1 00:00:00,000 --> 00:00:21,940 Hi everybody, and welcome back to Airway First, a podcast from the Children's Airway 2 00:00:21,940 --> 00:00:22,940 First Foundation. 3 00:00:22,940 --> 00:00:25,440 I'm your host, Rebecca Downing. 4 00:00:25,440 --> 00:00:27,960 My guest today is Dr. Tasha Terzoh. 5 00:00:27,960 --> 00:00:34,600 Dr. Terzoh graduated from Western University in 1994, where she received a postgraduate 6 00:00:34,600 --> 00:00:38,120 osteopathic manual medicine anatomy fellowship. 7 00:00:38,120 --> 00:00:44,600 She completed her internship at UCSF Family Medicine Residency at the Santa Rosa Community 8 00:00:44,600 --> 00:00:45,600 Hospital. 9 00:00:45,600 --> 00:00:54,280 Since 1995, she has been practicing osteopathy, homeopathy, functional medicine, prolotherapy, 10 00:00:54,280 --> 00:00:59,280 and PRP, specializing in cranial functional dysfunctions. 11 00:00:59,280 --> 00:01:04,400 She's a clinical adjunct assistant professor at the Turro College of Osteopathic Medicine, 12 00:01:04,400 --> 00:01:08,720 where she has been a guest lecturer since 2007. 13 00:01:08,720 --> 00:01:13,840 She's a founding member of the ALF Educational Institute and is an internationally recognized 14 00:01:13,840 --> 00:01:18,800 expert in the application of osteopathy and functional dentistry, with a focus on the 15 00:01:18,800 --> 00:01:23,560 use of advanced, light-wear functional devices and TMD. 16 00:01:23,560 --> 00:01:28,200 She is the author of the ALF approach, Changing the Face of Orthodontics. 17 00:01:28,200 --> 00:01:37,040 You can find out more about Dr. Terzoh at www.drtashaterzoh.com. 18 00:01:37,040 --> 00:01:39,960 And now, here's my interview with Dr. Terzoh. 19 00:01:39,960 --> 00:01:44,240 All right, thank you, Dr. Terzoh, and welcome to our podcast. 20 00:01:44,240 --> 00:01:45,240 It's great to have you. 21 00:01:45,240 --> 00:01:46,240 Thank you. 22 00:01:46,240 --> 00:01:47,240 It's great to be here. 23 00:01:47,240 --> 00:01:48,680 I'm excited to be able to share. 24 00:01:48,680 --> 00:01:51,040 Yeah, absolutely. 25 00:01:51,040 --> 00:01:57,000 So before we begin, just to kind of set the stage for everybody, what exactly is a DO 26 00:01:57,000 --> 00:02:00,440 and what is the practice of osteopathy? 27 00:02:00,440 --> 00:02:03,280 It's a great question. 28 00:02:03,280 --> 00:02:07,880 And I can start by talking about what is an orthopedic position in America, because it's 29 00:02:07,880 --> 00:02:10,840 different in America than in the rest of the world, actually. 30 00:02:10,840 --> 00:02:11,840 Really? 31 00:02:11,840 --> 00:02:12,840 Okay. 32 00:02:12,840 --> 00:02:13,840 Yes, yes. 33 00:02:13,840 --> 00:02:19,120 So we have different licensing capacities, basically, or regulations in America than 34 00:02:19,120 --> 00:02:20,200 we do in the rest of the world. 35 00:02:20,200 --> 00:02:23,720 So in the United States, there's two different ways to become a medical physician. 36 00:02:23,720 --> 00:02:31,600 There's two different organizations that regulate a medical license in the United States. 37 00:02:31,600 --> 00:02:37,400 One is the AMA, American Medical Association, and the other one is the AOA, American Osteopathic 38 00:02:37,400 --> 00:02:38,600 Association. 39 00:02:38,600 --> 00:02:41,440 And depending upon, and each one of those have different schools. 40 00:02:41,440 --> 00:02:46,800 So you have the allopathic, which is an MD, medical school, which is four years, and you 41 00:02:46,800 --> 00:02:51,120 have the osteopathic medical school, which is also four years. 42 00:02:51,120 --> 00:02:57,000 So when you apply to medical school, you choose to apply to, you can choose to apply to both, 43 00:02:57,000 --> 00:02:58,000 and many do both. 44 00:02:58,000 --> 00:03:04,480 I was captivated by the osteopathic philosophy, and I was very clear I wanted to be an osteopath, 45 00:03:04,480 --> 00:03:08,320 and I chose not to apply to any MD schools. 46 00:03:08,320 --> 00:03:15,280 The osteopathic philosophy, there's a philosophy behind how we practice medicine. 47 00:03:15,280 --> 00:03:18,920 My beloved husband's an MD, and we have a conversation often about this. 48 00:03:18,920 --> 00:03:21,480 There is no philosophy in allopathic medicine. 49 00:03:21,480 --> 00:03:26,280 It's basically kill all germs at all costs and avoid death. 50 00:03:26,280 --> 00:03:30,640 That's basically what they're, you know, that's basically what underneath what they're trying 51 00:03:30,640 --> 00:03:36,440 to do is that in the osteopathic philosophy, we have some basic, basic principles. 52 00:03:36,440 --> 00:03:41,000 And that is that the body has the inherent capacity to heal itself. 53 00:03:41,000 --> 00:03:44,480 So we may put a bandaid on, but we're not healing the patient. 54 00:03:44,480 --> 00:03:47,400 We're creating an environment for the patient to heal itself. 55 00:03:47,400 --> 00:03:49,680 So it's really coming from a different perspective. 56 00:03:49,680 --> 00:03:54,120 So I do a lot of functional medicine also, and I come from the osteopathic functional 57 00:03:54,120 --> 00:03:58,160 medicine perspective, which is how do I help this person help themselves? 58 00:03:58,160 --> 00:04:01,040 Where are the obstacles of health? 59 00:04:01,040 --> 00:04:05,480 What is limiting this person from optimizing their own health? 60 00:04:05,480 --> 00:04:08,560 And then a basic principle is that the body is a functional unit. 61 00:04:08,560 --> 00:04:13,840 So the body is one unit from the top of our heads to the bottom of our toes. 62 00:04:13,840 --> 00:04:20,200 There is no division and there is no effect in one part of the body. 63 00:04:20,200 --> 00:04:24,000 It doesn't have an effect in another part of the body. 64 00:04:24,000 --> 00:04:28,760 So if we have, and this really comes into play when we're talking about orthodontics, 65 00:04:28,760 --> 00:04:34,600 if we put braces on teeth and we move teeth, the whole head shifts, the base of the cranium 66 00:04:34,600 --> 00:04:40,080 shifts, the cervical shift, posture shifts, everything shifts to accommodate those teeth 67 00:04:40,080 --> 00:04:41,520 coming together. 68 00:04:41,520 --> 00:04:47,400 And that's why it's crucially important to be able to have collaboration and to be able 69 00:04:47,400 --> 00:04:52,120 to work together and to make sure that when those pearly whites are coming back together, 70 00:04:52,120 --> 00:04:53,320 everything else is in alignment. 71 00:04:53,320 --> 00:04:54,320 Or else what do we do? 72 00:04:54,320 --> 00:04:57,360 We lock in a strain pattern. 73 00:04:57,360 --> 00:05:02,000 So coming back to the osteopathic principles, the body's a functional unit from the head 74 00:05:02,000 --> 00:05:08,080 to toe and structure function of reciprocally interrelated, which means that a bridge is 75 00:05:08,080 --> 00:05:12,000 created in a certain structure to have a certain function, right? 76 00:05:12,000 --> 00:05:15,960 Just like our human body has a structure that has a function to it. 77 00:05:15,960 --> 00:05:19,160 So our structures function. 78 00:05:19,160 --> 00:05:20,160 That's really important. 79 00:05:20,160 --> 00:05:25,400 So we're coming from a more mechanical perspective of looking at the human body, meaning that 80 00:05:25,400 --> 00:05:31,080 if we have ribs that are not moving well and are restricted, if we get a pneumonia, most 81 00:05:31,080 --> 00:05:35,600 likely the pneumonia is going to go to the side where the ribs aren't moving really well. 82 00:05:35,600 --> 00:05:37,120 Oh, got it. 83 00:05:37,120 --> 00:05:41,320 So looking at the human body is not only a functional unit from head to toe, but that 84 00:05:41,320 --> 00:05:45,120 everything in the body has motion and motion is held. 85 00:05:45,120 --> 00:05:52,400 And this expansion contraction that happens of the breath, let's say, in the body, that 86 00:05:52,400 --> 00:05:58,200 is also the driving force for arterial blood supply going to a cell and venous and lymphatic 87 00:05:58,200 --> 00:05:59,840 return going away. 88 00:05:59,840 --> 00:06:04,000 So I'm giving you kind of bullet points and trying to build a big picture of what the 89 00:06:04,000 --> 00:06:07,800 philosophy is of osteopathy because that is a basic difference. 90 00:06:07,800 --> 00:06:13,760 The education is basically exactly the same as an MD, except for we have about 100 to 91 00:06:13,760 --> 00:06:18,360 500 hours, depending upon what school you go to, what aspect of school you go to, where 92 00:06:18,360 --> 00:06:23,240 we learn this philosophy and we also learn how to diagnose neuromuscular skeletal issues. 93 00:06:23,240 --> 00:06:27,240 So we come out of this in addition, that 500 is in addition. 94 00:06:27,240 --> 00:06:28,240 Exactly. 95 00:06:28,240 --> 00:06:31,480 So we have more class hours per se. 96 00:06:31,480 --> 00:06:35,480 And what happens with the MDs is they get out earlier and go to clinics and start doing 97 00:06:35,480 --> 00:06:41,680 more of their clinical rotations or clinical education earlier, a little earlier. 98 00:06:41,680 --> 00:06:43,840 Each school is very different. 99 00:06:43,840 --> 00:06:46,240 So we know how to work up back pain. 100 00:06:46,240 --> 00:06:51,760 When we graduate with our four years, we know how to work up a back pain or a headache or 101 00:06:51,760 --> 00:06:52,760 an ankle strain. 102 00:06:52,760 --> 00:06:58,040 And we learn nine different ways of treating neuromuscular skeletal issues. 103 00:06:58,040 --> 00:07:00,680 But it's just like taking a basic course in cardiology. 104 00:07:00,680 --> 00:07:05,160 It's not enough to go into practice, but it's at least a something. 105 00:07:05,160 --> 00:07:09,600 And then once we finish our four years, then we intermesh together in our residency program. 106 00:07:09,600 --> 00:07:17,200 So like I did one year of a family practice residency with UCSF, which were almost all 107 00:07:17,200 --> 00:07:18,200 MDs. 108 00:07:18,200 --> 00:07:21,520 There was like one other DO. 109 00:07:21,520 --> 00:07:28,000 In all residency programs, you'll find DOs and MDs in the same residency program. 110 00:07:28,000 --> 00:07:34,200 I would say then you get licensed by your state and our licenses exactly the same. 111 00:07:34,200 --> 00:07:40,200 So if I had specialized in surgery, I would be doing surgery at the DO, but I didn't. 112 00:07:40,200 --> 00:07:42,320 I chose to spend that it gets complicated. 113 00:07:42,320 --> 00:07:43,920 I'm so sorry about this. 114 00:07:43,920 --> 00:07:46,200 It gets complicated. 115 00:07:46,200 --> 00:07:52,480 Then 95% of my colleagues that are DOs don't practice the way I practice. 116 00:07:52,480 --> 00:07:55,360 So I practice as a traditional osteopath. 117 00:07:55,360 --> 00:08:00,960 In other words, I use my hands with every single patient to help them in terms of removing 118 00:08:00,960 --> 00:08:06,360 obstacles of health and helping their health optimize, basically. 119 00:08:06,360 --> 00:08:11,880 And I also did a four year training in TOT and the world of homeopathy. 120 00:08:11,880 --> 00:08:14,440 I do PRP and pro-lo therapy injections. 121 00:08:14,440 --> 00:08:16,400 So I do cellular regeneration. 122 00:08:16,400 --> 00:08:21,400 Do a lot of the injections in the jaw joints because I work a lot with TMD. 123 00:08:21,400 --> 00:08:24,200 I see a lot of babies. 124 00:08:24,200 --> 00:08:25,440 I see children. 125 00:08:25,440 --> 00:08:32,440 So it's kind of like a family practice old fashioned in a way because I'm using primarily, 126 00:08:32,440 --> 00:08:40,160 I start with my hands to see what are restrictions in the body and what we can do to remove those. 127 00:08:40,160 --> 00:08:45,080 And in the rest of the world, the osteopaths are not medical physicians. 128 00:08:45,080 --> 00:08:51,640 So in Canada and Australia, New Zealand, France, they're more like chiropractors. 129 00:08:51,640 --> 00:08:55,920 So they learn how to do, they learn osteopathy, they learn the orthopedic portion and how 130 00:08:55,920 --> 00:09:01,040 to do the hands on and they learn how to use the nine different modalities that are taught, 131 00:09:01,040 --> 00:09:02,640 but they're not medical physicians. 132 00:09:02,640 --> 00:09:07,960 So they can't do injections or they can't prescribe medication. 133 00:09:07,960 --> 00:09:14,760 They can't do anything that's in the world of a physician's world. 134 00:09:14,760 --> 00:09:15,760 Interesting. 135 00:09:15,760 --> 00:09:16,760 Yeah. 136 00:09:16,760 --> 00:09:17,760 Very interesting. 137 00:09:17,760 --> 00:09:23,000 So let's say your hands on and you touched on a little bit about modality. 138 00:09:23,000 --> 00:09:30,040 It's more how the body, if I were to come in and let's say I have, I know I'm having 139 00:09:30,040 --> 00:09:33,240 my annual sinus infection. 140 00:09:33,240 --> 00:09:35,120 So let's just start with something like that. 141 00:09:35,120 --> 00:09:42,760 When your hands on, how do you move and see, you're looking not just to treat, hi, I have 142 00:09:42,760 --> 00:09:46,120 a sinus infection, you're looking deeper is my understanding. 143 00:09:46,120 --> 00:09:47,120 For sure. 144 00:09:47,120 --> 00:09:51,880 So inherent within principles of osteopathy is digging for etiology. 145 00:09:51,880 --> 00:09:56,400 And that's one thing that's very, that I think from my perspective is quite unique to osteopathy. 146 00:09:56,400 --> 00:10:00,200 So I'm trying to, if you came in to see me with sinus infection, which definitely is something 147 00:10:00,200 --> 00:10:02,480 right up my alley, I feel very comfortable with. 148 00:10:02,480 --> 00:10:07,840 I felt many, many people with chronic allergies and get them off the antibiotics. 149 00:10:07,840 --> 00:10:11,040 I'm going to be thinking, what's going on? 150 00:10:11,040 --> 00:10:12,240 Where's their lack of motion? 151 00:10:12,240 --> 00:10:14,800 Why is there lack of motion in the mid face? 152 00:10:14,800 --> 00:10:20,000 What's going on where we're not getting mid face movement and what's not happening that 153 00:10:20,000 --> 00:10:22,560 needs to drain your sinuses. 154 00:10:22,560 --> 00:10:27,920 So draining sinuses, draining the middle ears is an inherent capacity within a human body 155 00:10:27,920 --> 00:10:34,280 and a lot of it has to do with the tongue and getting the tongue up and back and getting 156 00:10:34,280 --> 00:10:38,280 the pressure change that happens to the mid face when we have a functional swallow and 157 00:10:38,280 --> 00:10:41,800 a tongue resting position and a good dental occlusion. 158 00:10:41,800 --> 00:10:46,200 So if that, that's one of the things I'm going to look at, so I'm going to take a good history. 159 00:10:46,200 --> 00:10:50,520 I usually spend, I spend two hours with the patient initially. 160 00:10:50,520 --> 00:10:55,600 And that's when I'm going through absolutely everything from your birth history to your 161 00:10:55,600 --> 00:11:01,240 developmental history, to your nursing sucking swallow history, to your trauma history, what 162 00:11:01,240 --> 00:11:03,040 sort of head injuries did you have? 163 00:11:03,040 --> 00:11:08,040 Did you have any, you know, babies fall all the time off beds, countertops? 164 00:11:08,040 --> 00:11:10,240 I go through that. 165 00:11:10,240 --> 00:11:13,640 And I look at your orthodontic history, you know, what else happened? 166 00:11:13,640 --> 00:11:18,440 You know, are your teeth actually in a physiological position or a non-physiological position because 167 00:11:18,440 --> 00:11:21,920 they were forced there and the rest of your body wasn't able to, and your rest of your 168 00:11:21,920 --> 00:11:26,680 body is now accommodating for this new dental occlusion that's man made, that's based on 169 00:11:26,680 --> 00:11:32,040 classes like class one, two and three, which are lining up basically the pre, the first 170 00:11:32,040 --> 00:11:35,320 molar, but that's not a functional dental occlusion. 171 00:11:35,320 --> 00:11:39,520 A functional dental occlusion is when that dental occlusion is biocompatible with the 172 00:11:39,520 --> 00:11:40,520 rest of the body. 173 00:11:40,520 --> 00:11:41,520 Gotcha. 174 00:11:41,520 --> 00:11:45,160 Then I'm also going to be looking at your diet and your gut. 175 00:11:45,160 --> 00:11:48,680 So if I notice that I'm spending an hour and a half with the patient and they've got a 176 00:11:48,680 --> 00:11:55,160 great lip seal and they're breathing through their nose, now I'm like, hmm, why is it congested? 177 00:11:55,160 --> 00:11:58,720 Maybe it's from the gut and maybe this person has a food allergy. 178 00:11:58,720 --> 00:12:03,280 So I do work up of the gut and I look at maybe it's dairy, which a lot of times it is, or 179 00:12:03,280 --> 00:12:05,920 maybe it's wheat. 180 00:12:05,920 --> 00:12:11,200 And so then I'll see like, how open is this person to changing their diet? 181 00:12:11,200 --> 00:12:14,140 That's very challenging for some people. 182 00:12:14,140 --> 00:12:18,040 So it's a very individuated approach. 183 00:12:18,040 --> 00:12:22,920 The non-invigilated approach is give you antibiotics and just keep giving you antibiotics and like, 184 00:12:22,920 --> 00:12:25,520 well, this is your- Every year, come back in again. 185 00:12:25,520 --> 00:12:27,360 This is your core genetics. 186 00:12:27,360 --> 00:12:28,680 This is the way it is. 187 00:12:28,680 --> 00:12:33,640 And I'm just going to keep giving you antibiotics and this is like a five minute appointment. 188 00:12:33,640 --> 00:12:36,400 No, no, thank you. 189 00:12:36,400 --> 00:12:37,400 Not going to do that. 190 00:12:37,400 --> 00:12:43,200 I want to find out why this person is having this chronic recurrence sinus infection. 191 00:12:43,200 --> 00:12:44,720 Something's not right. 192 00:12:44,720 --> 00:12:45,720 Okay. 193 00:12:45,720 --> 00:12:46,720 All right. 194 00:12:46,720 --> 00:12:50,800 And you touched on this briefly, which they can't see. 195 00:12:50,800 --> 00:12:52,600 I was smiling when you did it. 196 00:12:52,600 --> 00:12:57,800 But when you were talking about the occlusions and the man-made occlusions and when I heard 197 00:12:57,800 --> 00:13:03,920 you speak at AAPMD, which I will put the link to that lecture in our show notes, one of 198 00:13:03,920 --> 00:13:10,200 the things you talked about was the impact of retractive orthodontics. 199 00:13:10,200 --> 00:13:14,840 And in kind of the approach specifically around airways. 200 00:13:14,840 --> 00:13:19,120 That's one thing here at Children's Airway First that we have seen and we're seeing over 201 00:13:19,120 --> 00:13:24,840 and over with people that we speak with, with other medical professionals. 202 00:13:24,840 --> 00:13:29,520 How do you approach, well, just there's really no good way to ask that. 203 00:13:29,520 --> 00:13:30,680 I mean, how do you approach that? 204 00:13:30,680 --> 00:13:36,240 You have a patient that's coming in that you know they're having issues and here they are. 205 00:13:36,240 --> 00:13:41,720 They're getting ready to either have orthodontic work done in their teen years or now you're 206 00:13:41,720 --> 00:13:44,720 in your 30s or 40s and you had that work done. 207 00:13:44,720 --> 00:13:51,040 And now you're presenting with chronic allergies, sleep apnea, things of that nature. 208 00:13:51,040 --> 00:13:52,040 Yeah. 209 00:13:52,040 --> 00:13:55,000 Well, it begins with early intervention. 210 00:13:55,000 --> 00:13:58,080 So I'm all hyped up about children. 211 00:13:58,080 --> 00:14:01,800 I have children myself, actually they're now young adults or they're trying to be young 212 00:14:01,800 --> 00:14:04,800 adults, we'll put it that way. 213 00:14:04,800 --> 00:14:10,960 Anyhow, I'm very passionate about children and if you know, if I could probably retire 214 00:14:10,960 --> 00:14:14,840 now and feel fulfilled because I know I've helped so many children. 215 00:14:14,840 --> 00:14:17,240 It's about and now it's all about education. 216 00:14:17,240 --> 00:14:22,960 It's educating parents, educating my colleagues, educating the dental world, the malfunction 217 00:14:22,960 --> 00:14:29,880 world about what are the signs that we see right when a baby's born that is going to 218 00:14:29,880 --> 00:14:32,720 tell us that this one is going to have an airway issue. 219 00:14:32,720 --> 00:14:36,640 So the airway issue typically comes before the teeth comes in. 220 00:14:36,640 --> 00:14:43,680 So the teeth come in, the teeth are coming in after the second swallow are already in 221 00:14:43,680 --> 00:14:49,920 place and the second swallow have more to do with increasing oral volume than our teeth 222 00:14:49,920 --> 00:14:50,920 do. 223 00:14:50,920 --> 00:14:56,400 Our teeth are simply coming together so we can now have a couple of things we can chew 224 00:14:56,400 --> 00:15:01,520 and the chewing and the function of chewing and how we're chewing very much dictates the 225 00:15:01,520 --> 00:15:03,600 growth of the mandible. 226 00:15:03,600 --> 00:15:05,120 So this is the epigenetics. 227 00:15:05,120 --> 00:15:13,880 This is how we use our function, how the functions in our face work is what develops a face. 228 00:15:13,880 --> 00:15:16,280 So learning how, yes, go ahead. 229 00:15:16,280 --> 00:15:17,280 Oh, I'm sorry. 230 00:15:17,280 --> 00:15:26,320 So the airway issue most of the time is there at birth or is it just the signs of dysfunction 231 00:15:26,320 --> 00:15:27,440 that lead to airway. 232 00:15:27,440 --> 00:15:28,920 It's like a dysfunction. 233 00:15:28,920 --> 00:15:29,920 Yes. 234 00:15:29,920 --> 00:15:30,920 Okay. 235 00:15:30,920 --> 00:15:35,320 So it's a dysfunctional side right at birth and it really has to do with how they nurse 236 00:15:35,320 --> 00:15:40,000 the second swallow of nursing and it has to do with can they nurse on both sides? 237 00:15:40,000 --> 00:15:42,560 Can they actually have the range of motion to turn their neck? 238 00:15:42,560 --> 00:15:45,080 If they don't, that's a subtle torticollis. 239 00:15:45,080 --> 00:15:51,280 So the birth experience is one of our biggest formative experiences that we have in our 240 00:15:51,280 --> 00:15:58,000 life that shape and form our head and our face because our head is what's opening up 241 00:15:58,000 --> 00:16:00,720 the cervix. 242 00:16:00,720 --> 00:16:06,840 So the whole entire how the baby's positioned, the kind of forces that are happening, the 243 00:16:06,840 --> 00:16:14,040 intervention that's happening from below up, let's say, have a huge effect on the functioning 244 00:16:14,040 --> 00:16:17,920 of our face and our head and our neck. 245 00:16:17,920 --> 00:16:22,400 So that's one thing that's being completely missed is taking a really good part of history. 246 00:16:22,400 --> 00:16:24,920 The other thing is taking a really good trauma history. 247 00:16:24,920 --> 00:16:29,400 So there's portions of the cranium that don't ossify until we're eight to nine years old. 248 00:16:29,400 --> 00:16:36,440 So any falls on the back of the head can twist and compress different cranial bones in pinching 249 00:16:36,440 --> 00:16:40,600 on certain cranial nerves, creating entrapment. 250 00:16:40,600 --> 00:16:43,000 And this makes these nerves not function as well. 251 00:16:43,000 --> 00:16:47,000 And these nerves are cranial nerves, nine, 10, 11 and 12. 252 00:16:47,000 --> 00:16:54,880 So four of these very important nerves that they all go to the head, face, mouth can be 253 00:16:54,880 --> 00:16:59,340 pinched and compromised with facial strains. 254 00:16:59,340 --> 00:17:08,800 So the hands on, if in my ideal utopia, every single newborn would have an osteopathic treatment 255 00:17:08,800 --> 00:17:13,040 from someone who specializes in cranial osteopathy, everything. 256 00:17:13,040 --> 00:17:18,240 And if I can get them early enough, because I will go to the delivery room with my mamas 257 00:17:18,240 --> 00:17:19,520 that I treat when they're pregnant. 258 00:17:19,520 --> 00:17:21,520 I was about to say at birth. 259 00:17:21,520 --> 00:17:23,200 At birth, at birth. 260 00:17:23,200 --> 00:17:26,840 But you know, bring them to me a week later, I'm still happy. 261 00:17:26,840 --> 00:17:31,720 But those are ones, if I follow them all the way through, they don't need orthodontia. 262 00:17:31,720 --> 00:17:34,040 Because what we're doing is integrating the functions. 263 00:17:34,040 --> 00:17:39,880 So it's the functions that get, that go in the wrong direction, that create a structure 264 00:17:39,880 --> 00:17:43,200 that then is holding a maladaptive airway. 265 00:17:43,200 --> 00:17:45,360 So airway is simply a structure. 266 00:17:45,360 --> 00:17:49,680 I usually have a toilet paper roll with me, but it's a toilet paper roll. 267 00:17:49,680 --> 00:17:52,560 If you imagine a hole, a toilet paper roll, right? 268 00:17:52,560 --> 00:17:54,880 And you put that in the back of your tongue. 269 00:17:54,880 --> 00:17:55,880 That's your airway. 270 00:17:55,880 --> 00:17:59,520 Airway is collapsible soft tissue all the way around. 271 00:17:59,520 --> 00:18:06,200 So is the function of those nerves to give the soft tissue tone to be able to increase 272 00:18:06,200 --> 00:18:08,760 the size of our airway? 273 00:18:08,760 --> 00:18:11,680 So it's not about pulling the face forward. 274 00:18:11,680 --> 00:18:15,560 It's not about rapid pallid expanders, which only do two dimensional, not three dimensional 275 00:18:15,560 --> 00:18:17,920 expansion anyhow. 276 00:18:17,920 --> 00:18:22,120 It's about looking in the beginning at the functioning of these nerves to make sure that 277 00:18:22,120 --> 00:18:24,280 they're intact. 278 00:18:24,280 --> 00:18:33,840 The action that expresses the intactness of these four cranial nerves is nursing. 279 00:18:33,840 --> 00:18:39,080 So if we're having to hold our baby over our shoulders, or can only nurse in bed on the 280 00:18:39,080 --> 00:18:43,320 right side, but not the left side, can only nurse laying down, these are all signs of 281 00:18:43,320 --> 00:18:50,840 compensations for lack of tone and integration of these nerves and or a tongue tie. 282 00:18:50,840 --> 00:18:57,400 But not all tongue, not all nursing dysfunctions or nursing issues are tongue ties by any means. 283 00:18:57,400 --> 00:19:01,560 A lot of times is low tone to the hypergloctal nerve, which is a nerve that innervates the 284 00:19:01,560 --> 00:19:03,160 tongue. 285 00:19:03,160 --> 00:19:06,880 So can this be seen if you're not breastfeeding? 286 00:19:06,880 --> 00:19:09,560 Can you still spot it if the child is not breastfeeding? 287 00:19:09,560 --> 00:19:11,840 Yes, you can assess the suck. 288 00:19:11,840 --> 00:19:16,440 So even if you're a little pinky in their mouth, I mean, if moms are doing it's hard 289 00:19:16,440 --> 00:19:19,160 unless you've had other children to compare it to. 290 00:19:19,160 --> 00:19:20,160 Okay. 291 00:19:20,160 --> 00:19:22,720 So if they're breastfeeding, what's a good sex swallow? 292 00:19:22,720 --> 00:19:27,840 But if they have a low sex swallow and a low tone, then this is something that's worth 293 00:19:27,840 --> 00:19:32,840 looking at to see if it is a compression to the base of the cranial, which can quite easily 294 00:19:32,840 --> 00:19:34,760 be resolved. 295 00:19:34,760 --> 00:19:39,440 But if it's not resolved, the ongoing consequence leads to sleep apnea. 296 00:19:39,440 --> 00:19:40,440 Got it. 297 00:19:40,440 --> 00:19:41,440 Without a question. 298 00:19:41,440 --> 00:19:42,440 Amazing. 299 00:19:42,440 --> 00:19:43,440 Okay. 300 00:19:43,440 --> 00:19:44,440 Wow. 301 00:19:44,440 --> 00:19:50,960 So the other thing that I heard you talk about was about the food we eat. 302 00:19:50,960 --> 00:19:51,960 Yes. 303 00:19:51,960 --> 00:19:55,440 And I'm now, you know, when I heard you do it, I have to be honest, I started retracing 304 00:19:55,440 --> 00:19:57,680 my steps, you know, what did I feed my children growing up? 305 00:19:57,680 --> 00:20:00,080 If I set them up to win, oh my goodness. 306 00:20:00,080 --> 00:20:07,280 But you had mentioned that it actually impacts facial development or growth. 307 00:20:07,280 --> 00:20:08,280 100%. 308 00:20:08,280 --> 00:20:09,280 Yes. 309 00:20:09,280 --> 00:20:10,280 How so? 310 00:20:10,280 --> 00:20:11,280 Yes. 311 00:20:11,280 --> 00:20:13,400 So first of all, us moms, it's always our fault. 312 00:20:13,400 --> 00:20:17,520 We're always like, you know, we've got this radar looking for where did we go wrong? 313 00:20:17,520 --> 00:20:18,520 Right. 314 00:20:18,520 --> 00:20:19,520 The guilt one. 315 00:20:19,520 --> 00:20:20,520 Of course. 316 00:20:20,520 --> 00:20:21,520 Oh my gosh. 317 00:20:21,520 --> 00:20:22,520 Oh my gosh. 318 00:20:22,520 --> 00:20:23,520 Oh, God bless us all. 319 00:20:23,520 --> 00:20:24,520 Anyhow. 320 00:20:24,520 --> 00:20:25,520 Yes. 321 00:20:25,520 --> 00:20:26,520 So what we eat forms our face. 322 00:20:26,520 --> 00:20:31,600 And the reason why is because it's not only nutrition in terms of the nutrient dense 323 00:20:31,600 --> 00:20:35,720 food that we need to build healthy bones and healthy muscles. 324 00:20:35,720 --> 00:20:41,880 But it is what we chew has an influence on how we chew. 325 00:20:41,880 --> 00:20:45,760 So if we're feeding our babies, all these soft foods, you know, the ones that are in 326 00:20:45,760 --> 00:20:50,600 the packages where you just like you're driving and you've got the kids in the back and you 327 00:20:50,600 --> 00:20:53,360 just hand them the package and they squeeze it. 328 00:20:53,360 --> 00:20:54,360 The little applesauce. 329 00:20:54,360 --> 00:20:55,360 The little applesauces. 330 00:20:55,360 --> 00:20:56,360 Right. 331 00:20:56,360 --> 00:20:58,760 So those are all soft foods. 332 00:20:58,760 --> 00:21:05,720 So part of what's happened, if we look at evolution of or the change of human faces 333 00:21:05,720 --> 00:21:11,840 over time is that we have become more maxillary mandibular, which means that we're back. 334 00:21:11,840 --> 00:21:13,880 We're becoming more like bulldogs. 335 00:21:13,880 --> 00:21:15,360 We're getting a flatter face. 336 00:21:15,360 --> 00:21:20,840 And the reason for that is because of we're not chewing on bones anymore. 337 00:21:20,840 --> 00:21:24,400 You know, we used to chew on bones for like six hours a day or something like that. 338 00:21:24,400 --> 00:21:26,240 Like there was a lot of chewing. 339 00:21:26,240 --> 00:21:29,560 We'd have meat that we'd have to work. 340 00:21:29,560 --> 00:21:31,060 Nuts. 341 00:21:31,060 --> 00:21:32,060 This sort of thing. 342 00:21:32,060 --> 00:21:33,280 We didn't have smoothies. 343 00:21:33,280 --> 00:21:34,280 We didn't have juicing. 344 00:21:34,280 --> 00:21:36,160 You know, we didn't have applesauce. 345 00:21:36,160 --> 00:21:44,280 So it's all these soft foods that are creating the experience where we're not using our jaw 346 00:21:44,280 --> 00:21:45,280 as much. 347 00:21:45,280 --> 00:21:50,320 And so there's many, many studies done on mice rats. 348 00:21:50,320 --> 00:21:54,480 One of them, what they did was they took out the occlusion on one side. 349 00:21:54,480 --> 00:21:59,840 They took out how the bicuspid and the first molar contact on one side of the mouse or 350 00:21:59,840 --> 00:22:03,080 mice or rat, whatever, little poor rodents. 351 00:22:03,080 --> 00:22:05,720 And then they looked at mandibular development. 352 00:22:05,720 --> 00:22:11,120 And what they saw was that they had mandibular growth on the side where there was an occlusion. 353 00:22:11,120 --> 00:22:13,320 But on the side, there wasn't an occlusion. 354 00:22:13,320 --> 00:22:16,000 The mandible didn't grow. 355 00:22:16,000 --> 00:22:23,080 So what it shows us is that with the amount of contact that happens is the contact and 356 00:22:23,080 --> 00:22:28,200 the compression that happens and stimulates bone growth. 357 00:22:28,200 --> 00:22:29,800 Simulates the mandible to grow. 358 00:22:29,800 --> 00:22:32,960 So when I see the kids that are retrokinathic, right? 359 00:22:32,960 --> 00:22:37,440 First of all, if I see a baby that's retrokinathic, I know right away that mom has an airway issue. 360 00:22:37,440 --> 00:22:40,040 So what happened was mom had a... 361 00:22:40,040 --> 00:22:41,600 Mom has an airway issue. 362 00:22:41,600 --> 00:22:45,000 Mom, that's one of the main reasons why we're seeing all these babies with retrokinathia, 363 00:22:45,000 --> 00:22:47,120 which means that the mandible is back. 364 00:22:47,120 --> 00:22:56,280 So what happens is that mom has an airway issue and therefore the womb is a suboptimal 365 00:22:56,280 --> 00:22:59,480 oxygenated environment. 366 00:22:59,480 --> 00:23:03,800 And our environment is what dictates our growth patterns, right? 367 00:23:03,800 --> 00:23:07,200 Just like I'm talking about the epigenetics of what we eat creates a mandible. 368 00:23:07,200 --> 00:23:10,360 The same thing, the epigenetics happens in utero. 369 00:23:10,360 --> 00:23:17,560 So if mom has four bicuspid extraction, they've had braces, everything is pulled back, right? 370 00:23:17,560 --> 00:23:19,120 The tongue doesn't have room. 371 00:23:19,120 --> 00:23:23,040 So the tongue is going to go back because the poor little tongue doesn't know where else 372 00:23:23,040 --> 00:23:24,680 to go. 373 00:23:24,680 --> 00:23:28,680 We have suboptimal oxygenation happening as we're developing our babies. 374 00:23:28,680 --> 00:23:36,160 And so the face of the baby is an expression of the environment it's been in. 375 00:23:36,160 --> 00:23:38,160 Wow. 376 00:23:38,160 --> 00:23:41,000 Wow. 377 00:23:41,000 --> 00:23:42,400 That's a pretty big one for me. 378 00:23:42,400 --> 00:23:45,800 I just have to kind of let that one sit for a moment. 379 00:23:45,800 --> 00:23:46,800 Yes. 380 00:23:46,800 --> 00:23:50,800 Yes, I understand that. 381 00:23:50,800 --> 00:23:53,200 Wow. 382 00:23:53,200 --> 00:24:01,680 You're listening to Airway First with today's guest, Dr. Tasha Terzo. 383 00:24:01,680 --> 00:24:05,520 You can find out more about the Children's Airway First Foundation and our mission to 384 00:24:05,520 --> 00:24:11,360 ensure that every child has access to screening, evaluation, and treatment of all children's 385 00:24:11,360 --> 00:24:17,800 airway disorders before the age of six on our website at childrensairwayfirst.org. 386 00:24:17,800 --> 00:24:22,480 You can also find a ton of great resources for parents on our website, including videos, 387 00:24:22,480 --> 00:24:27,480 blogs, recommended books, comprehensive medical research, and more. 388 00:24:27,480 --> 00:24:32,840 As a reminder, this podcast and the opinions expressed here are not a medical diagnosis. 389 00:24:32,840 --> 00:24:37,840 If you suspect your child might have an airway issue, contact your pediatric airway dentist 390 00:24:37,840 --> 00:24:39,600 or pediatrician. 391 00:24:39,600 --> 00:24:55,720 And now, back to my interview with Dr. Tasha Terzo. 392 00:24:55,720 --> 00:25:01,880 It's coming from a whole perspective and it's coming from a functional perspective. 393 00:25:01,880 --> 00:25:11,320 So, so much of our perspectives within dentistry is all structural. 394 00:25:11,320 --> 00:25:17,200 And we think of dentists as fixing cavities and making teeth align. 395 00:25:17,200 --> 00:25:23,960 So what this perspective is, is now we're going to look at, well, what brings teeth 396 00:25:23,960 --> 00:25:26,240 into their position in the first place? 397 00:25:26,240 --> 00:25:27,720 And it's not genetics. 398 00:25:27,720 --> 00:25:29,080 That is for sure. 399 00:25:29,080 --> 00:25:30,280 It is not genetics. 400 00:25:30,280 --> 00:25:34,880 It's not like when we have our kid that has not room for their teeth that we need to pull 401 00:25:34,880 --> 00:25:41,280 the teeth out because just so sorry, genetically, you know, your mom and your dad or, you know, 402 00:25:41,280 --> 00:25:48,080 whatever whoever made you weren't compatible to create an oral volume that's conducive 403 00:25:48,080 --> 00:25:49,080 to life. 404 00:25:49,080 --> 00:25:50,800 So that is not true. 405 00:25:50,800 --> 00:25:56,560 What happens is, is it's the initial functions that don't go optimally, that create a suboptimal 406 00:25:56,560 --> 00:25:58,160 structure. 407 00:25:58,160 --> 00:26:04,120 So our faces and the structure of our face tell a picture of how we functioned with our 408 00:26:04,120 --> 00:26:08,840 nasal breathing, our lip seal, our tongue up posturing and our chewing. 409 00:26:08,840 --> 00:26:11,480 Those are the main components that grow a face. 410 00:26:11,480 --> 00:26:15,160 So this is coming from the point of view of early intervention is intervention on looking 411 00:26:15,160 --> 00:26:21,680 at the functions and trying to get those online so that we can develop a face that is perfect 412 00:26:21,680 --> 00:26:22,680 for us. 413 00:26:22,680 --> 00:26:26,680 It's a perfect expression of our optimal health. 414 00:26:26,680 --> 00:26:29,560 And how early we can start is birth. 415 00:26:29,560 --> 00:26:32,840 How late can we make an impact with this approach? 416 00:26:32,840 --> 00:26:35,480 We're actually talking. 417 00:26:35,480 --> 00:26:41,480 We can do now prebirth because now we can look at the moms and I can be like, you know 418 00:26:41,480 --> 00:26:42,800 what? 419 00:26:42,800 --> 00:26:46,880 How about if we do something to optimize your oxygen before you get pregnant? 420 00:26:46,880 --> 00:26:47,880 Right? 421 00:26:47,880 --> 00:26:48,880 Wow. 422 00:26:48,880 --> 00:26:49,880 Right? 423 00:26:49,880 --> 00:26:51,640 I mean, prenatals are nothing. 424 00:26:51,640 --> 00:26:52,640 Right. 425 00:26:52,640 --> 00:26:56,840 So prenatals are nothing compared to like optimizing oxygenation. 426 00:26:56,840 --> 00:27:00,600 I mean, I see my beans, we grow to oxygen just like a plant grows to sunshine. 427 00:27:00,600 --> 00:27:05,440 So we're going to contort and even in our structure as we're growing, you know, we're 428 00:27:05,440 --> 00:27:09,600 going to tongue thrust or we're going to lateral thrust with our tongue or we're going to open 429 00:27:09,600 --> 00:27:16,200 mouth, breathe, we're going to do whatever we can to optimize that function in our body. 430 00:27:16,200 --> 00:27:18,560 And it's never too late to heal for not dead. 431 00:27:18,560 --> 00:27:20,360 We're still transforming. 432 00:27:20,360 --> 00:27:21,720 That's my opinion. 433 00:27:21,720 --> 00:27:23,360 So I love that. 434 00:27:23,360 --> 00:27:24,880 I love that. 435 00:27:24,880 --> 00:27:28,480 Now this approach we're talking about, this is the ALF approach. 436 00:27:28,480 --> 00:27:29,480 Correct? 437 00:27:29,480 --> 00:27:30,480 Mm-hmm. 438 00:27:30,480 --> 00:27:39,560 Well, the ALF approach includes working collaboratively with an osteoporotic physician, someone doing 439 00:27:39,560 --> 00:27:44,440 hands-on, a myofunctional therapist and a dentist who's trained in how to adjust the 440 00:27:44,440 --> 00:27:48,080 alphapoints, how to make the alphapoints and how to adjust it. 441 00:27:48,080 --> 00:27:53,840 So it's very much of a collaborative approach, which I love because I think that, no, I think 442 00:27:53,840 --> 00:28:00,040 my experience is that we can serve our patients that much better when we work together. 443 00:28:00,040 --> 00:28:02,200 I understand that. 444 00:28:02,200 --> 00:28:03,200 Yeah, absolutely. 445 00:28:03,200 --> 00:28:08,640 And that's one of the things that we're at Children's Airway First rallying for is this 446 00:28:08,640 --> 00:28:09,640 collaboration. 447 00:28:09,640 --> 00:28:13,840 I mean, we are much stronger together and that includes everything from myofunctional therapy, 448 00:28:13,840 --> 00:28:19,320 you know, DOs, MDs, dentists, everybody coming together. 449 00:28:19,320 --> 00:28:28,120 So with, you know, looking at that, that collaborative approach, which would be at that point treating 450 00:28:28,120 --> 00:28:34,400 the patient, the entire patient, you know, it stands in the way of obtaining the information 451 00:28:34,400 --> 00:28:42,120 that is needed to treat the whole patient instead of this kind of siloed reactive approach, 452 00:28:42,120 --> 00:28:45,680 which is where at least American medicine is right now. 453 00:28:45,680 --> 00:28:49,240 Well, it's a paradigm shift. 454 00:28:49,240 --> 00:28:57,120 It's really a paradigm shift, you know, if the MD is fulcrum within the germ theory 455 00:28:57,120 --> 00:29:02,600 and the, you know, we're going to do medications, we're not going to dig for answers, we're 456 00:29:02,600 --> 00:29:05,120 not going to question, we're not going to be curious. 457 00:29:05,120 --> 00:29:07,440 And I mean, DOs can absolutely be like this too. 458 00:29:07,440 --> 00:29:13,720 I in no way mean to put it all on MDs in any way. 459 00:29:13,720 --> 00:29:17,200 Again, my beloved husband's an MD, so it's not about that. 460 00:29:17,200 --> 00:29:20,440 It's about that kind of approach, right? 461 00:29:20,440 --> 00:29:25,960 So curiosity, I think that actually curious, I think there's some things, one is curiosity. 462 00:29:25,960 --> 00:29:30,360 I think most health professions are not moving with curiosity. 463 00:29:30,360 --> 00:29:34,240 And to be curious, one has to take their ego and throw it out the window because you have 464 00:29:34,240 --> 00:29:38,080 to be, you can't be ego forward and I call it ego forward. 465 00:29:38,080 --> 00:29:42,320 And that's just really not pleasant to work with, especially in a collaborative way. 466 00:29:42,320 --> 00:29:47,920 So everyone has to take their ego and kind of put it aside, you know, eat some humble 467 00:29:47,920 --> 00:29:52,360 pie, recognize that gosh, maybe I'm missing something. 468 00:29:52,360 --> 00:29:54,280 So that takes curiosity. 469 00:29:54,280 --> 00:29:56,160 Curiosity means an open mind. 470 00:29:56,160 --> 00:29:58,320 You know, Einstein was very, very curious. 471 00:29:58,320 --> 00:29:59,960 He was a curious human being. 472 00:29:59,960 --> 00:30:00,960 Right. 473 00:30:00,960 --> 00:30:01,960 Open minded. 474 00:30:01,960 --> 00:30:04,840 Mr. Foller was open minded. 475 00:30:04,840 --> 00:30:12,680 You know, that's where we can then integrate a new paradigm is when we are open minded, 476 00:30:12,680 --> 00:30:14,800 curious, questioning. 477 00:30:14,800 --> 00:30:21,160 And in order to do that, one has to have open eyes to look and see the problem in the first 478 00:30:21,160 --> 00:30:22,160 place. 479 00:30:22,160 --> 00:30:25,840 You know, there's a lot of people that are just missing that there's an epidemic of 480 00:30:25,840 --> 00:30:28,280 airway issues now, right? 481 00:30:28,280 --> 00:30:31,800 And then there's a question of what to do about the airway issue. 482 00:30:31,800 --> 00:30:37,680 You know, if you have the concept that the body is hard and rigid, because all of our 483 00:30:37,680 --> 00:30:41,800 anatomy that we're taught comes from dead people and they're hard and rigid and they 484 00:30:41,800 --> 00:30:43,120 don't move. 485 00:30:43,120 --> 00:30:49,580 But right, that's actually not the living real experience of a human body. 486 00:30:49,580 --> 00:30:53,080 You can look at it from what, what a body looks like in surgery. 487 00:30:53,080 --> 00:30:57,320 I mean, you know, I was fascinated with the human body and I drove from LA to San Diego 488 00:30:57,320 --> 00:31:00,560 every day for a month to do autopsies all day long. 489 00:31:00,560 --> 00:31:05,520 And a lot of those autopsies were on children and I was able to look at the inside of the 490 00:31:05,520 --> 00:31:11,240 calvarium, look at the dura membranes and how they, how they actually feel and look 491 00:31:11,240 --> 00:31:15,720 at the brain and look at the connection between the head and the cervicals. 492 00:31:15,720 --> 00:31:16,720 That was curious. 493 00:31:16,720 --> 00:31:22,760 And what I saw was, I mean, the human body that is basically alive or recently dead 494 00:31:22,760 --> 00:31:28,120 is very different than the anatomical perspective that we're having that the body's hard and 495 00:31:28,120 --> 00:31:29,120 rigid. 496 00:31:29,120 --> 00:31:34,000 So if you have that perspective that the body's hard and rigid and is compartmentalized, then 497 00:31:34,000 --> 00:31:38,520 you can put in something that's hard and rigid and fixed in the upper palate and push the 498 00:31:38,520 --> 00:31:40,200 face forward. 499 00:31:40,200 --> 00:31:44,400 But if you come from the perspective that the body is a whole functioning unit, that 500 00:31:44,400 --> 00:31:48,240 everything, anything that happens to the head is going to have consequences all the way 501 00:31:48,240 --> 00:31:50,920 down the body. 502 00:31:50,920 --> 00:31:55,280 All the way down, then if you put something hard, fixed and rigid in the body, it's actually 503 00:31:55,280 --> 00:31:56,280 not biocompatible. 504 00:31:56,280 --> 00:32:03,120 It's not biologically compatible with life because living tissue isn't hard, fixed and 505 00:32:03,120 --> 00:32:04,120 rigid. 506 00:32:04,120 --> 00:32:05,640 It's more of a biotensegrity. 507 00:32:05,640 --> 00:32:10,800 So this is where Buckminster Fuller gave us this phenomenal principle of tensegrity. 508 00:32:10,800 --> 00:32:16,360 The body has this capacity to have a bio biotensegrity, which means that all the pieces have to be 509 00:32:16,360 --> 00:32:21,920 moving and the movement of each of the pieces creates the stability in the body. 510 00:32:21,920 --> 00:32:27,480 So stability is created by the capacity for all the parts to move. 511 00:32:27,480 --> 00:32:33,560 So if you put something hard, fixed and rigid, whether it's a hard plate in the ankle or 512 00:32:33,560 --> 00:32:38,080 in the hip, the rest of the body is going to have to compensate, which is fine. 513 00:32:38,080 --> 00:32:39,080 Sometimes that's what we have to do. 514 00:32:39,080 --> 00:32:41,600 We need hip replacements sometimes. 515 00:32:41,600 --> 00:32:46,480 But to know that there's compensations for it and to then be able to assess what are 516 00:32:46,480 --> 00:32:50,480 the compensations and to treat the compensations to optimize health. 517 00:32:50,480 --> 00:32:52,280 Makes sense. 518 00:32:52,280 --> 00:32:58,240 Now, on the curiosity that you mentioned, which I have to say personally, I do agree 519 00:32:58,240 --> 00:33:00,840 with. 520 00:33:00,840 --> 00:33:07,800 Does that also require though the curiosity aspect of it more time? 521 00:33:07,800 --> 00:33:12,880 You can't be this curious in five minutes seeing a patient. 522 00:33:12,880 --> 00:33:16,080 You mentioned earlier, you spend two hours with patients. 523 00:33:16,080 --> 00:33:18,280 I spent two hours with the initial consult. 524 00:33:18,280 --> 00:33:19,600 With the initialer. 525 00:33:19,600 --> 00:33:23,880 And my follow-ups are half an hour, which is still much longer than physicians are charging 526 00:33:23,880 --> 00:33:24,880 basically. 527 00:33:24,880 --> 00:33:27,160 So it does put me outside the box. 528 00:33:27,160 --> 00:33:30,800 And one of the consequences of that is that I don't bill insurance directly. 529 00:33:30,800 --> 00:33:32,560 So it's all fee for service. 530 00:33:32,560 --> 00:33:33,960 And that has a consequence. 531 00:33:33,960 --> 00:33:37,160 And I have to deal with that consequence in different ways that I have to deal with it. 532 00:33:37,160 --> 00:33:42,040 So that was something I had to come to peace with when I was 26 years old and starting 533 00:33:42,040 --> 00:33:43,040 my practice. 534 00:33:43,040 --> 00:33:47,880 That I knew that how the gift that I had to provide wasn't going to be in the box. 535 00:33:47,880 --> 00:33:51,360 And there was going to be a consequence to that. 536 00:33:51,360 --> 00:33:54,960 One of the ways I feel like I can make up for it is teaching. 537 00:33:54,960 --> 00:33:59,520 Spreading the word and talking about what other options are. 538 00:33:59,520 --> 00:34:03,960 And yes, you have to also like, for example, we just had an orthodontist go through one 539 00:34:03,960 --> 00:34:06,240 of the courses that I teach at. 540 00:34:06,240 --> 00:34:13,920 And she sees 90 patients a day and she couldn't fit the ALF approach into her practice at 90 541 00:34:13,920 --> 00:34:16,120 patients a day because it takes more time. 542 00:34:16,120 --> 00:34:20,920 The ALF, the ALF, which is a light wire that goes behind the upper and lower teeth is every 543 00:34:20,920 --> 00:34:25,000 month you go in, you see the ALF dentist, they take it out and they have to problem 544 00:34:25,000 --> 00:34:32,520 solve exactly where to activate, where to activate the wire for that individual. 545 00:34:32,520 --> 00:34:34,640 So there's no cookie cutter. 546 00:34:34,640 --> 00:34:40,360 And so when you take cookie cutter, all the other ways, the palate expanders, bio block, 547 00:34:40,360 --> 00:34:44,640 orthotropics, DNA, homeoblock, all these things are turned screws. 548 00:34:44,640 --> 00:34:48,960 It doesn't take much intelligence to turn a screw, right? 549 00:34:48,960 --> 00:34:54,200 Doing the ALF approach takes time and it takes education. 550 00:34:54,200 --> 00:34:59,280 So this is another issue that's happening is dentists are advertising saying that they 551 00:34:59,280 --> 00:35:05,240 do the ALF and it's really a catch and a bait and switch, I think it's called bait and switch, 552 00:35:05,240 --> 00:35:12,720 which they want people to come in because they want more business, but they really don't 553 00:35:12,720 --> 00:35:14,240 know how to do the ALF. 554 00:35:14,240 --> 00:35:17,920 They haven't taken a course in how to do the ALF. 555 00:35:17,920 --> 00:35:22,640 And then they say, oh, the ALF won't help with that, but the bio block will or orthotropics 556 00:35:22,640 --> 00:35:26,720 will or this will help or the rapid palate expander would be a better way for you. 557 00:35:26,720 --> 00:35:30,600 So one of the main questions we've been talking to parents is that if you go see someone who's 558 00:35:30,600 --> 00:35:35,760 advertising that they're doing the ALF is ask them what courses they've taken. 559 00:35:35,760 --> 00:35:41,400 And right now, you know, the course that I can recommend wholeheartedly is the course 560 00:35:41,400 --> 00:35:46,240 with Dr. Dr. Bronson called the AEI, ALF Educational Institute. 561 00:35:46,240 --> 00:35:49,920 And that's something that I teach with. 562 00:35:49,920 --> 00:35:54,240 So I help teach those courses to dentists. 563 00:35:54,240 --> 00:36:00,200 So maybe that's a great limiting step is for dentists to realize that if they're wanting 564 00:36:00,200 --> 00:36:03,960 to do this approach, they need to invest time and resources to get trained and do it the 565 00:36:03,960 --> 00:36:04,960 right way. 566 00:36:04,960 --> 00:36:05,960 Absolutely. 567 00:36:05,960 --> 00:36:06,960 Yeah, absolutely. 568 00:36:06,960 --> 00:36:11,960 I think it basically comes down to money, money and ego, I would say, right? 569 00:36:11,960 --> 00:36:18,560 It's mean it would be like, well, I may not make as much money with this, but I'm at least 570 00:36:18,560 --> 00:36:21,280 doing no harm and I'm helping people. 571 00:36:21,280 --> 00:36:24,880 The ego part, you have to throw it away if you want to be curious. 572 00:36:24,880 --> 00:36:26,640 Right, agreed. 573 00:36:26,640 --> 00:36:27,640 Absolutely. 574 00:36:27,640 --> 00:36:28,800 Great. 575 00:36:28,800 --> 00:36:35,560 So thinking about medical professionals, kind of shifting gears a little bit instead 576 00:36:35,560 --> 00:36:41,360 of parents from this perspective, what kind of questions should they be asking? 577 00:36:41,360 --> 00:36:45,720 Are there questions they could ask to help identify some of these suboptimal airways 578 00:36:45,720 --> 00:36:48,800 and children earlier? 579 00:36:48,800 --> 00:36:50,080 So really good question. 580 00:36:50,080 --> 00:36:54,920 The question that we have to start with is who are they talking to? 581 00:36:54,920 --> 00:36:56,480 Are they talking to the dentists? 582 00:36:56,480 --> 00:36:58,000 They're talking to the pediatrician. 583 00:36:58,000 --> 00:37:04,160 They're talking to the osteopath or the malfunctional therapist or the lactation consultant. 584 00:37:04,160 --> 00:37:11,840 So the answer, and then it was going to depend on if any of them have any education in this 585 00:37:11,840 --> 00:37:14,600 world of growth and development. 586 00:37:14,600 --> 00:37:16,960 It's basically facial growth and development of children. 587 00:37:16,960 --> 00:37:17,960 Facial growth. 588 00:37:17,960 --> 00:37:18,960 Right. 589 00:37:18,960 --> 00:37:23,720 So it is a consequence of the functioning of the face. 590 00:37:23,720 --> 00:37:26,080 So once again, we want to dig underneath. 591 00:37:26,080 --> 00:37:29,960 Again, imagine the toilet paper roll. 592 00:37:29,960 --> 00:37:34,920 It is literally a collapsible space behind the tongue. 593 00:37:34,920 --> 00:37:39,080 So we have to think of everything that affects that area of the body. 594 00:37:39,080 --> 00:37:43,120 I have an on-demand course that's open for parents. 595 00:37:43,120 --> 00:37:44,120 Certainly parents. 596 00:37:44,120 --> 00:37:45,120 It's an on-demand course. 597 00:37:45,120 --> 00:37:49,760 It's 11 hours of me talking. 598 00:37:49,760 --> 00:37:54,160 And I go, one of the lectures is called Airway and Beyond. 599 00:37:54,160 --> 00:37:58,480 And what I do is I take the airway, structure of the airway and expand it into the function 600 00:37:58,480 --> 00:38:01,920 in the human body, which is really comes down to breath and breathing. 601 00:38:01,920 --> 00:38:07,840 So breathing is a function that ends second swallow chewing that creates an airway. 602 00:38:07,840 --> 00:38:10,560 So we want to again look at what are the functions. 603 00:38:10,560 --> 00:38:14,880 But to circle back around with your question, unfortunately, it's not a good, I don't have 604 00:38:14,880 --> 00:38:16,360 a good answer for it. 605 00:38:16,360 --> 00:38:20,040 I think it's better for parents to be educated. 606 00:38:20,040 --> 00:38:21,800 That's what I really encourage. 607 00:38:21,800 --> 00:38:24,560 There's these podcasts. 608 00:38:24,560 --> 00:38:28,040 You can take my online class. 609 00:38:28,040 --> 00:38:29,040 Read the book. 610 00:38:29,040 --> 00:38:30,040 Read my book. 611 00:38:30,040 --> 00:38:31,040 All you have to do is read the book. 612 00:38:31,040 --> 00:38:34,320 And then the parents are going to be educated on what to look for in their children. 613 00:38:34,320 --> 00:38:38,640 And that way we're directly advocating for our kids. 614 00:38:38,640 --> 00:38:40,840 Got it. 615 00:38:40,840 --> 00:38:44,840 And by the way, I will put a link to both your book and the course, the on-demand course. 616 00:38:44,840 --> 00:38:47,640 And I'll show notes for parents. 617 00:38:47,640 --> 00:38:53,680 So just a couple more questions when we're looking at this multidisciplinary approach 618 00:38:53,680 --> 00:38:58,320 to medicine, specifically around pediatrics. 619 00:38:58,320 --> 00:39:01,000 What does that look like to you? 620 00:39:01,000 --> 00:39:05,720 What is your kind of utopia? 621 00:39:05,720 --> 00:39:07,000 What is the right way to do it? 622 00:39:07,000 --> 00:39:10,360 What would be the end all be all for you? 623 00:39:10,360 --> 00:39:16,560 So the form of it is what I actually have in my office, which pre-COVID I had in my 624 00:39:16,560 --> 00:39:19,320 functional therapist coming to my office every two weeks. 625 00:39:19,320 --> 00:39:25,800 Now she does everything on Zoom, but we're very collaborative in good communication. 626 00:39:25,800 --> 00:39:30,040 I have an alph-pediatric dentist in my office. 627 00:39:30,040 --> 00:39:35,160 And I have an osteopathic colleague in my office because I'm quite full. 628 00:39:35,160 --> 00:39:40,320 So I get to refer to someone who's been educated in all of this. 629 00:39:40,320 --> 00:39:41,480 That's kind of my utopia. 630 00:39:41,480 --> 00:39:44,840 I'm quite happy in that. 631 00:39:44,840 --> 00:39:51,320 And that can be created in other places in the world also. 632 00:39:51,320 --> 00:39:56,200 So it's the connection with the osteopath who's trained in this. 633 00:39:56,200 --> 00:39:59,480 So it's very important for me to be clear. 634 00:39:59,480 --> 00:40:02,000 Many of my colleagues do not know about this. 635 00:40:02,000 --> 00:40:05,840 They don't understand the connection between the dental occlusion and the cranium. 636 00:40:05,840 --> 00:40:10,200 They don't understand, they don't even know how to assess tongue function. 637 00:40:10,200 --> 00:40:13,600 So that's what I'm very much passionately trying to do. 638 00:40:13,600 --> 00:40:19,160 I'm teaching so much and I'm trying to get my colleagues to join in this to really be 639 00:40:19,160 --> 00:40:24,520 able to stay on the cutting edge and to be able to give this service. 640 00:40:24,520 --> 00:40:27,200 It's not, certainly back around to what does it look like. 641 00:40:27,200 --> 00:40:28,760 It's not essential. 642 00:40:28,760 --> 00:40:33,840 Like it doesn't have to be that the alph-dentist is in the same office as the cranium osteopath 643 00:40:33,840 --> 00:40:35,960 or the malfunctional therapist. 644 00:40:35,960 --> 00:40:42,080 What's most important is that we have good communication and collaboration skills, which 645 00:40:42,080 --> 00:40:43,240 is sometimes personality-inducted. 646 00:40:43,240 --> 00:40:45,720 So that's connected working together. 647 00:40:45,720 --> 00:40:48,240 So they can be personality limited. 648 00:40:48,240 --> 00:40:52,360 If it's just someone on the team that you, for whatever reason, you move in life differently 649 00:40:52,360 --> 00:40:56,040 than they move in life and you don't feel like you can work together, even though you're 650 00:40:56,040 --> 00:41:00,480 both competent in what you do, it's going to be a more challenging. 651 00:41:00,480 --> 00:41:01,480 So sure. 652 00:41:01,480 --> 00:41:02,480 Yeah. 653 00:41:02,480 --> 00:41:03,480 Absolutely. 654 00:41:03,480 --> 00:41:12,760 So, Joy, what would you recommend to a parent that has a child that has a sleep issue or 655 00:41:12,760 --> 00:41:16,320 is sure that their child has some kind of airway issue, whether or not they're at the 656 00:41:16,320 --> 00:41:20,280 stage of, okay, now it's very sense time. 657 00:41:20,280 --> 00:41:21,440 How would you guide these parents? 658 00:41:21,440 --> 00:41:25,000 What would your recommendation be? 659 00:41:25,000 --> 00:41:29,360 I wish I had a quick and simple one for that one, but it would depend upon the age of the 660 00:41:29,360 --> 00:41:30,360 child. 661 00:41:30,360 --> 00:41:32,480 Do they have teeth or not? 662 00:41:32,480 --> 00:41:34,320 How old are they? 663 00:41:34,320 --> 00:41:37,520 That gives me, do we have an option for an owl or not? 664 00:41:37,520 --> 00:41:41,000 Am I dealing with a one-year-old or a six-month-old? 665 00:41:41,000 --> 00:41:44,320 So then I'm going to really look at their history, their birth history. 666 00:41:44,320 --> 00:41:48,200 I'm going to get my hands on them and I'm going to see how the structure is moving, how 667 00:41:48,200 --> 00:41:49,520 is the face of the cranium moving? 668 00:41:49,520 --> 00:41:50,520 Is there a good motion? 669 00:41:50,520 --> 00:41:54,600 I'm going to assess their interoral suck and swallow and look at that, look at their friend, 670 00:41:54,600 --> 00:41:56,480 if they have a friend limit, something like that. 671 00:41:56,480 --> 00:42:03,320 And then start working with the granite either like, see someone to release a tongue, if 672 00:42:03,320 --> 00:42:05,160 that's really the issue. 673 00:42:05,160 --> 00:42:06,400 I work a lot with lasers. 674 00:42:06,400 --> 00:42:08,360 I love photobiomodulation. 675 00:42:08,360 --> 00:42:11,360 I think it's the absolutely cutting edge of medicine. 676 00:42:11,360 --> 00:42:19,800 I have a laser in my office where we use it underneath the tongue and it can elongate 677 00:42:19,800 --> 00:42:20,800 the fibers. 678 00:42:20,800 --> 00:42:26,480 So if some baby is kind of like maybe tongue tied, maybe not tongue tied, we treat them 679 00:42:26,480 --> 00:42:32,720 osteopathically and then we use the laser to not just elongate the fibers underneath 680 00:42:32,720 --> 00:42:37,240 the tongue, but also to stimulate the neural integration of a suck and swallow. 681 00:42:37,240 --> 00:42:38,840 So we do points on the face. 682 00:42:38,840 --> 00:42:46,600 It's almost like you could think of it as neural reflexive integration, but with laser 683 00:42:46,600 --> 00:42:47,680 and it's phenomenal. 684 00:42:47,680 --> 00:42:57,320 So those are some of the, what I look at in treating human beings that don't have teeth. 685 00:42:57,320 --> 00:43:01,120 It's interesting, just this morning I got an email from a family in Kauai that's reaching 686 00:43:01,120 --> 00:43:02,120 out that exactly has this. 687 00:43:02,120 --> 00:43:06,120 They have a five year old, they haven't slept in three years, he has an airway issue and 688 00:43:06,120 --> 00:43:08,000 they're like, what do we do? 689 00:43:08,000 --> 00:43:12,480 So the first thing I have to do is I've got to get online and assess the situation and 690 00:43:12,480 --> 00:43:15,480 try to figure out what's going on with this specific human being. 691 00:43:15,480 --> 00:43:20,000 So finding someone who can help with finding out exactly what the problem is, where's the 692 00:43:20,000 --> 00:43:21,000 obstacle? 693 00:43:21,000 --> 00:43:22,000 That's what we're trying to find. 694 00:43:22,000 --> 00:43:24,760 Where is the obstacle? 695 00:43:24,760 --> 00:43:30,880 And then I try to connect them with, this one will go probably to an alfdentist because 696 00:43:30,880 --> 00:43:37,840 he's five and if he's compliant enough, we can do two, three year olds. 697 00:43:37,840 --> 00:43:39,840 Yeah. 698 00:43:39,840 --> 00:43:41,840 Awesome. 699 00:43:41,840 --> 00:43:50,880 So typically at the end of a podcast, I like to provide our guests an opportunity just to 700 00:43:50,880 --> 00:43:55,520 speak to parents and leave them with whatever you think is appropriate. 701 00:43:55,520 --> 00:43:57,240 So I'd like to offer you that time. 702 00:43:57,240 --> 00:44:00,400 Oh gosh, that makes me almost want to cry. 703 00:44:00,400 --> 00:44:04,880 Ugh, the first thing that comes up is that I'm just so sorry. 704 00:44:04,880 --> 00:44:09,600 You know, it's just so challenging and so difficult to be a parent these days. 705 00:44:09,600 --> 00:44:14,960 You know, 26 years ago when I was first in practice, the kids, you know, it would be 706 00:44:14,960 --> 00:44:19,760 rare for me to see a kid with X-men allergies and asthma and a breathing disorder. 707 00:44:19,760 --> 00:44:20,760 You know, we didn't see that. 708 00:44:20,760 --> 00:44:25,760 It's only 20, I've only been in practice 26 years and now every single one of my kids, 709 00:44:25,760 --> 00:44:28,520 I would say has a gut issue to some extent. 710 00:44:28,520 --> 00:44:30,600 They all have information and gut issues. 711 00:44:30,600 --> 00:44:35,320 So I'm all my kiddos I'm treating for gut issues. 712 00:44:35,320 --> 00:44:38,240 So I think I just have to say, hang in there. 713 00:44:38,240 --> 00:44:42,960 Whenever there's a problem, there's a solution, you know, for glycoposphate, crazy stuff that's 714 00:44:42,960 --> 00:44:43,960 happening. 715 00:44:43,960 --> 00:44:47,800 It's like there's a solution to that, you know. 716 00:44:47,800 --> 00:44:54,440 We just have to keep our eyes open and be curious and our ears open and be determined 717 00:44:54,440 --> 00:44:59,360 to figure out how to give our children the best care possible and to stay fulcrummed 718 00:44:59,360 --> 00:45:00,360 and function. 719 00:45:00,360 --> 00:45:01,360 Right? 720 00:45:01,360 --> 00:45:05,360 Don't, it's easy to get overwhelmed. 721 00:45:05,360 --> 00:45:07,120 It's easy to feel like. 722 00:45:07,120 --> 00:45:08,120 Sure. 723 00:45:08,120 --> 00:45:09,120 Yeah. 724 00:45:09,120 --> 00:45:12,800 Just give me the magic pill. 725 00:45:12,800 --> 00:45:19,280 Give me the magic thing and make my kid either sleep or make this go away. 726 00:45:19,280 --> 00:45:23,520 Sometimes that happens, but don't compromise. 727 00:45:23,520 --> 00:45:34,800 Don't compromise for a quick fix necessarily that doesn't, isn't long term health giving. 728 00:45:34,800 --> 00:45:35,800 I would say. 729 00:45:35,800 --> 00:45:42,680 Put in that category things that are hard and fixed and in the mouth. 730 00:45:42,680 --> 00:45:45,200 Got it. 731 00:45:45,200 --> 00:45:51,080 I cannot thank you enough for coming on here and sharing everything. 732 00:45:51,080 --> 00:45:54,840 It was absolutely educational and very enlightening. 733 00:45:54,840 --> 00:45:55,840 So thank you so much. 734 00:45:55,840 --> 00:45:56,840 You're so welcome. 735 00:45:56,840 --> 00:46:01,760 I really appreciate the opportunity and, you know, may all children be able to find their 736 00:46:01,760 --> 00:46:02,760 health. 737 00:46:02,760 --> 00:46:09,200 Thanks again to today's guest, Dr. Tasha Tersot for sharing her medical insight and to each 738 00:46:09,200 --> 00:46:11,840 of you for listening to today's episode. 739 00:46:11,840 --> 00:46:15,080 If you're new to our podcast, please don't forget to subscribe. 740 00:46:15,080 --> 00:46:19,200 And if you enjoyed today's episode, please remember to leave us a review or comment about 741 00:46:19,200 --> 00:46:20,960 what you enjoyed most. 742 00:46:20,960 --> 00:46:25,840 You can stay connected to the Children's Airway First Foundation by following us on Instagram, 743 00:46:25,840 --> 00:46:30,080 Facebook, Twitter, LinkedIn and Pinterest. 744 00:46:30,080 --> 00:46:34,200 If you'd like to be a guest on an upcoming episode, shoot us a note via the context page 745 00:46:34,200 --> 00:46:41,440 on our website or send us an email directly at info at childrensairwayfirst.org. 746 00:46:41,440 --> 00:46:45,760 And finally, thanks to all the parents and medical professionals out there that are working 747 00:46:45,760 --> 00:46:50,240 to help make the lives of kids around the globe just a little bit better. 748 00:46:50,240 --> 00:47:19,240 Take care, stay safe and happy breathing, everyone.