1 00:00:00,000 --> 00:00:20,640 Hi everybody, and welcome back to Airway First, a podcast from the Children's Airway 2 00:00:20,640 --> 00:00:21,640 First Foundation. 3 00:00:21,640 --> 00:00:24,640 I'm your host, Rebecca Downing. 4 00:00:24,640 --> 00:00:30,640 My guest today is Dr. Magna Dassani, a sleep apnea and airway dentist from Houston, Texas. 5 00:00:30,640 --> 00:00:35,280 Dr. Dassani has practiced dentistry for over two decades, and she's passionate about the 6 00:00:35,280 --> 00:00:38,120 role of the dentist in whole body health. 7 00:00:38,120 --> 00:00:42,960 She frequently sees patients for whom the dentist is the only consistent medical provider. 8 00:00:42,960 --> 00:00:47,440 By screening patients, connecting them with the appropriate specialist, and devising treatment 9 00:00:47,440 --> 00:00:51,240 plans, Dr. Dassani changes lives. 10 00:00:51,240 --> 00:00:55,800 In recent years, she's begun to identify and treat adults in pediatric sleep apnea in her 11 00:00:55,800 --> 00:00:57,120 practice. 12 00:00:57,120 --> 00:01:01,080 While many of her patients have reached adult home without ever being educated about how 13 00:01:01,080 --> 00:01:05,920 the shape of their skull affects their breathing and sleep, Dr. Dassani's in-depth knowledge 14 00:01:05,920 --> 00:01:10,760 of oral-facial anatomy allows her to help patients with underlying defects of the tongue, 15 00:01:10,760 --> 00:01:12,600 jaw, and palate. 16 00:01:12,600 --> 00:01:17,200 As a mentor, Dr. Dassani works to educate fellow dental professionals about sleep disorder 17 00:01:17,200 --> 00:01:21,600 breathing so that these treatments can become more easily available to patients throughout 18 00:01:21,600 --> 00:01:23,160 North America. 19 00:01:23,160 --> 00:01:28,200 As a writer, as well as a clinician, Dr. Dassani has published two books on sleep apnea and 20 00:01:28,200 --> 00:01:29,700 the dental practice. 21 00:01:29,700 --> 00:01:37,640 You can find both books, Healthy Sleep Happy Kids and Sleep, Breathe, Dream on Amazon.com. 22 00:01:37,640 --> 00:01:44,240 You can find out more about Dr. Dassani on her website at www.magnandassani.com. 23 00:01:44,240 --> 00:01:48,320 And now, here's my interview with Dr. Bangda Dassani. 24 00:01:48,320 --> 00:01:52,760 Thank you so much for being on our podcast this morning, Dr. Dassani. 25 00:01:52,760 --> 00:01:54,840 Thank you so much for having me. 26 00:01:54,840 --> 00:02:01,040 What a journey it has been to get here between mostly my schedule and the schedules, but we 27 00:02:01,040 --> 00:02:03,120 made it, so I'm super excited. 28 00:02:03,120 --> 00:02:04,720 Yes, thank you. 29 00:02:04,720 --> 00:02:10,400 And I'm really very excited because you have a very unique message that I think parents 30 00:02:10,400 --> 00:02:11,400 need to hear. 31 00:02:11,400 --> 00:02:12,400 It's incredibly important. 32 00:02:12,400 --> 00:02:16,280 Thank you for hanging in there and continuing to reschedule. 33 00:02:16,280 --> 00:02:18,320 Let's just go ahead and just dive right in. 34 00:02:18,320 --> 00:02:24,760 As a dentist, the approach you take is very different than a lot of dentists, and you're 35 00:02:24,760 --> 00:02:29,760 really focused on the whole body, but specifically on sleep. 36 00:02:29,760 --> 00:02:33,000 So I thought we could just start there and talk a little bit about where this focus comes 37 00:02:33,000 --> 00:02:35,640 from, where your approach comes from. 38 00:02:35,640 --> 00:02:44,360 Yeah, so I'm fond of saying dentists fix more than teeth or fix more than cavities. 39 00:02:44,360 --> 00:02:53,840 And we are actually in the unique position of being able to follow our patients and a 40 00:02:53,840 --> 00:02:57,520 lot of them for a huge part of their life. 41 00:02:57,520 --> 00:03:04,000 I mean, it's not uncommon for us to see moms come in when they're pregnant, and then we 42 00:03:04,000 --> 00:03:09,840 are usually the first providers to see those child from a dental perspective, of course, 43 00:03:09,840 --> 00:03:17,960 because they tag along with the siblings and the parents all the way until a lot of times 44 00:03:17,960 --> 00:03:18,960 adulthood. 45 00:03:18,960 --> 00:03:24,520 They go away to college, come back because they come to visit parents, see us for their 46 00:03:24,520 --> 00:03:28,960 cleanings, and they see us twice a year at least. 47 00:03:28,960 --> 00:03:35,720 So we are in that position, but we're able to assess, evaluate, and impact whatever's 48 00:03:35,720 --> 00:03:40,200 going on with their growth and development in the head, face, and neck, and guess where 49 00:03:40,200 --> 00:03:41,200 our airway is. 50 00:03:41,200 --> 00:03:48,240 So I can actually spot a problem before it becomes a problem. 51 00:03:48,240 --> 00:03:55,960 If I can guide that family, that child, that parent into, hey, this might be our next best 52 00:03:55,960 --> 00:03:56,960 step. 53 00:03:56,960 --> 00:03:59,400 And it doesn't always have to be in the dental office. 54 00:03:59,400 --> 00:04:01,640 And I'm fond of telling the doctors that I coach, too. 55 00:04:01,640 --> 00:04:09,480 It's like, we are sometimes the quarterback as to where or what happens with a child's 56 00:04:09,480 --> 00:04:11,680 or even a person's treatment. 57 00:04:11,680 --> 00:04:17,720 And it's not uncommon for me to observe something and go, oh my gosh, go see the ENT. 58 00:04:17,720 --> 00:04:24,600 Oh, make sure you talk to a pediatrician about this, to have that multidisciplinary team 59 00:04:24,600 --> 00:04:28,480 of the cardiologists, the neurologists, the pediatrician, the ENTs. 60 00:04:28,480 --> 00:04:32,080 And we all come together because what is the goal at the end of the day? 61 00:04:32,080 --> 00:04:34,080 It is our patients' life. 62 00:04:34,080 --> 00:04:43,580 And yes, if we can hone in, actually dial in, have this laser focus on the airway as well. 63 00:04:43,580 --> 00:04:47,680 If I can address something while you are growing, oh my gosh, I don't have to put a 64 00:04:47,680 --> 00:04:50,040 band-aid on you when you're grown up. 65 00:04:50,040 --> 00:04:52,120 Right, absolutely. 66 00:04:52,120 --> 00:04:57,280 And I've spared you so much heartache, trouble, and discomfort by way of your health, right? 67 00:04:57,280 --> 00:05:01,760 I mean, we know how many kids, teens, adults struggle with their health. 68 00:05:01,760 --> 00:05:06,880 And I'm going to segue this into how did this happen for me? 69 00:05:06,880 --> 00:05:10,360 It's by losing a family member. 70 00:05:10,360 --> 00:05:20,120 And for someone that was completely healthy, didn't have any known comorbidities for us 71 00:05:20,120 --> 00:05:30,120 to lose them without any warning, made me determined that I, you know, when I got into 72 00:05:30,120 --> 00:05:35,120 airway, I'm the first to admit I was selfish. 73 00:05:35,120 --> 00:05:41,000 My only goal was I do not want my family to have to go through this ever again. 74 00:05:41,000 --> 00:05:45,720 Because if sleep apnea was the issue, surely there's something I can do to impact this. 75 00:05:45,720 --> 00:05:47,800 Surely there are solutions. 76 00:05:47,800 --> 00:05:51,240 And this was 20 years ago. 77 00:05:51,240 --> 00:05:53,240 Surely there's a way out. 78 00:05:53,240 --> 00:05:55,840 I may not be able to impact it as a dentist. 79 00:05:55,840 --> 00:05:56,840 I didn't know anything. 80 00:05:56,840 --> 00:05:59,880 Then there's, we don't get this education in dental school. 81 00:05:59,880 --> 00:06:00,880 Right. 82 00:06:00,880 --> 00:06:01,880 We've heard. 83 00:06:01,880 --> 00:06:03,880 I'm still very surprised about this. 84 00:06:03,880 --> 00:06:04,880 I know. 85 00:06:04,880 --> 00:06:05,880 Pediatricians as well. 86 00:06:05,880 --> 00:06:06,880 Exactly. 87 00:06:06,880 --> 00:06:07,880 It's shocking. 88 00:06:07,880 --> 00:06:08,880 Exactly. 89 00:06:08,880 --> 00:06:12,560 And it's like, well, at least I can get answers. 90 00:06:12,560 --> 00:06:17,720 At least I know what questions to ask of my doctors when we do come across this. 91 00:06:17,720 --> 00:06:19,800 I didn't ever want to go through it again. 92 00:06:19,800 --> 00:06:27,880 But in the deeper I looked, I was like, oh my gosh, this is something right up my alley. 93 00:06:27,880 --> 00:06:31,840 I can do this to where I can help my family. 94 00:06:31,840 --> 00:06:35,840 Remember, I'm still focused just on my family because the loss was so great. 95 00:06:35,840 --> 00:06:42,560 But then what I realized is as you get into this, it's like, once you see it, you cannot 96 00:06:42,560 --> 00:06:44,560 not see it. 97 00:06:44,560 --> 00:06:45,560 Can I do it? 98 00:06:45,560 --> 00:06:46,560 Yeah. 99 00:06:46,560 --> 00:06:51,560 And I found out that, I found out that, I found out that, I found out that my family 100 00:06:51,560 --> 00:06:56,560 grew, it grew into my office manager's dad, who I could help. 101 00:06:56,560 --> 00:07:02,560 It grew into the patient in the dental chair who talked about his grandson that was snoring. 102 00:07:02,560 --> 00:07:08,000 It grew into, it's just one of those things that it keeps getting bigger and bigger and 103 00:07:08,000 --> 00:07:11,560 bigger until you just can't ignore it. 104 00:07:11,560 --> 00:07:14,040 You have to do something about it. 105 00:07:14,040 --> 00:07:22,320 We were mainly talking to adults that could not use their CPAP and we were helping them. 106 00:07:22,320 --> 00:07:27,880 And then I would get these questions, hey doc, my grandson snores. 107 00:07:27,880 --> 00:07:29,720 Whatever you did, the appliance helps me. 108 00:07:29,720 --> 00:07:31,120 Can you make my grandson this? 109 00:07:31,120 --> 00:07:33,880 Just like, no, he's a child. 110 00:07:33,880 --> 00:07:37,640 And I still didn't have answers then. 111 00:07:37,640 --> 00:07:40,920 Until same thing, when you have something personal, hit you. 112 00:07:40,920 --> 00:07:45,840 My office manager, Christina, has been with me 11 years and she was pregnant with Avery 113 00:07:45,840 --> 00:07:47,760 when she started working with me. 114 00:07:47,760 --> 00:07:56,440 Well Avery is your classic child with everything Avery that we see in a kid. 115 00:07:56,440 --> 00:08:00,200 And at one point, her and I stopped and she looked at me and she goes, doc, do you think 116 00:08:00,200 --> 00:08:01,200 this is Avery? 117 00:08:01,200 --> 00:08:09,600 I was like, oh my gosh, we are missing an entire demographic of the population. 118 00:08:09,600 --> 00:08:13,600 And same thing, nobody's talking about this. 119 00:08:13,600 --> 00:08:15,120 I didn't learn this. 120 00:08:15,120 --> 00:08:16,400 I didn't know what to do. 121 00:08:16,400 --> 00:08:19,280 I didn't even know what questions to ask. 122 00:08:19,280 --> 00:08:21,240 So that was another rabbit hole to go down. 123 00:08:21,240 --> 00:08:24,960 And you know this once you go down this rabbit hole, it's like, you're in it, like it or 124 00:08:24,960 --> 00:08:25,960 not. 125 00:08:25,960 --> 00:08:26,960 You're in it. 126 00:08:26,960 --> 00:08:27,960 Yeah. 127 00:08:27,960 --> 00:08:28,960 And you see it everywhere. 128 00:08:28,960 --> 00:08:29,960 That's the other thing. 129 00:08:29,960 --> 00:08:33,520 Once you know what to look for, you see it everywhere. 130 00:08:33,520 --> 00:08:34,720 You see it watching TV. 131 00:08:34,720 --> 00:08:36,520 You see it standing in the line at the grocery store. 132 00:08:36,520 --> 00:08:38,320 You see it when your children's friends come over. 133 00:08:38,320 --> 00:08:40,560 I mean, you see it everywhere. 134 00:08:40,560 --> 00:08:41,560 Exactly. 135 00:08:41,560 --> 00:08:43,880 And I was just talking to somebody yesterday. 136 00:08:43,880 --> 00:08:45,120 It gets so bad. 137 00:08:45,120 --> 00:08:46,320 Like you talk about it so much. 138 00:08:46,320 --> 00:08:50,040 I have two girls, they're teenagers, but when they were growing up, because you know, we've 139 00:08:50,040 --> 00:08:54,800 been doing this for a while now, we'd be at Target and my kid would go like, mom, that 140 00:08:54,800 --> 00:08:55,800 kid's now breathing. 141 00:08:55,800 --> 00:08:57,800 So stop looking at people in Target. 142 00:08:57,800 --> 00:09:00,800 But I understood you. 143 00:09:00,800 --> 00:09:01,800 Yes. 144 00:09:01,800 --> 00:09:02,800 Yes. 145 00:09:02,800 --> 00:09:06,960 So that was what got me going. 146 00:09:06,960 --> 00:09:11,680 And you're really focused a lot on the sleep aspect of it specifically. 147 00:09:11,680 --> 00:09:12,680 Correct. 148 00:09:12,680 --> 00:09:14,600 So I'm still a general dentist. 149 00:09:14,600 --> 00:09:15,600 Yeah. 150 00:09:15,600 --> 00:09:20,600 I still drill, fill, do whatever a stentist do. 151 00:09:20,600 --> 00:09:30,000 But a large focus of my practice is sleep because this is not something that you can 152 00:09:30,000 --> 00:09:32,360 put into a box. 153 00:09:32,360 --> 00:09:38,800 It is not something where I can isolate it and say, as an adult or as a child, sleep 154 00:09:38,800 --> 00:09:44,720 is going to sit in this corner and everything dental is going to sit in this other side. 155 00:09:44,720 --> 00:09:49,160 They're all interconnected because let's take a look. 156 00:09:49,160 --> 00:09:53,760 You know, when we have a child in the chair, that's just coming for cleaning, nothing else. 157 00:09:53,760 --> 00:09:57,640 But we see all these signs and symptoms and clues. 158 00:09:57,640 --> 00:10:03,800 As a child, that is, for example, mouth breathing can have red, puffy and flame swollen gums 159 00:10:03,800 --> 00:10:07,840 that bleed is prone to more decay. 160 00:10:07,840 --> 00:10:10,040 And how do you separate that? 161 00:10:10,040 --> 00:10:15,480 It all ties in together because then you got to figure out why. 162 00:10:15,480 --> 00:10:17,000 Where's that mouth breathing coming from? 163 00:10:17,000 --> 00:10:18,280 What can I do about it? 164 00:10:18,280 --> 00:10:21,120 And it just turns into this big old cycle. 165 00:10:21,120 --> 00:10:22,120 Right. 166 00:10:22,120 --> 00:10:23,120 Right. 167 00:10:23,120 --> 00:10:24,120 Absolutely. 168 00:10:24,120 --> 00:10:30,120 And I think, I'll put a link to it on our website just for, or in the show notes, but 169 00:10:30,120 --> 00:10:32,640 there's a link to on our website. 170 00:10:32,640 --> 00:10:36,760 We've got signs as a parent to look for. 171 00:10:36,760 --> 00:10:37,760 Yes. 172 00:10:37,760 --> 00:10:42,520 But as a dentist and as well as I'm sure it's not just you at this point, it's you and your 173 00:10:42,520 --> 00:10:44,680 staff. 174 00:10:44,680 --> 00:10:47,040 What signs are you all looking for when they come in? 175 00:10:47,040 --> 00:10:48,040 Specifically children. 176 00:10:48,040 --> 00:10:49,240 Yeah, yeah, for sure. 177 00:10:49,240 --> 00:10:50,240 There's so much. 178 00:10:50,240 --> 00:10:55,600 You know, when we have an adult with sleep issues, I like to say I can fit them inside 179 00:10:55,600 --> 00:10:56,600 a box. 180 00:10:56,600 --> 00:11:00,920 Adults present with very specific signs and symptoms. 181 00:11:00,920 --> 00:11:05,400 And you check those boxes, you know, for the snoring, the daytime sleepiness, the getting 182 00:11:05,400 --> 00:11:09,520 up to use the bathroom multiple times a night, choking and gasping in your sleep. 183 00:11:09,520 --> 00:11:13,360 I can fit typically you into a box. 184 00:11:13,360 --> 00:11:19,600 But as a child, I could have seven children with nine different symptoms and they could 185 00:11:19,600 --> 00:11:25,120 all be positive for sleep disorder breathing, which is why it's so important, you know, 186 00:11:25,120 --> 00:11:33,440 parents play a big role in our team here because there's so much that they can observe at home 187 00:11:33,440 --> 00:11:37,440 that we don't see the child asleep in our offices. 188 00:11:37,440 --> 00:11:38,880 And this is where the parents come in. 189 00:11:38,880 --> 00:11:44,600 So what do we look for and what can parents look for? 190 00:11:44,600 --> 00:11:47,240 Mouth breathing is a big one. 191 00:11:47,240 --> 00:11:52,120 Usually when, you know, and my team is trained to do the same, I walk into an arbitrary and 192 00:11:52,120 --> 00:11:57,160 I immediately focus on the parent, not because I don't like the kid. 193 00:11:57,160 --> 00:12:05,040 I love kids, which is also I could never become a pediatric dentist. 194 00:12:05,040 --> 00:12:11,400 But in the reason I want to do that is in our office, we have TVs on the ceiling. 195 00:12:11,400 --> 00:12:15,480 So the child is really laying back and they're watching TV or now, you know, today's day 196 00:12:15,480 --> 00:12:17,720 and age, even if you don't, they're what are they doing? 197 00:12:17,720 --> 00:12:19,160 Typically, they're on their phone. 198 00:12:19,160 --> 00:12:20,160 Right. 199 00:12:20,160 --> 00:12:27,320 What I want to see is because anytime you walk in and you you're talking to somebody, 200 00:12:27,320 --> 00:12:29,200 we automatically come to attention. 201 00:12:29,200 --> 00:12:30,200 Don't we? 202 00:12:30,200 --> 00:12:31,200 We sit upright. 203 00:12:31,200 --> 00:12:33,080 We adjust our posture, all of that. 204 00:12:33,080 --> 00:12:34,080 Right. 205 00:12:34,080 --> 00:12:36,120 That's not their normal resting posture. 206 00:12:36,120 --> 00:12:40,920 Normal resting posture, remember, should be lips together, breathing through the nose 207 00:12:40,920 --> 00:12:43,880 and the tongue resting in the roof of the mouth passively. 208 00:12:43,880 --> 00:12:48,840 Well, when I walk in and introduce myself to the parent and completely ignore the child, 209 00:12:48,840 --> 00:12:52,800 the child goes back to what it is that they're doing, which is, I don't know, watch Indora 210 00:12:52,800 --> 00:12:54,800 on TV. 211 00:12:54,800 --> 00:13:01,600 And I catch this child either sitting with their mouth open, breathing through their 212 00:13:01,600 --> 00:13:06,480 mouth or whatever that posture looks like. 213 00:13:06,480 --> 00:13:11,840 And I can immediately focus that attention to the parent and go, is this how she is or 214 00:13:11,840 --> 00:13:14,320 he is at home as well? 215 00:13:14,320 --> 00:13:15,320 And I'll get one of two responses. 216 00:13:15,320 --> 00:13:16,320 Right. 217 00:13:16,320 --> 00:13:22,400 I was like, oh my gosh, yes, I have to remind him or to close the mouth during, I don't know, 218 00:13:22,400 --> 00:13:27,720 reading, playing puzzles, whatever it is that they're doing, watching TV. 219 00:13:27,720 --> 00:13:28,920 And that's the connection. 220 00:13:28,920 --> 00:13:29,920 Boom. 221 00:13:29,920 --> 00:13:30,920 We start right there. 222 00:13:30,920 --> 00:13:34,360 Or the parent's going to say, you know what, I haven't really noticed. 223 00:13:34,360 --> 00:13:38,440 And for me, then it is, let's pay attention. 224 00:13:38,440 --> 00:13:44,240 When you go home, now the parent is diodin into what is it that I need to look for? 225 00:13:44,240 --> 00:13:47,880 So that is key number one. 226 00:13:47,880 --> 00:13:57,600 As a dentist, I will look for my team will look for other telltale clues that tell us 227 00:13:57,600 --> 00:14:03,600 that something is going on that's impacting their area. 228 00:14:03,600 --> 00:14:07,440 And typically it will be growth and development, right? 229 00:14:07,440 --> 00:14:12,840 We look for if this is a child that either has permanent teeth or has permanent teeth 230 00:14:12,840 --> 00:14:15,520 coming in, is there any crowding? 231 00:14:15,520 --> 00:14:18,240 Crowding tells me there's just not enough room. 232 00:14:18,240 --> 00:14:22,800 There's a discrepancy between the size of the jaw and the size of the teeth. 233 00:14:22,800 --> 00:14:29,520 Or a lot of times when those permanent teeth come in behind the baby teeth, right? 234 00:14:29,520 --> 00:14:31,320 Shark teeth, as we call them. 235 00:14:31,320 --> 00:14:32,320 Right. 236 00:14:32,320 --> 00:14:37,040 They just aren't, there isn't enough space in the jaw for those teeth to be able to do 237 00:14:37,040 --> 00:14:38,040 what they do. 238 00:14:38,040 --> 00:14:43,480 The permanent teeth erupt, try to push themselves out and that's what causes the baby teeth 239 00:14:43,480 --> 00:14:46,440 to get loose and fall out. 240 00:14:46,440 --> 00:14:50,760 Well guess something is not working the way it needs to and which is why these teeth are 241 00:14:50,760 --> 00:14:52,680 in all different kinds of positions. 242 00:14:52,680 --> 00:14:56,400 So is there enough room for those permanent teeth to come in? 243 00:14:56,400 --> 00:15:00,440 Yeah, there could be a discrepancy in the size of the teeth and the size of the jaw. 244 00:15:00,440 --> 00:15:04,880 You got dad's teeth and mom's jaw, smaller jaw, bigger teeth, sure. 245 00:15:04,880 --> 00:15:08,240 But at the end of the day, we still need the space. 246 00:15:08,240 --> 00:15:09,240 Right. 247 00:15:09,240 --> 00:15:10,720 So that is a big telltale clue. 248 00:15:10,720 --> 00:15:13,800 If there is crowding, don't wait. 249 00:15:13,800 --> 00:15:19,880 Talk to your doctors, talk to your dentists and make sure this is being at least evaluated. 250 00:15:19,880 --> 00:15:24,320 They may not be the ones treating it, but at least they'll know where to send you out. 251 00:15:24,320 --> 00:15:29,000 We want those full wide smiles in a chat. 252 00:15:29,000 --> 00:15:33,680 I don't like seeing those dark corridors, as I call them, when they're smiling. 253 00:15:33,680 --> 00:15:38,240 The key example is, look at Julia Roberts' smile, right? 254 00:15:38,240 --> 00:15:40,160 You want those wide smiles. 255 00:15:40,160 --> 00:15:46,360 Or keeping in tune with everything going on in the last few weeks. 256 00:15:46,360 --> 00:15:54,720 William and Kate, when you look at their smiles, Kate has that wide, full smile, right? 257 00:15:54,720 --> 00:15:57,960 And when you look at it, you can start that slightly more narrow smile. 258 00:15:57,960 --> 00:15:58,960 What do I look for? 259 00:15:58,960 --> 00:16:01,440 I want her smile. 260 00:16:01,440 --> 00:16:03,120 So we want those teeth to fill up. 261 00:16:03,120 --> 00:16:10,800 I don't want those dark corridors along the side. 262 00:16:10,800 --> 00:16:15,960 Outside the mouth, if I'm just extra orally looking, what does the nose look like? 263 00:16:15,960 --> 00:16:17,600 Is there a deviated septum? 264 00:16:17,600 --> 00:16:20,160 Is one nostril bigger than the other? 265 00:16:20,160 --> 00:16:22,200 Are there narrow pinched nostrils? 266 00:16:22,200 --> 00:16:24,080 That's where our airway starts. 267 00:16:24,080 --> 00:16:25,280 Let's start at the very beginning. 268 00:16:25,280 --> 00:16:31,360 Is this something that you need to see the EMT to have evaluated and addressed? 269 00:16:31,360 --> 00:16:32,520 Chapped lips, right? 270 00:16:32,520 --> 00:16:38,680 Any story, my younger daughter, who's now 14, when she was young, every time, and I tell 271 00:16:38,680 --> 00:16:42,680 my parents, anybody that feels guilty about not noticing this in their kids, like worst 272 00:16:42,680 --> 00:16:46,720 mom right here, I didn't notice anything. 273 00:16:46,720 --> 00:16:47,720 You know what? 274 00:16:47,720 --> 00:16:52,120 The guilt has no place in what we do for our kids, right? 275 00:16:52,120 --> 00:16:55,960 So I always try to tell parents, as a doctor, I miss things. 276 00:16:55,960 --> 00:17:01,240 So there's no place for you to feel bad about it because I didn't know what I didn't know. 277 00:17:01,240 --> 00:17:02,240 Exactly. 278 00:17:02,240 --> 00:17:05,840 There's no way I could have addressed it, which is why I say that. 279 00:17:05,840 --> 00:17:09,960 But when my younger daughter was growing up every year for birthdays, for Christmas, anytime 280 00:17:09,960 --> 00:17:12,640 anybody asked her, it's like, baby, what do you want? 281 00:17:12,640 --> 00:17:14,080 You know what she'd ask for? 282 00:17:14,080 --> 00:17:17,920 She'd ask for a chapstick. 283 00:17:17,920 --> 00:17:23,640 Because her lips were always chapped because that child was a mouth breather. 284 00:17:23,640 --> 00:17:28,360 And I'm going, oh my God, how did I not see this? 285 00:17:28,360 --> 00:17:30,000 So that is one thing we look for. 286 00:17:30,000 --> 00:17:36,760 And I'm not talking about, you know, it's the season's changing or you're in a place 287 00:17:36,760 --> 00:17:38,320 like the pole or whatever. 288 00:17:38,320 --> 00:17:39,320 It's chronic. 289 00:17:39,320 --> 00:17:46,480 But if you have a child that is constantly that has cracked lips or dry lips, that could 290 00:17:46,480 --> 00:17:47,760 be a telltale sign. 291 00:17:47,760 --> 00:17:49,480 Are they breathing through their mouth? 292 00:17:49,480 --> 00:17:52,600 What's going on there? 293 00:17:52,600 --> 00:17:57,120 We also look for the shape of the palate. 294 00:17:57,120 --> 00:18:01,160 We want that palate to be a wide U shaped palate. 295 00:18:01,160 --> 00:18:07,200 The roof of the mouth is also the floor of the nose. 296 00:18:07,200 --> 00:18:16,880 So the shape of that palate, if you have a high arched V shaped deep narrow palate, the 297 00:18:16,880 --> 00:18:22,080 other side of it, and I know you can see me because we're on video right now, but this 298 00:18:22,080 --> 00:18:27,080 is what the upper airway looks like. 299 00:18:27,080 --> 00:18:29,040 And that is narrow as well. 300 00:18:29,040 --> 00:18:31,240 That is constricted as well. 301 00:18:31,240 --> 00:18:35,080 So that tells me a story. 302 00:18:35,080 --> 00:18:38,080 Look back in the back of the throat, what do the tonsils look like? 303 00:18:38,080 --> 00:18:39,600 Are those tonsils enlarged? 304 00:18:39,600 --> 00:18:48,520 Are they contributing to any obstruction, which can then possibly be play a role in obstructing 305 00:18:48,520 --> 00:18:49,520 that airflow? 306 00:18:49,520 --> 00:18:52,440 So, Doc, these kids need to see an ENT. 307 00:18:52,440 --> 00:18:55,760 Just know two ways about it. 308 00:18:55,760 --> 00:18:58,800 What does the tongue look like? 309 00:18:58,800 --> 00:19:06,920 And true macroglossy, like truly where the tongue is super large, is not all that common. 310 00:19:06,920 --> 00:19:14,360 When the tongue looks too big for the mouth, how about we think about is the jaw space, 311 00:19:14,360 --> 00:19:18,080 the space there, the size of the jaws too little for the tongue? 312 00:19:18,080 --> 00:19:23,320 Let's flip it over. 313 00:19:23,320 --> 00:19:27,960 So when I have a child open their mouth wide, not even say, ah, not even stick your tongue, 314 00:19:27,960 --> 00:19:29,720 just open your mouth, baby. 315 00:19:29,720 --> 00:19:35,480 And when I see that tongue spilling over onto the chewing surfaces of those back molars 316 00:19:35,480 --> 00:19:39,000 for those kids, we might have a problem. 317 00:19:39,000 --> 00:19:40,720 That might need to be addressed. 318 00:19:40,720 --> 00:19:44,520 Not like that does need to be addressed. 319 00:19:44,520 --> 00:19:48,160 Because what happens, where's that tongue going to go when this child is going to lay 320 00:19:48,160 --> 00:19:50,360 back? 321 00:19:50,360 --> 00:19:52,480 It's going to fall backwards into the throat. 322 00:19:52,480 --> 00:19:58,400 It's going to potentially create an obstruction, which means that the child is getting less 323 00:19:58,400 --> 00:20:01,440 oxygen to the brain while they're asleep. 324 00:20:01,440 --> 00:20:06,600 If the tongue has those scalloped edges, little markings on the tongue, which is just from 325 00:20:06,600 --> 00:20:07,800 the teeth, right? 326 00:20:07,800 --> 00:20:11,880 And they have the shape of those teeth show up. 327 00:20:11,880 --> 00:20:13,840 That's the same thing. 328 00:20:13,840 --> 00:20:16,560 The justice and enough room. 329 00:20:16,560 --> 00:20:19,160 Clenching and grinding is a big one. 330 00:20:19,160 --> 00:20:24,840 Children to have tooth wear in some cases that we see are, there's so much wear from 331 00:20:24,840 --> 00:20:26,080 the child grinding so much. 332 00:20:26,080 --> 00:20:27,080 And you know what? 333 00:20:27,080 --> 00:20:28,400 A lot of parents will say this too. 334 00:20:28,400 --> 00:20:34,240 It's like, I can hear my child grinding down the hallway. 335 00:20:34,240 --> 00:20:39,880 And clenching and grinding is your body's reflex to open up the airway. 336 00:20:39,880 --> 00:20:42,080 Oh, okay. 337 00:20:42,080 --> 00:20:45,080 Yeah, you know, just let's look at it this way. 338 00:20:45,080 --> 00:20:51,600 A muscle that is tense occupies less space than a muscle that is relaxed. 339 00:20:51,600 --> 00:20:57,600 So for those of us that, and I know I do it, when we pose for pictures, what do we do? 340 00:20:57,600 --> 00:20:59,400 We pop our arm up, do we not? 341 00:20:59,400 --> 00:21:05,880 Because that makes that bicep look so much more toned and skinnier as opposed to not 342 00:21:05,880 --> 00:21:06,880 posing it right. 343 00:21:06,880 --> 00:21:07,880 When it's down. 344 00:21:07,880 --> 00:21:08,880 Yeah. 345 00:21:08,880 --> 00:21:09,880 Right. 346 00:21:09,880 --> 00:21:10,880 And that's exactly what it does. 347 00:21:10,880 --> 00:21:15,400 When we clenching and grinding, it tightens up all these muscles because we got to use 348 00:21:15,400 --> 00:21:17,760 our muscles when we clench and grind. 349 00:21:17,760 --> 00:21:21,480 That is your body's reflex to open up the airway. 350 00:21:21,480 --> 00:21:25,600 So if you have a child that is constantly grinding at night, get this looked at. 351 00:21:25,600 --> 00:21:28,040 And no, a night guard is not the answer for a child. 352 00:21:28,040 --> 00:21:31,000 I'll even say that. 353 00:21:31,000 --> 00:21:32,000 Because what is that? 354 00:21:32,000 --> 00:21:33,000 It's a band-aid. 355 00:21:33,000 --> 00:21:34,000 I don't want a band-aid. 356 00:21:34,000 --> 00:21:35,000 Oh, right. 357 00:21:35,000 --> 00:21:36,000 There's a problem there. 358 00:21:36,000 --> 00:21:37,360 Yeah, that is growing. 359 00:21:37,360 --> 00:21:42,920 And I can impact growth and development, and I want to get in as quickly as I can to help 360 00:21:42,920 --> 00:21:46,720 this child breathe and grow to their best ability. 361 00:21:46,720 --> 00:21:54,280 Having conversations with moms while they're in the office as well is huge. 362 00:21:54,280 --> 00:21:57,760 When we started this, my team would be like, Doc, will you stop talking? 363 00:21:57,760 --> 00:21:59,320 Because you have other patients waiting for you. 364 00:21:59,320 --> 00:22:01,640 You have these moms really need to go places. 365 00:22:01,640 --> 00:22:07,480 And I was like, I know, but I can't not get all the information from them. 366 00:22:07,480 --> 00:22:12,480 A child that is struggling at school, that has trouble focusing, that has trouble getting 367 00:22:12,480 --> 00:22:19,000 along with their peers, that has behavioral issues that can be related to sleep disorders, 368 00:22:19,000 --> 00:22:24,160 that can be related to lack of oxygen to the brain. 369 00:22:24,160 --> 00:22:28,040 So that's where sleep comes in now. 370 00:22:28,040 --> 00:22:30,360 Why sleep is so important for children. 371 00:22:30,360 --> 00:22:31,360 Correct. 372 00:22:31,360 --> 00:22:39,720 So we use all of these signs and symptoms and what we see to start to connect the dots. 373 00:22:39,720 --> 00:22:43,560 So when I see any of this, I will start asking mom questions. 374 00:22:43,560 --> 00:22:45,800 Does your child snore? 375 00:22:45,800 --> 00:22:50,160 Audible breathing in a child when they're asleep does count as snoring. 376 00:22:50,160 --> 00:22:52,320 They don't have to snore like you and I. 377 00:22:52,320 --> 00:22:54,040 Any audible breathing. 378 00:22:54,040 --> 00:22:55,040 Correct. 379 00:22:55,040 --> 00:22:56,040 Okay. 380 00:22:56,040 --> 00:23:01,320 When I talk to the mom about what kind, like is this child a messy sleeper? 381 00:23:01,320 --> 00:23:03,360 Are they a restless sleeper? 382 00:23:03,360 --> 00:23:08,600 Do they start on one side of the bed and move over and they're all over the place? 383 00:23:08,600 --> 00:23:14,760 So both my girls, my, one of my girls was has still been like, she literally never had 384 00:23:14,760 --> 00:23:19,200 to make the bed in the morning because she'd get up, smooth the covers and she was fine. 385 00:23:19,200 --> 00:23:21,160 She didn't toss and turn. 386 00:23:21,160 --> 00:23:24,840 But the other one, you'd go into her room in the morning and be like, good Lord child, 387 00:23:24,840 --> 00:23:26,360 who have you been fighting with? 388 00:23:26,360 --> 00:23:27,360 Right. 389 00:23:27,360 --> 00:23:29,720 The blankets are everywhere. 390 00:23:29,720 --> 00:23:35,800 The pillows are on the floor and like she starts in one position, ends up in the other. 391 00:23:35,800 --> 00:23:37,440 That can be a sign as well. 392 00:23:37,440 --> 00:23:42,880 So these are questions that I then start to ask parents to be able to connect the dots 393 00:23:42,880 --> 00:23:45,320 is to what is going on. 394 00:23:45,320 --> 00:23:49,120 These are all my clues. 395 00:23:49,120 --> 00:23:51,920 We talk about bedwetting as well. 396 00:23:51,920 --> 00:23:55,120 We talk about breastfeeding as an infant. 397 00:23:55,120 --> 00:23:56,320 Of course, I'm seeing a little one. 398 00:23:56,320 --> 00:24:01,080 We ask about are they breastfed or bottlefed, but even the older ones, because when I look 399 00:24:01,080 --> 00:24:06,560 at somebody that has a constricted palate that has the growth and development of a narrow, 400 00:24:06,560 --> 00:24:14,520 long face that I'm seeing as opposed to those wider faces and very non-judgmental. 401 00:24:14,520 --> 00:24:20,360 But I want to know, hey, is your baby or was this child breastfed or bottlefed? 402 00:24:20,360 --> 00:24:25,440 Is that's going to give me a clue as to where they even able to nurse? 403 00:24:25,440 --> 00:24:29,960 If mom chose not to nurse, I completely respect that decision, but were they able to nurse? 404 00:24:29,960 --> 00:24:32,040 A lot of times it hurt. 405 00:24:32,040 --> 00:24:33,040 It was painful. 406 00:24:33,040 --> 00:24:35,600 My next question has to be why? 407 00:24:35,600 --> 00:24:38,080 And that's what I tell my team. 408 00:24:38,080 --> 00:24:39,080 They give you an answer. 409 00:24:39,080 --> 00:24:40,080 Think why? 410 00:24:40,080 --> 00:24:41,480 And you get the answer to that. 411 00:24:41,480 --> 00:24:43,480 Ask it a second time. 412 00:24:43,480 --> 00:24:44,480 Why? 413 00:24:44,480 --> 00:24:45,480 What are we not seeing? 414 00:24:45,480 --> 00:24:46,480 What are we missing? 415 00:24:46,480 --> 00:24:51,640 So when I have a mom that says, oh, like bottlefed, okay, tell me more, what was going on with 416 00:24:51,640 --> 00:24:52,640 that? 417 00:24:52,640 --> 00:24:57,120 Well, it hurt too much or she had trouble latching on or it took her forever to eat. 418 00:24:57,120 --> 00:24:59,440 It seemed like it was a full-time job. 419 00:24:59,440 --> 00:25:02,000 Now I know to ask myself, why? 420 00:25:02,000 --> 00:25:04,000 Why was that happening? 421 00:25:04,000 --> 00:25:06,920 Then that leads me down the rabbit hole of, is there a tie? 422 00:25:06,920 --> 00:25:08,360 Is there a tongue tie going on? 423 00:25:08,360 --> 00:25:11,720 Because remember when I'm still evaluating the mouth, not only am I looking the shape 424 00:25:11,720 --> 00:25:18,280 and the position of the tongue, is there a tie because that itself again, tongue needs 425 00:25:18,280 --> 00:25:19,920 to be resting in the roof of the mouth. 426 00:25:19,920 --> 00:25:24,800 If it's unable to, that is impacting growth and development. 427 00:25:24,800 --> 00:25:43,040 My early blues are a child that was unable to breastfeed. 428 00:25:43,040 --> 00:25:47,520 You are listening to Airway First with today's guest, Dr. Meghna Dasani. 429 00:25:47,520 --> 00:25:51,080 You can find out more about the Children's Airway First Foundation and our mission to 430 00:25:51,080 --> 00:25:56,080 ensure that every child has access to screening, evaluation, and treatment of all children's 431 00:25:56,080 --> 00:26:02,080 airway disorders before the age of six on our website at childrensairwayfirst.org. 432 00:26:02,080 --> 00:26:07,760 The CAF website offers tons of great resources for parents, including videos, blogs, recommended 433 00:26:07,760 --> 00:26:11,120 books, comprehensive medical research, and so much more. 434 00:26:11,120 --> 00:26:15,640 We've also recently launched the Airway Huddle, a Facebook support group for parents of children 435 00:26:15,640 --> 00:26:18,360 with airway and sleep-related issues. 436 00:26:18,360 --> 00:26:24,200 You can access the Airway Huddle support group at facebook.com backslash groups backslash 437 00:26:24,200 --> 00:26:25,440 airway huddle. 438 00:26:25,440 --> 00:26:29,880 Are you interested in becoming a guest or have an idea for an upcoming episode? 439 00:26:29,880 --> 00:26:35,120 Shoot us a note via the contacts page on our website or send us an email directly at info 440 00:26:35,120 --> 00:26:38,000 at childrensairwayfirst.org. 441 00:26:38,000 --> 00:26:43,280 As a reminder, this podcast and the opinions expressed here are not a medical diagnosis. 442 00:26:43,280 --> 00:26:47,960 If you suspect your child might have an airway issue, contact your pediatric, airway dentist, 443 00:26:47,960 --> 00:26:48,960 or pediatrician. 444 00:26:48,960 --> 00:27:05,680 And now, let's jump back into my interview with today's guest, Dr. Meghna Desani. 445 00:27:05,680 --> 00:27:06,680 So it's a waterfall effect. 446 00:27:06,680 --> 00:27:08,400 You look at one and you ask the questions. 447 00:27:08,400 --> 00:27:13,400 You look at something, you ask the questions, and then no conversation is the same in the 448 00:27:13,400 --> 00:27:14,400 office. 449 00:27:14,400 --> 00:27:19,040 If you could have two parents and two operatories, it will not follow the same route because what 450 00:27:19,040 --> 00:27:25,320 am I seeing to what why am I asking and what questions am I asking as follow-ups is what 451 00:27:25,320 --> 00:27:27,040 is going to drive that conversation. 452 00:27:27,040 --> 00:27:28,040 So there's so many. 453 00:27:28,040 --> 00:27:31,800 Remember what I said earlier, seven kids can present with nine different symptoms and they 454 00:27:31,800 --> 00:27:33,720 could all be positive. 455 00:27:33,720 --> 00:27:37,680 And this is why, because we just don't know what's going on. 456 00:27:37,680 --> 00:27:39,840 And it sounds so weird. 457 00:27:39,840 --> 00:27:43,840 My team would be like, talk, why are you asking parents about bedwetting? 458 00:27:43,840 --> 00:27:47,600 We, that's not up our wheelhouse, right? 459 00:27:47,600 --> 00:27:50,640 But I will tell you this. 460 00:27:50,640 --> 00:27:54,680 In our early days, when we started to have these conversations and talk to parents about 461 00:27:54,680 --> 00:28:01,360 this, we had a 16-year-old coming with his mom. 462 00:28:01,360 --> 00:28:07,000 And typically in our office, when it's a new patient, you know, the team gets all, you 463 00:28:07,000 --> 00:28:10,840 know, whatever we need, all the information, the data I need first before I walk in to see 464 00:28:10,840 --> 00:28:11,840 the patient. 465 00:28:11,840 --> 00:28:15,400 And my assistant came to tell me and she's like, doc, you might want to see this one 466 00:28:15,400 --> 00:28:16,400 first. 467 00:28:16,400 --> 00:28:17,400 I was like, why, what's going on? 468 00:28:17,400 --> 00:28:21,120 It's like, you know what you need to do, you know, get the history, like check whatever 469 00:28:21,120 --> 00:28:24,360 medications if actually needed, blah, blah, blah. 470 00:28:24,360 --> 00:28:27,440 And she's like, no, you want to come into this one first. 471 00:28:27,440 --> 00:28:28,440 Okay. 472 00:28:28,440 --> 00:28:36,160 So I walk in 16-year-old boy in the chair and mom's in the room and I was like, hey, 473 00:28:36,160 --> 00:28:37,160 bud, what's up? 474 00:28:37,160 --> 00:28:38,640 Like, you know, just my usual. 475 00:28:38,640 --> 00:28:44,440 And like that child is sitting with his head bowed and just mumbles, can she not be here? 476 00:28:44,440 --> 00:28:46,640 Like for the assistant. 477 00:28:46,640 --> 00:28:50,920 And I said, no, we kind of need her here. 478 00:28:50,920 --> 00:28:52,800 I need a team member just like your mom's here. 479 00:28:52,800 --> 00:28:54,360 I need a team member here. 480 00:28:54,360 --> 00:28:56,000 Now tell me what's going on. 481 00:28:56,000 --> 00:28:57,360 And he still has his head bowed. 482 00:28:57,360 --> 00:29:01,520 You could tell he's so embarrassed like he just does not want to be here. 483 00:29:01,520 --> 00:29:03,840 And he goes, well, I still wet my bed. 484 00:29:03,840 --> 00:29:05,480 Like literally he mumbled it out. 485 00:29:05,480 --> 00:29:06,480 I was like, say what? 486 00:29:06,480 --> 00:29:07,880 Say that again. 487 00:29:07,880 --> 00:29:09,440 I still wet my bed. 488 00:29:09,440 --> 00:29:16,360 That was a 16-year-old boy in my chair telling me he's here because he still wants the bed. 489 00:29:16,360 --> 00:29:17,360 Let's back up here. 490 00:29:17,360 --> 00:29:18,960 I am a dentist. 491 00:29:18,960 --> 00:29:22,040 I deal with teeth. 492 00:29:22,040 --> 00:29:29,400 You know that when this family has found themselves in my practice for their teenage 493 00:29:29,400 --> 00:29:39,400 boy that is still wetting the bed, you know I am probably their last option. 494 00:29:39,400 --> 00:29:44,680 And sure enough, they had done everything they could, everything. 495 00:29:44,680 --> 00:29:47,440 They'd been to numerous pediatricians. 496 00:29:47,440 --> 00:29:51,680 They checked off all the boxes, made sure he wasn't drinking on gallon of water before 497 00:29:51,680 --> 00:29:56,880 going to bed, cleaned up his diet, saw whoever they needed to. 498 00:29:56,880 --> 00:29:57,880 Everything was fine. 499 00:29:57,880 --> 00:29:59,000 Thank God. 500 00:29:59,000 --> 00:30:02,280 Everything was fine. 501 00:30:02,280 --> 00:30:06,880 And sure enough with whatever clues we noticed within the practice and I told mom, I said, 502 00:30:06,880 --> 00:30:11,720 I don't know if this is going to help, but I think it is. 503 00:30:11,720 --> 00:30:12,720 Are you willing? 504 00:30:12,720 --> 00:30:14,240 I mean, she's like, you know, I've done everything. 505 00:30:14,240 --> 00:30:16,840 What I've exhausted all my options. 506 00:30:16,840 --> 00:30:18,240 What can it hurt? 507 00:30:18,240 --> 00:30:19,840 Because it's non-invasive, right? 508 00:30:19,840 --> 00:30:21,560 Whatever we're doing. 509 00:30:21,560 --> 00:30:25,680 And sure enough, the child comes in for a three-month follow-up. 510 00:30:25,680 --> 00:30:29,080 Our office is, we have eight operatories down a long hallway. 511 00:30:29,080 --> 00:30:33,360 He was walking in and I was just walking out of the break room with my coffee. 512 00:30:33,360 --> 00:30:37,120 And he runs, 16-hour boy running up to me, not a good idea. 513 00:30:37,120 --> 00:30:38,120 Right? 514 00:30:38,120 --> 00:30:40,360 There's like teenage boys, never. 515 00:30:40,360 --> 00:30:45,880 He runs down that hallway, makes me put my coffee down and gives me the biggest hug. 516 00:30:45,880 --> 00:30:51,240 And he whispers in my ear, he's like, I haven't had an accident since I saw you last. 517 00:30:51,240 --> 00:30:52,240 I tell you why. 518 00:30:52,240 --> 00:30:53,600 I was done that day. 519 00:30:53,600 --> 00:30:54,600 I was done. 520 00:30:54,600 --> 00:30:56,280 I was like, I'm going home. 521 00:30:56,280 --> 00:30:59,520 My day, week, month, year cannot get better. 522 00:30:59,520 --> 00:31:01,520 I was done. 523 00:31:01,520 --> 00:31:02,920 Wow. 524 00:31:02,920 --> 00:31:06,320 So ask the questions. 525 00:31:06,320 --> 00:31:12,840 And for moms that may be the listening parents, educators, ask the questions. 526 00:31:12,840 --> 00:31:15,480 Because you never know who has the answer. 527 00:31:15,480 --> 00:31:21,080 Because if we don't have the answer, we might know somebody that might have the answer. 528 00:31:21,080 --> 00:31:25,440 I always share this story because I want parents to know, I know you're going to be thinking, 529 00:31:25,440 --> 00:31:26,440 so weird. 530 00:31:26,440 --> 00:31:27,960 Like why would I talk about, what are they going to do? 531 00:31:27,960 --> 00:31:28,960 Somy diapers? 532 00:31:28,960 --> 00:31:29,960 Like, you know? 533 00:31:29,960 --> 00:31:30,960 Right. 534 00:31:30,960 --> 00:31:31,960 But you never... 535 00:31:31,960 --> 00:31:33,080 But it is a sign. 536 00:31:33,080 --> 00:31:35,640 It's a sign that parents don't know. 537 00:31:35,640 --> 00:31:43,040 I mean, until I started my work with Children's Airway, I would never, ever have put those 538 00:31:43,040 --> 00:31:46,200 two together, that that's a sign of an airway issue. 539 00:31:46,200 --> 00:31:47,200 Never. 540 00:31:47,200 --> 00:31:48,200 Yeah. 541 00:31:48,200 --> 00:31:49,200 So there's a lot. 542 00:31:49,200 --> 00:31:52,520 There's a lot, sure. 543 00:31:52,520 --> 00:31:58,000 And on your website, you also talk about how anxiety can impact a child's sleep. 544 00:31:58,000 --> 00:32:00,360 And I thought maybe we could talk a little bit about that. 545 00:32:00,360 --> 00:32:03,800 How does that happen, first of all, and what can parents do to help with that? 546 00:32:03,800 --> 00:32:05,600 Yeah, yeah, for sure. 547 00:32:05,600 --> 00:32:09,920 So anxiety has, you know, there's so many reasons that can happen, right? 548 00:32:09,920 --> 00:32:14,480 And again, it's a big group that we want to make sure we're looking at. 549 00:32:14,480 --> 00:32:18,240 Kids could have anxiety from whatever's going on at school. 550 00:32:18,240 --> 00:32:20,200 We do big things in school. 551 00:32:20,200 --> 00:32:25,040 Our kids, you know, we expect them to go to school with a great attitude. 552 00:32:25,040 --> 00:32:32,080 We expect them to learn, be respectful to their teachers, to their peers, to do whatever 553 00:32:32,080 --> 00:32:36,960 it is, you know, that they're asked to do. 554 00:32:36,960 --> 00:32:43,080 And come home with that great attitude, do their homework, be respectful at home, go 555 00:32:43,080 --> 00:32:45,280 to all their classes that we send them to, go to bed. 556 00:32:45,280 --> 00:32:48,280 There's a lot that goes on in their day. 557 00:32:48,280 --> 00:32:53,680 We never know what part of that day contributes, did not end well, or did not go the way they 558 00:32:53,680 --> 00:32:55,640 wanted it to. 559 00:32:55,640 --> 00:32:59,800 For us as adults that have learned to deal with things, a lot of times it's not a big 560 00:32:59,800 --> 00:33:00,800 deal. 561 00:33:00,800 --> 00:33:01,800 Right. 562 00:33:01,800 --> 00:33:03,640 But for that child, it might be a big deal. 563 00:33:03,640 --> 00:33:05,920 And there may be anxiety surrounding it. 564 00:33:05,920 --> 00:33:09,560 So sometimes the anxiety comes from that, where they're getting into bed and they're still 565 00:33:09,560 --> 00:33:16,240 ruminating over the day, what didn't go right, but it impacts their sleep. 566 00:33:16,240 --> 00:33:20,760 It can't fall asleep because they're constantly thinking about it because that loop has not 567 00:33:20,760 --> 00:33:23,120 been closed in their head. 568 00:33:23,120 --> 00:33:27,840 So that is one way in which, yes, that sleep is being impacted, but let's look at it from 569 00:33:27,840 --> 00:33:29,840 an airway perspective. 570 00:33:29,840 --> 00:33:37,160 If this is a child that has sleep disorder breathing, you know, they're stopping breathing, 571 00:33:37,160 --> 00:33:41,880 oxygen levels are dropping, whatever is happening at night time. 572 00:33:41,880 --> 00:33:46,320 The brain is now perceiving this as our brain is smart, right? 573 00:33:46,320 --> 00:33:51,600 It's only job is to keep us alive when we're asleep. 574 00:33:51,600 --> 00:33:55,600 And the brain is perceiving this as a threat, right? 575 00:33:55,600 --> 00:33:59,760 The brain goes, dude, like you stop breathing and I don't get oxygen and I have to work 576 00:33:59,760 --> 00:34:03,640 harder to wake you up to make sure the oxygenated blood comes to me. 577 00:34:03,640 --> 00:34:12,200 The brain is going through its loop and that can contribute to anxiety surrounding sleep. 578 00:34:12,200 --> 00:34:19,400 For kids that are used to running around, acting up, not wanting to fall asleep, whatever 579 00:34:19,400 --> 00:34:26,000 it is, with relation to sleep, that might be something that's playing into it. 580 00:34:26,000 --> 00:34:30,880 So the brain is telling you, it's a bad thing that you're trying to fall asleep. 581 00:34:30,880 --> 00:34:36,080 And what does that show up as, as anxiety in these kids, because it's not safe? 582 00:34:36,080 --> 00:34:38,880 How do you and I feel when it's not safe someplace? 583 00:34:38,880 --> 00:34:39,880 Right? 584 00:34:39,880 --> 00:34:44,760 When you walk down a dark alley at 11 p.m. and there are shadows, what do we perceive 585 00:34:44,760 --> 00:34:45,760 it at? 586 00:34:45,760 --> 00:34:47,200 There's anxiety going in there. 587 00:34:47,200 --> 00:34:49,400 You don't feel safe. 588 00:34:49,400 --> 00:34:55,360 Well, if this child is stopping breathing, isn't getting oxygen, you know, and I say this 589 00:34:55,360 --> 00:34:59,880 in air quotes, bad things, the brain is perceiving are happening at night. 590 00:34:59,880 --> 00:35:06,720 Well, how is it going to react or respond as anxiety, which is why it's so important 591 00:35:06,720 --> 00:35:13,560 to have these and moms, parents don't always have the answers, but it helps to talk about 592 00:35:13,560 --> 00:35:17,200 this, but also make sure you talk to your kids about this. 593 00:35:17,200 --> 00:35:18,680 Where is this coming from? 594 00:35:18,680 --> 00:35:23,000 Because once we know what's causing it, it's when you can address it. 595 00:35:23,000 --> 00:35:31,480 Is it from, I don't know, getting an 82 on your Mac when you knew all the answers yesterday 596 00:35:31,480 --> 00:35:35,120 that is making you feel bad about it? 597 00:35:35,120 --> 00:35:38,800 Then a lot of hugs and cuddles and talking it out with mom and knowing that you can do 598 00:35:38,800 --> 00:35:41,320 better next time is the answer. 599 00:35:41,320 --> 00:35:47,840 But if it's because your brain feels like you're choking in your sleep, then something else 600 00:35:47,840 --> 00:35:49,080 might be the answer. 601 00:35:49,080 --> 00:35:52,980 So it's very important to figure out where this is coming from. 602 00:35:52,980 --> 00:35:58,160 And how might a child, when you're having these conversations, because obviously they're 603 00:35:58,160 --> 00:36:05,440 not going to be able to say, I'm choking in my sleep, could they present it in more of 604 00:36:05,440 --> 00:36:11,160 a manner of I just can't sleep or I try, but I can't sleep or as a parent, what are we 605 00:36:11,160 --> 00:36:12,920 listening for? 606 00:36:12,920 --> 00:36:16,640 How would it present from them? 607 00:36:16,640 --> 00:36:20,360 In this case is when we would tie in the other signs and symptoms that we looked at. 608 00:36:20,360 --> 00:36:22,920 Does your child have those dark circles under their eyes? 609 00:36:22,920 --> 00:36:24,560 Is your child's moving? 610 00:36:24,560 --> 00:36:29,360 Are these other signs and symptoms tying in for us to connect the dots? 611 00:36:29,360 --> 00:36:33,440 Yes, the child may not be able to see this, but here's another thing. 612 00:36:33,440 --> 00:36:41,280 If you have a child that has this anxiety, this chronic insomnia, maybe take in on them 613 00:36:41,280 --> 00:36:42,280 at night. 614 00:36:42,280 --> 00:36:46,600 And I tell moms, our phones are a powerful tool. 615 00:36:46,600 --> 00:36:51,880 Yes, we use them to capture all these amazing memories of our kids, but go in and record 616 00:36:51,880 --> 00:36:55,720 your child's sleeping because sometimes mom's like, I don't know what's right or what's 617 00:36:55,720 --> 00:36:56,720 not. 618 00:36:56,720 --> 00:37:02,440 And I don't want to be the mom that's presenting with little concerns where it really may not 619 00:37:02,440 --> 00:37:06,040 be because we don't want to come across that crazy parent also. 620 00:37:06,040 --> 00:37:07,040 I've been there. 621 00:37:07,040 --> 00:37:09,640 I do worry about little things. 622 00:37:09,640 --> 00:37:11,960 Go take your phone and record your child's sleeping. 623 00:37:11,960 --> 00:37:17,880 If you think that, I'm not sure if they're snoring, but whatever it may be, record it 624 00:37:17,880 --> 00:37:23,120 and show it to your doctor, to your pediatrician, to your dentist and say, this is her at night, 625 00:37:23,120 --> 00:37:26,280 every night for, I don't know, the last three, four, five nights. 626 00:37:26,280 --> 00:37:29,400 Is this a concern? 627 00:37:29,400 --> 00:37:31,160 Ask your healthcare provider. 628 00:37:31,160 --> 00:37:33,840 Get expert eyes on it. 629 00:37:33,840 --> 00:37:35,560 And then it's a yes or a no. 630 00:37:35,560 --> 00:37:40,040 I think that ties into one of the things. 631 00:37:40,040 --> 00:37:43,960 There's so much on your website and I'm definitely going to put a link in the show notes because 632 00:37:43,960 --> 00:37:50,200 I absolutely strongly advise any parent listening to go to your website. 633 00:37:50,200 --> 00:37:53,920 There's so much amazing information there. 634 00:37:53,920 --> 00:37:58,200 I can say this is one of the few times putting the show notes together that there was so 635 00:37:58,200 --> 00:37:59,200 much to cover. 636 00:37:59,200 --> 00:38:02,640 I just really wasn't sure where to start. 637 00:38:02,640 --> 00:38:07,560 One of the other things that's on your website and you talk about is the link between sleep 638 00:38:07,560 --> 00:38:08,560 and healthy hearts. 639 00:38:08,560 --> 00:38:10,360 Oh my gosh, yes. 640 00:38:10,360 --> 00:38:11,360 Yeah. 641 00:38:11,360 --> 00:38:14,680 And as parents, again, you're seeing your child, they're running around, they're acting 642 00:38:14,680 --> 00:38:15,680 normal. 643 00:38:15,680 --> 00:38:16,680 You don't think about these things. 644 00:38:16,680 --> 00:38:18,000 So I thought maybe we could take some time. 645 00:38:18,000 --> 00:38:19,480 Let's just talk about that. 646 00:38:19,480 --> 00:38:21,720 And that's critically important. 647 00:38:21,720 --> 00:38:26,280 And it's something when we talk about airway, we don't often talk about. 648 00:38:26,280 --> 00:38:27,280 Absolutely. 649 00:38:27,280 --> 00:38:28,280 Absolutely. 650 00:38:28,280 --> 00:38:33,200 So just backing up a few big steps. 651 00:38:33,200 --> 00:38:38,520 When we talk about sleep disorder breathing, one of the main things that we do, we do 652 00:38:38,520 --> 00:38:43,160 we focus on our like to address is sleep apnea, right? 653 00:38:43,160 --> 00:38:49,880 Sleep apnea is when a person and I say person because it applies to adults as well as kids 654 00:38:49,880 --> 00:38:56,360 stops breathing for multiple times throughout the night. 655 00:38:56,360 --> 00:39:02,640 Typically what happens is when we sleep, no, always this happens when we sleep, our muscles 656 00:39:02,640 --> 00:39:04,400 relax, right? 657 00:39:04,400 --> 00:39:08,480 That's how our body feels, rests, rejuvenates, all of that. 658 00:39:08,480 --> 00:39:14,320 When these muscles relax, the tongue, which is also a muscle also relaxes and that tongue 659 00:39:14,320 --> 00:39:17,000 can fall backwards into the airway. 660 00:39:17,000 --> 00:39:24,840 That creates an obstruction, obstructed sleep apnea, which closes up the airway. 661 00:39:24,840 --> 00:39:30,040 So now in kids, let's tie in a child that may have enlarged tonsils or adenoids as well, 662 00:39:30,040 --> 00:39:31,040 right? 663 00:39:31,040 --> 00:39:32,040 So that compounds the problem. 664 00:39:32,040 --> 00:39:34,920 Just one little side note there. 665 00:39:34,920 --> 00:39:36,640 So now we have this tongue that's falling back. 666 00:39:36,640 --> 00:39:38,040 It's obstructed the airway. 667 00:39:38,040 --> 00:39:41,680 There's no oxygen going in. 668 00:39:41,680 --> 00:39:44,640 The brain, which needs oxygenated blood, the heart slows down. 669 00:39:44,640 --> 00:39:48,000 The heart doesn't have much to do because it's like, dude, there's no oxygenated blood. 670 00:39:48,000 --> 00:39:50,080 I'm just going to sit here and chill. 671 00:39:50,080 --> 00:39:53,320 And at some point the brain goes like, dude, wake up. 672 00:39:53,320 --> 00:39:54,720 I need air. 673 00:39:54,720 --> 00:39:56,800 I need oxygen. 674 00:39:56,800 --> 00:40:03,600 So these impulses are sent to the heart and the heart has to speed up to be able to carry 675 00:40:03,600 --> 00:40:07,440 oxygen enough oxygenated blood to the brain. 676 00:40:07,440 --> 00:40:14,000 And this cycle happens all continuously multiple times throughout the night. 677 00:40:14,000 --> 00:40:15,520 What did I just say earlier? 678 00:40:15,520 --> 00:40:17,120 What happens at night? 679 00:40:17,120 --> 00:40:25,360 At night is when we are sleeping, we are healing, we are resting, we are rejuvenating all of 680 00:40:25,360 --> 00:40:29,840 our muscles, you know, the different parts of our body that have worked so hard during 681 00:40:29,840 --> 00:40:30,920 the day. 682 00:40:30,920 --> 00:40:35,440 So for an adult, it may be walking the dog, it may be CrossFit for our children. 683 00:40:35,440 --> 00:40:36,440 It's playing lacrosse. 684 00:40:36,440 --> 00:40:42,480 It's on the football field learning whatever needs to happen with them. 685 00:40:42,480 --> 00:40:46,000 The heart is also a muscle. 686 00:40:46,000 --> 00:40:50,680 Nighttime is when all of this healing, repairing, rejuvenating needs to happen. 687 00:40:50,680 --> 00:40:58,880 But instead what is happening when this obstruction, obstructive sleep apnea is happening, the heart 688 00:40:58,880 --> 00:41:00,960 is working overtime. 689 00:41:00,960 --> 00:41:02,200 Is it not? 690 00:41:02,200 --> 00:41:08,520 It is re-eated insults and injury that is happening because it's the stop, start, stop, 691 00:41:08,520 --> 00:41:11,720 start, stop, start that's going on. 692 00:41:11,720 --> 00:41:20,480 And instead of this heart now healing, it has more of this insult happening to it. 693 00:41:20,480 --> 00:41:26,240 This is what puts us, puts our kids, puts our communities at a higher risk for these 694 00:41:26,240 --> 00:41:28,640 are people that present with high blood pressure. 695 00:41:28,640 --> 00:41:30,280 How many children are we seeing? 696 00:41:30,280 --> 00:41:33,960 High blood pressure, right? 697 00:41:33,960 --> 00:41:42,880 This is what puts us at a high, just cardiac enlargement, cardiac disease, heart attacks, 698 00:41:42,880 --> 00:41:49,360 everything that goes in the realm of an adult's higher risk for strokes. 699 00:41:49,360 --> 00:41:55,040 That's where the whole let's make sure the healing actually happens as opposed to thinking. 700 00:41:55,040 --> 00:41:58,720 And I tell parents this, you know, most parents go like, well, my kid sleeps enough. 701 00:41:58,720 --> 00:42:02,920 I'm sure your kid gets the seven, eight, nine, 10 hours of sleep, whatever it is that they 702 00:42:02,920 --> 00:42:07,960 need based on their age, but are they getting enough quality sleep? 703 00:42:07,960 --> 00:42:08,960 That's right. 704 00:42:08,960 --> 00:42:09,960 Is it restful? 705 00:42:09,960 --> 00:42:10,960 Yeah. 706 00:42:10,960 --> 00:42:16,040 That's where the disconnect is because I may think my kids slept for 12 hours, but if 707 00:42:16,040 --> 00:42:22,720 they woke up five times on the hour every hour and not get up, eat, sleep, watch TV and 708 00:42:22,720 --> 00:42:28,560 go to bed kind of thing, but these kind of arousals, that's not truly restful sleep, 709 00:42:28,560 --> 00:42:29,560 is it? 710 00:42:29,560 --> 00:42:31,920 No, no, it's not. 711 00:42:31,920 --> 00:42:37,800 So as a parent, I know, you know, you mentioned monitoring them because I think we've all 712 00:42:37,800 --> 00:42:41,880 done it as parents when they're babies, we're in there all night, we're watching them and 713 00:42:41,880 --> 00:42:47,920 then they get a little older and you put them down and you go in the other room and you 714 00:42:47,920 --> 00:42:52,560 relax and you have your tea and you read and that's it. 715 00:42:52,560 --> 00:42:58,280 So periodically go in, spend five, 10 minutes at different times of the night, monitor your 716 00:42:58,280 --> 00:42:59,280 child. 717 00:42:59,280 --> 00:43:04,760 So as a parent, now I'm seeing these symptoms, you know, I've watched them at night. 718 00:43:04,760 --> 00:43:09,600 I'm seeing some of the others, maybe the dark circles, maybe, you know, they have this kind 719 00:43:09,600 --> 00:43:14,920 of ADHD hyperactivity that's not really, I'm seeing some of the symptoms, but when I look 720 00:43:14,920 --> 00:43:19,920 in their mouth, everything that looks normal to me as a parent, you know, there's no tongue 721 00:43:19,920 --> 00:43:22,760 tie, the tonsils look fine. 722 00:43:22,760 --> 00:43:24,880 Now what do you do as a parent? 723 00:43:24,880 --> 00:43:29,840 You ask questions, you still bring up these concerns to your doctors. 724 00:43:29,840 --> 00:43:35,440 Be a dear pediatrician that you may be seeing every year, twice a year, whatever it is that 725 00:43:35,440 --> 00:43:36,880 you need to see them. 726 00:43:36,880 --> 00:43:42,520 If your child is one, I know you see your dentist twice a year, at least every six months. 727 00:43:42,520 --> 00:43:45,520 Ask questions. 728 00:43:45,520 --> 00:43:49,280 Bring up these concerns to your dentist. 729 00:43:49,280 --> 00:43:50,280 It does not matter. 730 00:43:50,280 --> 00:43:54,920 I promise you were not going to think like, well, why are you telling me this? 731 00:43:54,920 --> 00:44:00,800 Not once have I said that to a parent, and I know nobody I know is going to say this. 732 00:44:00,800 --> 00:44:05,600 What we will do is if it is outside the realm of our practices guide you towards somebody 733 00:44:05,600 --> 00:44:10,760 else, but it will help us connect the dots for you. 734 00:44:10,760 --> 00:44:17,000 So ask questions, bring it up to your providers, whoever it is that you may be seeing, to at 735 00:44:17,000 --> 00:44:18,320 least get some more clarity. 736 00:44:18,320 --> 00:44:21,920 You never know who is going to be able to help your child. 737 00:44:21,920 --> 00:44:24,400 It is the advocacy aspect. 738 00:44:24,400 --> 00:44:27,760 We hear this time and time again. 739 00:44:27,760 --> 00:44:39,440 Another thing that we hear about, or is mentioned from time to time, is migraines. 740 00:44:39,440 --> 00:44:44,760 That is something most of us as parents deal with in children, but this airway issue can 741 00:44:44,760 --> 00:44:48,440 also present itself in that way, is that correct? 742 00:44:48,440 --> 00:44:49,440 Correct. 743 00:44:49,440 --> 00:44:52,720 It all comes down to the lack of oxygen. 744 00:44:52,720 --> 00:44:58,560 In a lot of times for migraines, it is the insomnia that can set up. 745 00:44:58,560 --> 00:45:04,440 The correlation with migraines ties directly into the insomnia. 746 00:45:04,440 --> 00:45:09,040 Based on what article you read, some will tell you it is the migraines that set this 747 00:45:09,040 --> 00:45:15,280 off and the insomnia and then the other way around, either way, they are all connected. 748 00:45:15,280 --> 00:45:21,800 So getting that sleep addressed can help a great deal. 749 00:45:21,800 --> 00:45:24,360 And how as a parent do we get the sleep addressed? 750 00:45:24,360 --> 00:45:27,960 I know there is sleep labs, there is telemedicine. 751 00:45:27,960 --> 00:45:35,480 Let's talk a little bit about that, what the process is to get in, what it is like. 752 00:45:35,480 --> 00:45:42,400 So telemedicine, I am assuming you are asking that in regards to having these conversations, 753 00:45:42,400 --> 00:45:43,400 consultations? 754 00:45:43,400 --> 00:45:44,400 Yes. 755 00:45:44,400 --> 00:45:47,000 Is that an option to start with? 756 00:45:47,000 --> 00:45:50,800 Because I know it is such a big thing now. 757 00:45:50,800 --> 00:45:56,920 It could be, especially with COVID and everything, when things were shut down, when we had so 758 00:45:56,920 --> 00:46:00,640 many more restrictions in place, that was a great tool. 759 00:46:00,640 --> 00:46:06,880 So for parents, a lot of times the initial conversation consult, yes, absolutely, can 760 00:46:06,880 --> 00:46:09,160 happen over telemedicine. 761 00:46:09,160 --> 00:46:13,320 But for us to be able to actually assess, evaluate, peek our heads in, look what is 762 00:46:13,320 --> 00:46:21,840 going on, and in person visit does make more sense to get that conversation on the consult 763 00:46:21,840 --> 00:46:22,840 going. 764 00:46:22,840 --> 00:46:30,520 As far as sleep labs, for kids, I always, anytime there is a sleep concern, be it whoever 765 00:46:30,520 --> 00:46:38,080 you are talking to, your dentist, your pediatric dentist, your pediatrician, whoever, I always 766 00:46:38,080 --> 00:46:41,920 recommend seeing an ENT, get those tonsils and adenoids evaluated. 767 00:46:41,920 --> 00:46:45,400 That should always be a first line of evaluation. 768 00:46:45,400 --> 00:46:50,880 Again, they have their own guidelines as the dental world has its guidelines for what can 769 00:46:50,880 --> 00:46:53,560 and cannot be done at what stages. 770 00:46:53,560 --> 00:46:57,520 But I always, parents, let them get their eyes on it. 771 00:46:57,520 --> 00:47:04,160 I work with a fabulous ENT and we have a great working relationship where I'm like, you know, 772 00:47:04,160 --> 00:47:09,120 I'd rather worry more than not worry enough about my patients. 773 00:47:09,120 --> 00:47:14,280 I'd rather have you get your eyes on it and you say they're good or good catch. 774 00:47:14,280 --> 00:47:18,160 I'd rather have that. 775 00:47:18,160 --> 00:47:25,360 Working with the sleep lab, if a sleep study is warranted, again, I live and practice in 776 00:47:25,360 --> 00:47:32,400 Houston, so we have a lot of bigger hospitals and a lot more access to all of this. 777 00:47:32,400 --> 00:47:34,760 But it can be a challenge sometimes. 778 00:47:34,760 --> 00:47:39,000 There's not enough that have pediatric testing. 779 00:47:39,000 --> 00:47:46,120 Pediatric, our patients have to be screened and scored a specific way as opposed to adults. 780 00:47:46,120 --> 00:47:51,960 So I tell parents, make sure that they do have that. 781 00:47:51,960 --> 00:47:57,760 Or they have somebody that is trained and knows how to score a pediatric patient. 782 00:47:57,760 --> 00:48:03,120 So take the referral from your ENT or your MDs or whoever before you go to have that 783 00:48:03,120 --> 00:48:04,120 done. 784 00:48:04,120 --> 00:48:09,360 Typically, it's in a lab that's attached to a hospital. 785 00:48:09,360 --> 00:48:16,640 And if they're doing in-lab sleep study or PSG, which is what we need for children, it 786 00:48:16,640 --> 00:48:20,280 can be a bit overwhelming for kids at times. 787 00:48:20,280 --> 00:48:21,440 Sure. 788 00:48:21,440 --> 00:48:26,120 Because the PSG is those sleep studies, they're attached to all these leads that give us the 789 00:48:26,120 --> 00:48:29,520 information that we need and want. 790 00:48:29,520 --> 00:48:33,320 But it can be a lot for a kid. 791 00:48:33,320 --> 00:48:37,000 So just make sure you're talking to your child about what to expect, what's going to come. 792 00:48:37,000 --> 00:48:38,000 It does not hurt. 793 00:48:38,000 --> 00:48:39,000 That's the good point. 794 00:48:39,000 --> 00:48:41,520 It does not hurt. 795 00:48:41,520 --> 00:48:44,360 But there's a lot of data that's being gathered. 796 00:48:44,360 --> 00:48:47,960 And it can be funny to have everything attached to you. 797 00:48:47,960 --> 00:48:50,960 I usually tell the kids, we turn it into a game. 798 00:48:50,960 --> 00:48:53,200 You're going to be an alien for the night or whatever. 799 00:48:53,200 --> 00:48:56,240 You're going to have all these wires coming out of you. 800 00:48:56,240 --> 00:48:59,600 Parents are typically allowed to spend the night there with their kids. 801 00:48:59,600 --> 00:49:03,360 So that's very reassuring for the children. 802 00:49:03,360 --> 00:49:05,560 But just preparing them for... 803 00:49:05,560 --> 00:49:07,360 There's a lot of people putting all of this. 804 00:49:07,360 --> 00:49:08,360 Not going to hurt. 805 00:49:08,360 --> 00:49:10,720 You just sleep with it as best as you can. 806 00:49:10,720 --> 00:49:12,960 And then they take it all out in the morning and you go home. 807 00:49:12,960 --> 00:49:13,960 It doesn't hurt. 808 00:49:13,960 --> 00:49:17,440 And it'll tell us what we need to do to help you. 809 00:49:17,440 --> 00:49:22,160 So just like anything else explaining to the kids that it's going to be okay. 810 00:49:22,160 --> 00:49:24,040 I'm going to be right there with you. 811 00:49:24,040 --> 00:49:27,440 But knowing that there's a lot that's going to happen. 812 00:49:27,440 --> 00:49:28,440 Right. 813 00:49:28,440 --> 00:49:32,400 How early could a child go in for something like this? 814 00:49:32,400 --> 00:49:36,800 Honestly, I defer to my specialists for that. 815 00:49:36,800 --> 00:49:43,680 They get to make the call on what they're seeing and what is going on. 816 00:49:43,680 --> 00:49:51,960 I have seen two-year-olds get a sleep study because the ENT thought that was what was 817 00:49:51,960 --> 00:49:52,960 needed. 818 00:49:52,960 --> 00:49:56,280 But again, you have to understand not all two-year-olds are going to be compliant to 819 00:49:56,280 --> 00:49:58,720 allow them to do everything. 820 00:49:58,720 --> 00:50:02,240 And then there are some older kids too that get anxious about it. 821 00:50:02,240 --> 00:50:03,240 So it just... 822 00:50:03,240 --> 00:50:09,920 I say it comes down to what the specialist thinks is needed based on the child and everything 823 00:50:09,920 --> 00:50:12,440 else that's going on. 824 00:50:12,440 --> 00:50:13,660 Absolutely makes sense. 825 00:50:13,660 --> 00:50:20,640 So for a parent that is looking for a dentist like you, one that's actually looking for 826 00:50:20,640 --> 00:50:28,080 Airway and when we go on our insurance company websites to find a provider, are there specific 827 00:50:28,080 --> 00:50:29,440 terms we're looking for? 828 00:50:29,440 --> 00:50:31,320 How do we know? 829 00:50:31,320 --> 00:50:32,320 Yeah. 830 00:50:32,320 --> 00:50:36,000 Unfortunately, insurance is not going to list any of that. 831 00:50:36,000 --> 00:50:38,280 Just ask your dentist. 832 00:50:38,280 --> 00:50:40,440 It's like most are screening now. 833 00:50:40,440 --> 00:50:45,240 There's a lot of awareness in the dental world. 834 00:50:45,240 --> 00:50:47,560 And just, you know, hey, do you look for airway issues? 835 00:50:47,560 --> 00:50:53,400 Or I have a concern, is this something you can help address or do you know somebody that 836 00:50:53,400 --> 00:50:54,400 can? 837 00:50:54,400 --> 00:50:56,200 In our practice, it's the same thing. 838 00:50:56,200 --> 00:51:01,640 There are plenty of patients that get sent by other docs that don't see this or treat 839 00:51:01,640 --> 00:51:02,640 this. 840 00:51:02,640 --> 00:51:06,920 They come to us just for the airway issues and see their regular dentist for their cleanings 841 00:51:06,920 --> 00:51:09,960 and fillings and everything else that may be needed. 842 00:51:09,960 --> 00:51:17,040 So yeah, like I said, it takes a team and just ask, just talk to your dentist. 843 00:51:17,040 --> 00:51:18,040 Got it. 844 00:51:18,040 --> 00:51:23,800 One of the last things that I always do in our interviews is open the floor to our guests. 845 00:51:23,800 --> 00:51:28,720 So anything that maybe we didn't cover or anything specifically that you wouldn't like, 846 00:51:28,720 --> 00:51:33,720 a message you'd like to leave with parents. 847 00:51:33,720 --> 00:51:34,720 Thank you for that. 848 00:51:34,720 --> 00:51:37,120 But no, I think we covered a lot. 849 00:51:37,120 --> 00:51:45,120 The only thing I would say to parents is don't be afraid or embarrassed or ashamed to ask 850 00:51:45,120 --> 00:51:46,120 questions. 851 00:51:46,120 --> 00:51:52,560 If there's one thing I can tell moms because I see a lot of these parents every day. 852 00:51:52,560 --> 00:51:54,280 First off, it's not your fault. 853 00:51:54,280 --> 00:51:59,320 It truly isn't because as moms, we tend to be ourselves up thinking we might have done 854 00:51:59,320 --> 00:52:00,720 or not done something. 855 00:52:00,720 --> 00:52:01,720 It's not your fault. 856 00:52:01,720 --> 00:52:05,560 A lot of it is genetics, growth and development, the world that we live in. 857 00:52:05,560 --> 00:52:08,000 You know, everything's changing. 858 00:52:08,000 --> 00:52:09,400 It is what it is. 859 00:52:09,400 --> 00:52:15,120 You, I say kudos for at least addressing it, noticing it and ask questions. 860 00:52:15,120 --> 00:52:22,120 If you are not happy, satisfied or you think it is not the answer because nobody knows 861 00:52:22,120 --> 00:52:27,000 your child like you do, ask again or ask somebody else. 862 00:52:27,000 --> 00:52:29,800 Get a second, third, and opinion. 863 00:52:29,800 --> 00:52:31,840 It does not matter. 864 00:52:31,840 --> 00:52:36,520 But nobody, be your child's advocate is all I would say. 865 00:52:36,520 --> 00:52:37,520 Ask questions. 866 00:52:37,520 --> 00:52:38,520 Perfect. 867 00:52:38,520 --> 00:52:39,520 Perfect. 868 00:52:39,520 --> 00:52:41,720 Thank you so much for being here, Dr. Dasani. 869 00:52:41,720 --> 00:52:43,320 I really appreciate it. 870 00:52:43,320 --> 00:52:44,320 Thank you for having me. 871 00:52:44,320 --> 00:52:47,240 It's been a pleasure. 872 00:52:47,240 --> 00:52:51,880 Thanks again to today's guest, Dr. Magnet Dasani, for sharing her medical insight into each 873 00:52:51,880 --> 00:52:54,520 of you for listening to today's episode. 874 00:52:54,520 --> 00:52:57,120 If you're new to our podcast, please don't forget to subscribe. 875 00:52:57,120 --> 00:53:01,680 And if you enjoyed today's episode, leave us a review or comment telling us about what 876 00:53:01,680 --> 00:53:03,560 you enjoyed most. 877 00:53:03,560 --> 00:53:08,320 You can stay connected to the Children's Airway First Foundation by following us on Instagram, 878 00:53:08,320 --> 00:53:10,680 Facebook, Twitter, and LinkedIn. 879 00:53:10,680 --> 00:53:16,040 Or join us via our Facebook Parent Support Group, the Airway Huddle, at facebook.com. 880 00:53:16,040 --> 00:53:19,400 Backslash Groups, Backslash Airway Huddle. 881 00:53:19,400 --> 00:53:23,800 If you'd like to be a guest or have an idea for an upcoming episode, shoot us a note via 882 00:53:23,800 --> 00:53:30,200 our contacts page on our website, or send us an email directly at info at childrensairwayfirst.org. 883 00:53:30,200 --> 00:53:35,600 Remember, this podcast and the opinions expressed here are not a medical diagnosis. 884 00:53:35,600 --> 00:53:41,120 If you suspect your child might have an airway issue or related sleep disorder, contact your 885 00:53:41,120 --> 00:53:44,400 pediatric airway dentist or pediatrician. 886 00:53:44,400 --> 00:53:47,960 And finally, thanks to all the parents and medical professionals out there that are 887 00:53:47,960 --> 00:53:52,040 working to help make the lives of kids around the globe just a little bit better. 888 00:53:52,040 --> 00:53:55,560 Take care, stay safe, and happy breeding everyone.