically firing. So their palmar grasp is then equal. 

Their eyes are like looking straight at you. Their swallow goes from being like. Thrusty or chompy or uncoordinated, we can actually have it become the tongue, like we don't even move ahead with our surgeries now, unless the tongue is suctioned to the roof of the mouth and they have a functional swallow, which we can test with a certain, then the ninny soother that we, the [00:56:00] pacifier that we like to use, you can see right in the mouth. 

You can see that there's swallowing. So now we know we've done the neurological, the fascial, like softening, muscles get information as well. Like neuromuscular sensory, like it's like a control alt delete for the system. It goes, okay, everything's all. just needs a bit of a reset. Boom. And then here it is. 

And now we only want to promote this balanced functional midline, the relaxation, the calm, that's what the parents always say. It's I've never seen my baby so calm. We have videos of like babies starting out crying and upset with us. And then we do this protocol and they are so So they move into releases with their nervous system relaxed. 

We know they've achieved a functional swallow. Their tongue is suctioned to the roof of their mouth. They can now produce their own serotonin. Their own dopamine is going to be there from this swallow. And then we do this really conservative release [00:57:00] and, it's, yeah, it's become totally amazing. We use it. 

In kids, adults, everybody, like it, it can soften and relax in addition to that. Then here's the other thing though, right? It's none of this work is like a magic pill. There's a series of, home care, like exercises and myofunctional support course, and then additional ones to go with this 1064 laser, but that there's, then afterwards, of course, the malfunctional support craniosacral therapy, osteopathy, that has to be used to let the benefit move through the whole body. 

But now we've actually got the tip of the iceberg, right? But the metaphor is it's going to the rest of the body, but we've given the message to the fascia. That it can glide. We've made the release more conservative. The body's midline has gotten all this messaging to center Neurologically and to be able to just Let the body receive the releases [00:58:00] in a balanced state And the stretching is easier in a baby. 

I don't know For, cause the tissue, you might see a baby like that has this habit that they are swallowing with their upper lip, right? And they're, they, and they're, they've got the downturn corners of the mouth that you shaped upper lip, whatever the jaw is far back. And they're struggling to try to make this suck swallow work. 

We've actually seen the jaw, come and pop forward because the tongue is now free enough to come forward, come up the baby sitting there, relaxed. The parents are like. We've never seen our baby so relaxed and look at their jaws forward. And then the mom puts them on to feed. It's a different, they latch, they can open. 

They often say that how wide they can open. And so it's become a real thrill and a joy for us to be doing these really conservative releases and getting parents to understand, so, If the tip of the tongue is actually the tip of this [00:59:00] whole digestive tract peristalsis, which we know is the movement of the smooth muscle of our digestive tract from the top all the way down to. 

It starts from the tongue tip, right? So it's the way it starts, just like the wave in a stadium, right? if someone starts the wave and it really flows and moves through, it's like a good feeling instead of when it gets dry, it's didn't go anywhere, right? But either needs to be started again, or that's where we see the things you've heard many of your colleagues and speak about like a head bob. 

Somebody does that. And I have a video because they've got to start that peristalsis some way if they can't do it from the tip of the tongue. So the tongue is thrusting and we see this all the time, right? Babies come in, they've had reflux, like problems spitting up. They come in. and they're on Omeprazole or they're put on reflux medications. 

[01:00:00] It's not getting better. They've been on them for four to six weeks. They're looking at upping the dosage. And then they, we recognize a non functional swallow. We bring them immediately online with a functional swallow by using this 1064 laser technique. And then they, actually have peristalsis happening. 

So then the craziest thing is the parents who come in and say our baby used to poo every 10 days or every seven days. And the day leading up to the poo, they were screaming, their body was tight. They were in so much pain. Now their baby's pooing. Like every, I keep meaning to do a post on poop. I think that would be the greatest thing to be able to see, this is how it  

Rebekah: should be. 

Hilary: This is how it should be. And peristalsis that's happening because of functional swallow, the relaxation of the fascia, the melting of this hyaluronic acid into a liquid form from the gelatinous or the sticky form, letting that fascia move, letting diaphragm go, like all this stuff is [01:01:00] happening and the baby has the release. 

And  

Rebekah: that's all it was.  

Hilary: Stretches. Like when the parent needs to stretch the upper lip and the tongue and get in there and that's like super hard, the tissues are soft now. They move like this fighting organ that now is free, but it has to be like, Oh, hell that it's so much different. And it's still hard, but as a clinician, I used to, for a recall, so we do releases if so now our protocol is. 

We don't even let anybody cover like we've said to refer and of course like the New York Times article now I'm saying okay now we need to do baby lays and there's a fee associated with it Oh now what a cash grab that dentist not only wanted to make money off these releases and all these babies that don't need it now they want to add this baby lays thing and now they're really money hungry and It's if you knew what it takes for us to add this into our protocol to have staff trained up to do it to buy the laser to do it I have no idea what there is Yeah, but anyway, that aside, what we now do is we really we don't even have people come here who [01:02:00] aren't aware that we do dual modality releases because it's been enough months in our community. 

We started in like October. So we've been, we went through like having all of our. All our referrals drop off and people go okay, that's a final straw. This clinician is just greedy and making money and what's this baby lays thing and people can't afford it and dah, dah, dah. But once you do it, you can't do it another way. 

Right? You go like, I want to see these babies succeed. So I used to, so we would do, we do, our assessment. We would sometimes, but not always do release the same day. Sometimes we would just come for assessment, go home and think about it. Sometimes they would want to do release the same day, but we always insist. 

And usually we're referred by lactation consultants, speech language pathologists, myofunctional therapists, or,like osteocranios who are working with babies. So that's how they even came to us. So we wouldn't, we don't even work with people who aren't. On that side of the collaboration care of this. 

Yeah. But then now we've started to recognize, [01:03:00] that. We can get quite an impact on, changing out, having any compensation of the cheek or lip tension by doing a 1064, like non surgical release, having the baby use a NINI pacifier, which you can only hold on to if you have a proper functional swallow. 

Are you familiar with the NINI? Have you heard about it? I am. So you can't, there is no stock and ball to that. You can't grip lips around and hold a nini and then retrude a jaw, right? You can only hold a nini if you have flanging and the ability to properly suck. And so we could have a whole long soother conversation, I'd be happy to do that. 

But the message is we now see like almost no reattachment.it's rare. I used to, so they would come for their assessment. Maybe we [01:04:00] treat the same day or they come back and treat. Then we do a 1 week recall and a 2 week recall. And then if needed a 2 month recall and or they can be virtual for their own or whatever. 

But,I used to stand outside the room and my assistants would say, our breastfeeding educator came ready for you for, you know, one week before here's I'm like, okay, please let there be no reattachment. Please let there be no, but  

Rebekah: now that's not.  

Hilary: This is what's better. This is what's better. 

This is what's better. Here's what we're working on. The baby's responding this way in their reflexes. We've done this little Q tip test to get the neuromuscular integration of the tongue. Milk tongue's gone away. That's the biggest thing, right? Yeah. When is somebody's release successful? It's successful if they do not drool, if they don't have reflex. 

And if they, can have their tongue suctioned up to the roof of their mouth, then we actually know. And if not, then there's indication for using this, non surgical continued release technique on the neuromuscular side of things, because it's getting [01:05:00] into the nerves and reprogramming, getting into the brain and going back to the brainstem. 

Here's these nerve efferents. Okay. I'm just sending back and saying, let's, let's go back and do what we're really supposed to do now that we have these freedom of these tissues. So sometimes they just need repeated visits and training to break those old habits that started 12 weeks in utero. Right. 

Rebekah: In school, and I know it was the same in med school, but the brain, the brain, the brain, the brain, the brain, right? That's the power that does everything.  

Hilary: Yeah.  

Rebekah: Yeah. apparently it has a friend and it's the brain in the mouth and who knew the mouth had this much power, especially starting at birth that could impact what your life is going to be like in 60, 70 years. 

Totally. Totally.  

Hilary: when we see babies do their first breast crawl in our clinic because they were unable to do a breast crawl for whatever reason, maybe it ended up being in a C section and the mom was unable to tolerate the baby on their tummy at the time. [01:06:00] Maybe the tethering was so tight or their mouth was too small or they like things weren't, like whatever wasn't allowing, the, they couldn't get a flange. 

They weren't coordinated enough to do the breast crawl or it wasn't offered to them or whatever, to see them do. So what we'll now do is, we really promote,laid back feeding to have upright baby swallow happening, not necessarily on their side. there's places for that and there, and we still, we don't. 

We don't tell people that what they're doing is wrong. We just try to offer. And I'll say often, if you were to have something to drink right now, would you like to lie down on your side to swallow or would you like to be upright about training a symmetrical functional swallow? And what we're asking is the tongue as a midline structure to go up and be symmetrical. 

Do we want to be as upright as possible? And so we look at the Japanese studies, which show that. really the best way to do it and that a baby's capable of doing that. So once the reflexes are on board, [01:07:00] babies who come into the clinic who sometimes have like head bobbing or they, they can't put their head up right or their eyes, whatever, after we've used our non surgical 1064 release technique, and we offer them the breast crawl and we support the parent in being able to just put their hands at the baby's feet and, maybe have the arm there. 

And Bobbing and rooting out. That's the other reflex. We tested the reflex. I forgot to say that. But, and they're like, this is they couldn't have done this. they're and their cervical spine has become strong because we've treated, the, with the laser, we've done the cervical spine and all this stuff is on board  

Rebekah: way back  

Hilary: and the mom. 

The release, the mom feels when they're laying back, they're relaxed. Their shoulders are open. They're not, temporarily laid back. The baby has done this breast crawl. They come up and they're looking at them eye to eye. And then the oxytocin comes in, right? Then this, this is what. feeding is about.[01:08:00]  

And so they are feeling this baby on the breast and they're looking at each other. The suck is coordinated. They're not chomping. They're not resisting. They're not pulling off and pushing off. They're actually, I always say to the parents, like this moment right here where they've struggled for this first feed and then you're there. 

It's like that's when they are like having to make decisions as a teenager. This is in them now, right? this right here, this moment where they struggled and fed and then the oxytocin came.that's the reward, like right there, right? that's your first bits of serotonin and dopamine they're happening. 

So, even just this morning, I had a mom in who struggled through, two different NICUs in our province, and she's been in the care of so many awesome, intended, highly [01:09:00] trained  

Rebekah: people that  

Hilary: did not see this tongue tie. She traveled for two and a half months and couldn't. 

So now the baby's six months old. She's now been to a pediatrician in our town who said, yeah, no, I don't think that's a tongue ties a problem. I could show you the, we'll put up the picture of this one. And, so now, what's really sad, this baby. He has no tongue use, like he comes in, he's literally pouring drool. 

The mom's shirt is wet. His clothes are wet. He can't swallow. He has no functional swallow. But not only that, he's got complete cranial asymmetry. He's got a right torticollis that has not been. Even diagnosed yet treated. She had not been in the hands of any physical therapist until she finally was told by a friend, maybe she goes. 

So it's a really weird gap in these siloed systems. Not right now. Yeah. And this is where my goal is to be really seen and [01:10:00] known as someone who's discerning conservative, but I am not gonna, I'm not gonna not do. the tear of the non surgical part of the release to bring the baby online first. So we did get a lot of the baby's reflexes online, but we didn't properly, we got a bit of the swallow happening and, it was an improvement, but he has no, he has no tongue use. 

So breastfeeding ended up failing for them and this has been about three months now. So he's bottle fed. but you know, he's not soothed by putting a finger in the mouth. He doesn't act. There's not a, there's no signal. And I really hope that this gap for him that we can get to with these conservative modalities, the release, we ended up doing a release because he really needed, there's no way he couldn't have a release. 

it's like one of the tightest ties that I've seen. But, Yeah, just really, it's, it just really brings back the importance of us [01:11:00] recognizing the neural, the brain part, just like you said. Yeah, it's all connected. All connected. Yeah. And so, I just think that I'm so grateful to have that on board and I'm really being more drawn to wanting to be there for babies. 

I'm so keen. That's where it all starts. It starts there. As a senior citizen or as a I love  

Rebekah: that, right? The geriatric.  

Hilary: You know, it's the other thing I love that Kevin said in, in the spring at a conference I was at, he was speaking for a speaker after lunch and, you know, they're ringing the bell and they're giving people the warning and they're trying to curl people back into it and everyone's whatever. 

He gets on the mic and he says, look, you've all come a long way to hear me speak and I've come a long way to speak and we've got a limited amount of time and I've got stuff I want to say. Let's get going. It's awesome. It was basically like.  

Rebekah: Sounds about right.  

Hilary: Get in here. I got something to say. Talk about that. 

That sounds about  

Rebekah: right. Anytime you hear him speak, he's only going to touch on this much because he knows this much. And yeah, [01:12:00] and we've got our parents that haven't heard him. If you go to our YouTube channel, there are, we've got playlists set up.  

Hilary: And we  

Rebekah: have tons. Everybody that we've been speaking about is on there. 

Nordstrom's on there. Mariana's on there. Kevin's on there.  

Hilary: Yeah.  

Rebekah: Bill Harrell. I mean, a lot of people are on there and we even have a video from the Breathe Institute, which is Zaghi and, Koppels.  

Hilary: Yeah. Yeah.  

Rebekah: That he's doing this exact laser. Yeah. And granted, this is a grown man, but still it's cool because you can see it and he tells you what it feels like. 

So you're going to know what your baby's going to feel. So 

Hilary: Yeah. And you know what's really cool about, I mean, not only Dr. Zaghi and Dr. Coppelson, but the Whole Breath Institute group is how committed they are to being able to continue learning. 

And if their protocols are shifting. Yep. Yep. Yep. Yeah, we're doing it different now. And that's the way I feel, right? I feel it's really important to me for people to understand that we've added in this modality and it's non negotiable, for my care [01:13:00] and that we're so committed to becoming really a place where people go. 

I want people to go, ah, somebody's having a baby. Let's get a group of people together and see if we shouldn't get a gift certificate for them to have an assessment and treatment of right. Like they don't actually need, you've got enough bibs, my friend. Yeah. And in fact, you don't even need a bib if your baby has a functional swallow. 

So excellent point. Yeah. And so I, I really feel like that's my motivation is to be seen as just so open and willing and ready, but ready to recognize that it's not negotiable to get the nervous system online before we do conservative releases and the releases become more conservative, the more the nervous systems online. 

So it's  

Rebekah: right. And the more we're learning and then we're going to, we're going to be more collaborative. And I want to see this as part of these. These Lamaze and in like prenatal classes that should all be in there. And then it's going to be added to the curriculum of all the medical [01:14:00] schools, not just one. 

All of them, dentistry, pediatrics, everyone, and then we can see this change.  

Hilary: Yeah, what I was going to say is another real hats off to Dr. Zaghi and Dr. Coppelson is, when I went to the AIA in Houston in October, the Applied Integration Academy, and they had this course on body and bite and learning about when the body needs surgery and when the body needs breathing. 

Like respiratory neurodontics, right? Breathing the brain and the tongue on board first, then the body and the spine are aligned. We've gotten rid of these scoliotic curves and now. We can do expansions or surgical, the, all the amazing care that Dr. Coppelson can do. So he and I were actually partnered up for some of the, the tests we were doing on C spine and the shoulder internal rotations. 

And what it brings me back to is when we're talking about CBCT [01:15:00] and how you're accepting that your clinic has CBCT. So I took a CBCT of a staff member the other day. And kind of like the whole airport thing, kind of like the like going to a coffee shop or whatever and seeing people and you're like, I don't really want to say, I just got to look aside. 

The staff member of mine, was one day we were leaving the office. I said, Oh, what are you up to tonight? She said, Oh, I actually I've got a physio appointment. She said, My shoulder's really sore. Like I've started dragon boating and now my shoulder's really sore. I'm like. Do you want me to look inside your mouth? 

Look, yeah, she was kind of a newer staff member. So we hadn't done so she's like I said, do you want to see if I can help you? So We do this test that you learn at AIA, which Dr Coppelson also knows and this amazing group has taught us where you have the shoulder at 90 degrees and the arm at 90 degrees and then you Bend the arm down to see and you're holding here so that you're not, you see everybody's posture. 

That's compensatory, right? You've got the shoulders back and you're holding the shoulder like that. And you do this test. What point does the arm stop? there's a point [01:16:00] that stops without this being able to rotate. So when you get to that point. Then, you go inside the mouth, and if there's a limitation on one side or the other, so you know what the limitation is. 

So right  

Rebekah: before it rotates is where you start. Right before this  

Hilary: starts to lift up off the table, or this starts to rotate, yeah, can you get to 90 degrees in this, right? So, so then, you go inside the mouth. And you feel to the second molars. As a dentist, it's super annoying when somebody has flared second molars and they need a rubber dam clamp on there because they need decay treated and you're trying to get your burr in there and it's all like to the cheek and I forgot to move their jaw over and whatever. 

Now I know that if the second molar is flared, we're actually talking about palatal bone connected to the middle bone of the skull, the sphenoid, which is the direction of everything in the skull, right? What? So we're touching and impacting the gorgeous butterfly [01:17:00] shaped bone that connects to all the 22 cranial bones by touching the back of the second molar, leg of the jaw. 

So if you go in and you feel that one of them is more flared than the other, you're starting to recognize that there's a, like a cranial strain or some type of rotation in the cranial bones that connects to, The development of the arch on that side. So I put my, I test her shoulder internal rotation. 

Of course, it's completely limited. She's sore. She can hardly move the shoulder and we go in the mouth. Sure enough, that molar is flared. I'm like, Hey, just stay open. Don't bite down or use your tongue after I do this, but I'm just, you just go in and you just do 20 little pulses to that area. I like really just osteopathic, like just physiologic movement pulses, like the pulse of the brain, the pulse of the tongue, just body's ready for physiologically, right? 

You push on that and then [01:18:00] you have them stay open. So there's no more input coming from any other nerves and you do the same test and The arm like falls to 90 degrees. She's like, I know, have a good physio visit, and then you know, you know, that this is highly trained, maybe even not totally siloed physio, maybe already has some type of interconnection, but who would think that I could lightly pulse the second molar, affect the internal rotation of the shoulder, which is happening because it's connecting to the sphenoid, which is all getting connected, into both nervous system and the physicality of how we move our bodies. 

It's the craziest party trick dog and pony show. This is  

Rebekah: part of why I love my job because I have yet to read one of the books that has been given to us that we need to read for something or do one of these podcasts where I don't learn something and my mind is blown. It's kind of like when, when Linda came on and she was talking about fibromyalgia. 

Hilary: linda Harris. Okay. I  

Rebekah: don't know that book.  

Hilary: Oh my  

Rebekah: gosh. Okay. [01:19:00] So get it. It is a fast read and, it will blow your mind because she went in with fibromyalgia Yeah. and jaw issues and all of these things. 

And her dentist is Oh, I bet it's your 13th tooth. And she's what are you talking about? Sure enough, we do the films and everything. She's got like a cap or something or yeah. Yeah. We address it and guess what actually goes away. It's just mind blowing to me that I  

Hilary: have read that on your website. 

Yes, yes, yes, yes.  

Rebekah: It's mind blowing. Absolutely mind blowing. And to think that We're getting this knowledge. It's still so early and I understand that, right? But it's actually, let me rephrase that. Actually not that early. Thank you, Dr. Boyd, because there were so many papers and things he has brought that this has been out here for 80 to a hundred years, but yeah. 

And our consciousness modern mainstream, this is still early and that we could affect these changes to where people [01:20:00] don't have fibromyalgia,  

or just monitor and let's work on their dental. Up until the age of 6, and you have a totally different human race out here walking around.  

Hilary: And that's where it's so cool. 

I'm going to bring up, I'm going to close the, okay, make sure we come back to the whole notion of Kevin bringing that up, like Marina's work and like the legitimacy of a dentist being on board at birth. Malacuzin exists at birth. As part  

Rebekah: of the birth team. Yes. Right? Yes.  

Hilary: I want to come back to that idea, but what I wanted to say about the shoulder internal rotation and the CBCT is, we're heading down as a staff to actually, we've cultivated 3 days of private mentorship with Dr. 

Nordstrom. In July, we're taking his brain and the heart and mind all to ourselves for three days. And as part of this, I want to have all my [01:21:00] staff worked up for their own care. So that when we're down there. I'm seeing him deliver their appliances. I'm watching him look and observe them and we've done our part here and I've done my like preparation and he's got the case assessments and the cbcts and the scans and then whatever like everything's already there. 

We're actually just like starting to start their path of the journey of like alpha therapy basically and So anyway, so I'm taking her CBCT the other day because she speaks to people and I sit down to view it and I've got it in as 3D and I can show you a screenshot of this. 

I'm looking at her 3D scan and I can see her upper right first molar is flared in the x ray and I'm like, Oh, as soon as I look at that, I'm like, Oh my gosh, she's totally going to have trouble with her right shoulder internal rotation. And then I'm like, Oh my gosh, she did. We already did that test a couple months ago. 

It's crazy. Yeah, and the crazy part is what AIA has done for me and then [01:22:00] had me realize, which also makes you feel like, oh my gosh, now I have to have more responsibility is now you look at them and you see that you get them to open, you see the tongue elevated one way or the other, whether it's TRMR, you haven't even looked at that yet. 

You're just looking at their uvula, which is deviated. You see that their vagal tone is going to be off. That's the other thing that happens with, using this 10 64 in this format of Orla, is that the uvula straightens out, so you know that you know the connection to C one C two. So we're both getting vagal tone online. 

Trigeminal nerve as a gatekeeper of the vagus is starting to become safe. The body's becoming safer. The uvula straightens out. There's not that compensatory pull. And then you see,and you're able to see like the cervical spine start to align. Can be harder than that in an adult, but we still see a lot of this happening. 

But we need more modalities on board To do it, work with it, handle it. But  

Rebekah: because they've been dealing with it for so long, much has been [01:23:00] done. Yeah. They're dealing more  

Hilary: compensations and the spinal, you know, and they, and they, they walk, they stand, they've got shit. Yeah. That train left the in there that are all like  

there's so many parts to it, but now I look at people's tongue and I already know that they're probably developing a left bunion. And when you say that. And they're like, yeah, I have a bunion on my left toe. It's I know, I'm really sorry about that. I'm able to see that because it's kind of unfortunate. 

But what's really not easy is managing. So this comes back to the whole collaboration thing, right? We need to all get out of our silos. We need to be able to work together. But we're highly trained, caring, empathetic people who have our own businesses, our business models, the way our softwares are planned, the way our staff is trained, what our education is, the CE that we've just enrolled in that's taught us something that doesn't have this information in it. 

And then, like someone goes to get orthotics and they're like, yeah, my dentist knew that I had a bunion on [01:24:00] my left toe because of my second molar and they'd be like, Okay, they're a quack, right? so it, in sometimes you can't premeditate where this information is going and how it's going to be received. 

And what's unfortunate for me is I've had physical therapists. Say, get out of my realm. the dentist, you have no right to tell my patients how to posture their shoulders. I'm the physio. I'm the one who's going to tell them how they hold their sternum, not you. And I'm not. That's hard because it's kind of like the orthodontist who is I'm not on this journey with you. 

The braces are coming off. Then it's like the physio who might be sharing coaching duties with me and the cross country ski team. And I'm saying to them, you know what, I'm really concerned about all these little kids and all this most breathing that we're forcing them through and how cold the air is. 

And I really would like, in our bunny rabbit program for us to start by [01:25:00] like training most breathing. And if we can't do that, maybe they really need it. That is an uncomfortable place.  

Rebekah: Oh, sure.  

Hilary: And these people are good at what they do. They've been highly trained and they're successful. 

And maybe even too, they're like kind of moving into the easier stage of their career. Like I was moving into the cancer agency, right? I was just going to take it easy. I was just going to be on their  

Rebekah: team. That's where we are right now with this big medical change, right? It's here. We're at this precipice and I apologize, but I, and I know I'm, cause I'm supposed to be fairly neutral, but I'm very passionate about this because it takes It takes time. 

These luminaries and people like, like that have been on the podcast and people like you and yeah, that are open to make this change. Somebody has to stand up and start to make the shift for it to trickle down, right? For it to take effect. And it's also going to take the parents, these airway mama bears to stand up and go, no, my [01:26:00] child's not going to grow out of it. 

I respect you. You worked really hard in med school. You're great, but I'm going to go to someone else.  

Hilary: Yeah.  

Rebekah: And these are hard choices on both sides.  

Hilary: Totally hard choices. And it's totally hard choices becausethe risk is. You never know where this information is going and how it's going to be presented and where it's going to land and my, one of my biggest struggles has been trying to keep on top of, the letters, the communication about this, the documentation to be, because they're like, And then I have a couple of colleagues who are physical therapists, osteocranial, in fact, we are so blessed here. 

There's rarely a week goes by where I don't have a visiting osteocranial physio that comes in to be holding either the feet, the diaphragms, the head, like working cranial osteopathically with me. And I've done my own training in it so I can hold and I can feel, and I know when things are aligned and people are very blessed  

Rebekah: because those are not easy to find. 

They are  

Hilary: not easy to find. They're [01:27:00] like, we have so many, I've actually been looking, they are so hard to find in  

Rebekah: the US.  

Hilary: Yeah. I was speaking with a colleague from Portland after ICAP in Cleveland and they were like, I have none of this going on here where I am and I said, where I live, it's a really nice place. 

Plus the dollar exchange is very advantageous for someone from the US and like it's a fraction of what I know people are paying in the States. You should like, I should create a. Like a destination model where people come, they get their baby assessed, they come to our beautiful region. we have collaboration with hotels. 

Our physical therapists are here ready for them. They can have their cranio, their osteo, their lactation consultancy. Like we can be like a destination because it's all happening here in this town. It's so awesome.  

Rebekah: I'd sign up for that. I sign up for these solo tours around the world. I'd kill for something like that because it really is when you're out here in the trenches and I'm sure it's like this in other countries because we've talked to other people, but  

Hilary: yeah,  

Rebekah: in the US, both for adults and for kids to [01:28:00] find this, it's not easy and that's one of the biggest things we're advocating on is how do we get this care? 

yeah.  

Hilary: Okay. So maybe we become like a destination for this integrative care for places that are under service right now where you medical Disney. I  

Rebekah: love it.  

Hilary: Yeah, so and yeah, and they can enjoy themselves while they're here. There's lots of great things they can do and be part of. So anyway, that got us diverging off of something, but it's good to set it. 

But what were we just talking about before that we were  

Rebekah: talking about the collaboration between  

Hilary: operations? Yes. And how frustrating it is for me when I hear that somebody's misunderstood or miss,taken offense to the possibility that the mouth is connected to the body. And that this, yeah, so it's, it's coming, but then it also, it's a huge learning path of my path. 

Just because I know the information, I can see it and diagnose it doesn't mean I'm an expert at treating it. So I [01:29:00] still need to get mentorship in all this treatment and how to integrate that and then to be able to bring people in and have like they need to earn their money too, right? So then am I bringing them in and I'm paying them to be part of this? 

Am I training them? Do I know enough retraining? It's all such uncharted waters, right? And for Oh, my God, one of my staff said, you just have to really flow with Hillary because you never know when the next week she's going to have gone. Oh, okay. Now, what's really important to me is I'm recognizing these cases that don't have an anterior coupling reflex, and I need to add acrylic to all these appliances to get a little bit of contact in the front teeth first year before we get, it's going to signal the But you're  

Rebekah: developing, you're learning, that's the whole thing. 

That's why the institute is constantly in an airway health solutions. They're updating their. Yeah. All the time. All the time. As we learn.  

Hilary: As we learn. So, yeah. So then just figuring out what we can do and handle and what have you is good. But, yeah. 

We went back to the CBCT and that was so cool. Yeah. And go Oh, I already know what her body [01:30:00] looks like by looking at her second molar and being able to, scroll around. I know what's happening in her body and her spine. And sure enough, and you look and you can see, C1 is off on occiput. 

Occiput's over to the larger lung. You get her to look and you can see, yep, sure enough, this side. So we need to. Train breathing and compression into this in order to straighten out the spine. Because the larger rib is the raised shoulder and the cranial strain is pulled down to there. What is that? 

This is the six month old baby that had torticollis who was in my clinic with no treatment of torticollis, no functional tongue. And of course they're elevated like this, they're totally scbi, but we can, and up today he comes in, he's like upright and he stills not using his tongue, but he is more upright. 

So.  

Rebekah: And it's just amazing. And it's never too late. And that's the other thing. Granted, we're focused on kids because we understand this is the route. Let's get to the route. Yeah. Six before six, we're not going to have these problems, but some of us have already left that gate  

Hilary: a long  

Rebekah: time ago. So it's never too late to even as a parent, if you're [01:31:00] listening to this and you're thinking, I have this, I have this, I have it. 

And you're hearing yourself and what we're describing. Yeah. It's not too late. It's not too late.  

Hilary: so Linda, the book that she's got, we, so like we've been in a sense of overwhelming our clinic just by the demand and the ability to explain and be ready for systems to handle all this care. 

And, as a result, we've people have, well, what are we supposed to do in the meanwhile? And so we work with this, free app called human garage. Have you ever heard of them?  

Rebekah: I have not.  

Hilary: Okay. they're all about fascia. So it happened during COVID. This guy had this idea that if you kept working fascia, you could release a lot of body problems and they literally worked out of their garage so that they were in open air space and they moved to Canada and they've got this beautiful message to be able to reach a billion people. 

And however, I'm out of time, but it's to, to just, Give people free access to how to open up fascia. So human [01:32:00] group is a really good app that we recommend. Okay. And then, of course, you need to probably recommend, like Patrick McKeown's, Buteyko. Like absolutely we do. Yeah, just try to give them anything they can that's free and available right away. 

And, yeah,  

Rebekah: and I can recommend that app, also for kids because they do some, things on there for kids, but I use it. I absolutely love that app.  

Hilary: But you're totally right that it's not too late when I'm like, a couple of the most reward. So, one of the other honors and privileges, which I kind of feel like, am I really the person to be doing this? 

But John has asked me to speak at this symposium this summer. And so, when we circle back to, the, what brought me to this was him, JAWS, the integrative oral medicine course at the COIS Centre, realizing this path and then.finding the mentors that I needed for this were in all these other domains, right? 

It's been a long time since I've been at a dental [01:33:00] conference. And actually there was like one time I was going down for a hands on ALF course in Issaquah and I texted John and I was like, are you around? I could come and say hi. Other than, and he wasn't home. Other than that, I haven't seen him for six years because I've been putting all my money, all my resources, all my energy, all my knowledge. 

Except for we have a small, airway study club group through the Coyce Centre who I really treasure and value. Actually, you've interviewed Steve Acker, I think. Yeah. so we have this beautiful group that has totally kept me fueled and going and, but anyway,John, Dr. Coyce wrote to me this fall and he said, hey, would you consider coming to talk about all this stuff? 

Or come and talk at symposium. And I said, sure, what do you want me to talk about? And he said, this cranial manipulation stuff you're doing. So what's kind of cool is I accepted that honor and I still feel like there's about 40, 000 people in this world who'd be better to do it than me, but I'm going to just do my very best to do my best for that. 

But really what it's come down to is I'm preparing cases where I [01:34:00] see a baby who has the same physiology, the cranial side bends, the elevated shoulder, the breathing difficulties and the occlusion. And then you can see the same anatomical setup in a kid, kind of the way Marina does with the actual kid growing up. 

I'm just doing This one sample isn't that  

Rebekah: snapshot? Yeah. And then  

Hilary: getting to the adult age. And so when you talk about to these parents, yeah, it is not too late. My cases are ending with showing adults where they had shoulder discrepancy, eyes that were asymmetrical, midlines that were off. Non functional swallows, depression, difficulty sleeping, migraines, body pain, bunions, knee aches, like all the whole thing. 

And now they're like, they're sleeping, they're breathing, their jaws have developed, their mid face has developed. We know that if their mid face has developed. Their sphenoid is involved, that beautiful butterfly bone, which again, I'd love to speak more about that, but when the [01:35:00] cranium, as Derek Nordstrom would teach us, and AIA, Mike Cantrell, and James Anderson, and Alice would be teaching us, as we're seeing going from a flattened skull with a flat midface, As we develop the mid face and allow the occiput and this area of the skull to develop when that's happening and we're creating space for the tongue, whether the restriction was this way or this way as that's developing. 

And the tongue is starting to have a home and we're getting the serotonin release and the dopamine release. And they're going through the releases that are happening in their fascia through the osteopathic collaboration that we insist upon, or we won't work with, like our care is insists upon that because we know it's needed. 

if they've had, releases in our care, including the non surgical and the surgical releases, but as their fascia is unwinding, their digestive systems are unwinding, their nervous systems are relaxing, they're sleeping, they're [01:36:00] dreaming, they're not waking up to pee, their mouths are closed, their, breath is not there, and their faces are developing. 

These midfaces that are allowing us to see the corner of the angle of the mandible that didn't need surgery to be brought forward, but it was always there. It just couldn't come forward because it was trapped behind this maxilla unless it developed into a class 3 and jumped it. But if we can bring that upper jaw forward, which Marina shows in her, um, but if we can just see the body unravel and start to develop, these cheekbones, we see those glare in one of those tests that we know, right in kids or in adults is if we see a lot of whites of the eyes, when we're looking at somebody, these cheekbones are underdeveloped back when they come forward. 

And then the the whites of the eyes go away and the dark circles under the eyes and the cheeks come forward and the jaws widening. And then you start to [01:37:00] see this corner of the angle of the mandible and it's not melting into the neck. And you're like, yeah, this is a 47 year old baby. Yeah. 

Rebekah: Cause we're going back to the root.  

Hilary: Yeah. Going all the way  

Rebekah: back to there. And for anybody that doesn't know, cause we've mentioned it a few times and we've talked about it on other episodes, but if this is your first episode. This whole craniofacial thing, you're thinking, what language are they talking? 

I'll include the link to Dr. Stephen Hall's episode. Um,he's phenomenal and he's got a great book and he explains it so beautifully. And yeah, that was my introduction to it and it's, it can be a life changing addition to your medical journey.  

Hilary: We learn that the cranium fuses at age 21, right? 

We learn that. Yeah. There's this beautiful video of this pediatrician who's actually teaching us about the suck and swallow that's so good and in it as an [01:38:00] aside she mentions this is what the bones look like before they fuse, but they don't fuse. They're always It's free moving. 

They're always, I mean, our occiput fuses and our mandible is  

Rebekah: impacted,  

Hilary: but they're all movable. And so this beautiful bone, the sphenoid, which is a butterfly shaped bone that has two long wings that go up and two that go down connects to every single bone in the skull. And we have access to that through the maxilla and whatever the sphenoid is doing, the upper midline is doing. 

So as dentists. for us to see a midline that's off, we can expect then, it's not that the teeth genetically came into the wrong position. The sphenoid is actually in some type of cranial. imbalance. And the metaphor that I use, I was taught by the physical therapist who works, one of them that works with me, who's a craniosacral therapist. 

She's been a physio for like 40 years [01:39:00] and craniosacral therapy for over 30 years. and she's not a certified osteopath, but she's done so many of the courses in osteopathy. It's really a pleasure to work with her for all the skills she can bring in. She described to me, Craniosacral therapy. So if we were to talk to people who haven't known what it is. 

Mm-Hmm. like cranial strains are when the bones of the cranium are jammed in certain ways or mis oriented. So the plate,the sutures of our skull have different ways that they join. Some of them join like a zipper. Some of them, join more straight, others are like plate tectonics and they slide over each other. 

In particular, the temporal bone, which the ear and the ear canal, and Is the home for the little bed, the glenoid fossa that our two jaws. live in. It's a movable bone. So in [01:40:00] dentistry we have this pursuit of the ideal occlusion, the bite between the top and bottom jaw. We have this pursuit of it being something that can become stable and it's like we wanna give the person this grounding sense and we look for it dentally. 

And there's so many highly skilled, highly trained. Super, super well intended people looking to build these bites. That may not know that the bone that the jaw joint lives in is movable, and it's movable because it's connected to the sternocleidomastoid. So it's movable with muscular strain. It's movable with impact strain and it's movable. 

Based on the way that our tongue has helped the sphenoid bone to have its movement or been at the, they're chicken and egg. But this bone is what we balance out when we do. Alf therapy and other [01:41:00] forms of dental appliances that you sure you've got lots of people that have been on that have talked about how the impact of cranial balance. 

And for me, it's using outlay where alpha principles with Derek Nordstrom, but.the bones are not fused and so they can get jammed in these sutures and the way, ah, one of my other mentors, Herman Ramirez, he's a pediatric orthodontist in Ontario, he goes through and he says, What are some of the sutures in the head when he's testing you? 

So he wants to know, the parietal suture. He wants the lambda. He wants the maxillary suture. He wants you to tell, but he ends up saying the suture between the maxilla and the mandible is occlusion. So the way we bite is actually the suture between these two jaws, which brings us back to this cool painting, right? 

Yep,  

Rebekah: it does.  

Hilary: So I made a t shirt for him that has the original picture before the [01:42:00] premolar is put in and then the second one and it says The suture between the maxilla and the mandible is the occlusion. And so we as a profession In dentistry are studying and training and working are very very hardest and most heartfelt to establish a stable occlusion for a patient to feel good. 

If there's a cranial strain that exists when we establish that occlusion, If their shoulders still elevated, if they have a scoliotic tongue, if they have a strain in those cranial bones that are sliding like plate tectonics or that have jammed in a certain way, and we build a solid occlusion where actually can be serving to reinforce the cranial strain. 

So when I was telling you about my staff member with the dragon. And the internal rotation of me touching her second molar. I didn't have her bite together after I did [01:43:00] that osteopathic move, because if I did Her occlusion would immediately in a suture between her maxilla and mandible would undo the benefit of her shoulder and shoulder rotation, which is exactly what we did 2 seconds afterwards for me to say now just bite together and then we can't move our arm again. 

So, 

the way that this, Glenda is the name of the physio who explained cranial to me, explained it is to say. Okay. You know, when you go to a drawer and you go to pull out a drawer and it's something stuck, right? And like, okay, so I have three choices. One isI didn't need that badly. I'm just going to close it. 

Right. Else can figure this out. or like legitimately I'm in a hurry or I don't think I have the skills to do it. Or, There is somebody else who's better at this than I am. I'm going to wait for them. Legitimately, we're going to walk away.  

Other choice is we can take that drawer and we can go and just  

Rebekah: yank the [01:44:00] fire out of it. 

Yeah.  

Hilary: And like, maybe, maybe that thing will spring out. It's Oh, it was the staple remover. Or that was those. Barbecue tongs that had opened because they didn't get slimmed back to the dishwasher, whatever, like whatever it was causing that. Maybe they broke on the way out. Maybe it chipped a little bit of the drawer. 

Nobody will notice. Cause it's like on the undersurface, maybe it's still workable though. It's still workable. We got it with force. And you know what? I can buy a new wooden spoon or I can get a new tongue or whatever. Right. But it, I got, I got it there. The other option. Is to just take the drawer and jiggle it a little bit, push it in and jiggle it and look in, And go like,  

Rebekah: yeah, cause you reach up under there and you push down whatever it is,  

Hilary: something else here. I want to take this and I'm just going to push it down. Okay. So maybe there's your, Oh, maybe there's your, Visalign expander. Maybe there's your, like whatever else you're using, right?  

[01:45:00] and then, okay, now I'm just going to I'm going to push it in just a little further and, ah, now look at that and get all the way out. Yeah. And here it is. It's intact. And it, and. And I'll take better care of it now, right?  

Rebekah: Right.  

Hilary: That is craniosacral therapy or osteopathy. 

You, you assess and you find something that's stuck. You understand what it's connected to. You know if it's going to need further support other than just manual therapy. Whether it's releases, whether it's when it, right? But you move in the direction of the lesion. And you actually use this biotensegrity, right? 

Gavin James would teach so clearly with Barry Raphael on biotensegrity. You take the tensegrity of the fascia of the body, the muscles, the compensations, the tensions, the hard parts, the soft parts, the drawer, the cupboard, the walls, you've got the legs, you've got the feet, [01:46:00] your gait, you've got your lungs, you've got this whole body of hard, soft parts, rhythm centers, all interconnected with this web of fascia. 

And you just move in the direction of the lesion, and then it starts to let go. And then you can gently within the physiologic range of the body, start to have it release and breathe open. And the parts themselves are functioning more ideally, and they're available to you. And that is what we do. 

Life changing. Cranial sacral therapy and osteopathy. Yeah, it  

Rebekah: is absolutely life changing. So at the end of every episode. I always hand it back to you, the guest, because y'all are dancers.  

Hilary: And  

Rebekah: so for the last, the final word, the final thought for our parents, I will turn it over to you. 

Hilary: It's never too [01:47:00] late. It's never too late. And if your gut feels like there's something that's being missed, you're probably right. And you need to trust your gut as a parent. 

And it's really important when you start to see and recognize these things that you have to remember to see the beauty, as well as the diagnoses and the struggles, because it's so easy to just start to look at the airport or at Costco or wherever you are and just see all these 

it's easy to get, I have parents who like email every week and they're like, when will she see us? Because we know that there's, you know, it's so easy to get really,fixated on it that it can almost drive you crazy. And this is where Dr. Sherry Sammy, who's, I don't know if you're going to read her. 

She has [01:48:00] taught me to say. Remember to make sure you see the beauty in all of these ages and life forms and in yourself first before you start in on diagnosing on what you really see, because the humanity of what the world needs right now, where we're seeing the breakdown of all of our, what geopolitical financial mess of all these other systems, everything's breaking down. 

The only thing that we can grow is our systems of humanity and yeah, so it's really important to not get too wrapped up in, it's this balance. You need a balance of being able to listen to your gut, know that you may have to look a little bit further and wider for providers, but it's growing and it's coming and to be very gentle on yourself and on the people that you see these diagnoses in because you really have to. 

See the beauty in [01:49:00] them first and the humanity and the spirit. But on top of that, be very gentle on the people who are still in the silos because we want to bring them along with as empathetic of care as we possibly can. And the more that we're gentle on the people who are being the visionaries and the putting their backs out there for all the lashings and the. 

The stabbings and whatever we're getting professionally, be gentle on them because it's very hard. And we're just humans too.  

Rebekah: Agreed.  

Hilary: Until we were eight and had two rounds of orthodontics.  

Rebekah: Agreed. Agreed.  

Dr. Claire stag says it so beautifully as well. And it's all about. Giving grace. As a mom, give yourself grace. We didn't know we were doing the best we could. 

You know, as a provider, you work so hard through medical school, dental school, whatever. Give [01:50:00] yourself grace. You're doing  

Hilary: from  

Rebekah: your heart what you were taught, right? You didn't know. And anybody that's in the silo,  

Hilary: yeah, give them grace. Yes. Give them grace. Yeah. Because  

Rebekah: that's how we're all going to get there together. 

Hilary: Yeah. and the only thing we can do is meet people where they're at. Yep. So, I have moms with babies who are like, is it too late? And they're only three months old. I'm like, Oh no, you're fine.  

Rebekah: You're great. Yeah.  

Hilary: 65 year old babies. Like you are fine. Give, yes. Give yourself grace. Don't get, when you start to learn this information, don't get so fixated that it drives you crazy bec