Hi everybody and welcome back to Airway First, the podcast from the Children's Airway First
Foundation. I'm your host Rebecca Downing. In this episode, we'll continue to say goodbye
to 2022 and look forward to the year ahead by reflecting on some of the amazing guests we've
had on the program over the past year. In this part two episode of our hearing review, you'll
hear excerpts from episodes with some of the leaders in airway-centric dentistry. As with part one
in this series, I personally had a hard time pulling together and narrowing down the excerpts
we wanted to use from the episodes because each episode was full of so much amazing information.
I'll include links to every episode in the show notes so that if anything you hear resonates
with you, you can easily click on the link and listen to the full episode. So let's jump into
part two of our hearing review. The eight podcast excerpts you'll hear on today's episode are from
some of the global leaders in airway-centric dentistry. They'll touch on the benefits of and
advancements in airway-centric dentistry and sleep medicine. You'll hear from Dr. David Macintosh,
Dr. Steve Carstensen, Dr. Magna Desani, Registered Dental High Genestine Coach Chris Duvall,
Dr. Michael Gell, Dr. Felix Liao, and Dr. Ben Moraleo. We'll close the segment with an excerpt
from our very first podcast ever with Kauff's very own Candy and Brad Sparks.
So part of the complexity is actually just addressing the fact that people are just so unaware
of the importance of proper breathing in the first place. And then the next step is particularly with
sleep, is making parents in particular aware of the fact that snoring is not normal and that
even noisy heavy breathing is not normal. So part of the challenge is actually just making people
aware that there's a problem and that it's not normal. Yeah, absolutely. And it's got a criticism
of parents. It's not like there's an instruction book. If this red light is on, then please go
see ENT because breathing is a problem. So this is again, as you sort of alluded to is the education,
but as we'll go ahead and obviously dig into the weeds as we discuss things, we've got to have a
perspective here. So when we talk about snoring, mouth breathing, and then there's this thing
called sleep apnea, if we're talking about it specifically in the pediatric population,
we're talking about something that's affecting probably 20 to 25% of children
in their developmental years. If you do the simple math on that, that makes this the most
common chronic health condition of childhood. This is far more common than asthma, far more
common than diabetes. I'll guarantee you most parents have heard those two words and have some
sense of what those words mean. If I was to mention the overarching description of this condition,
which is sleep disorder breathing, I'll guarantee you that just get a blank stare for most parents
and go sleep disorder, breathing, what's that? And then if at a push, we might hit a mark on
something called sleep apnea and they might go, oh yeah, I know about that. But that's the worst
end of the spectrum of a condition that basically is founded on things that progress over time.
We've all normalized this to some degree. We have this term called the terrible twos,
for example. That's a term that society uses to write off behavioral issues in young kids.
That's one of the manifestations of sleep disorder breathing. We've normalized things and
snoring is a perfect example. There's plenty of movies that you can watch where they have kids
snoring and it's all just representative of the fact that that's part of what you expect to see
when the child is asleep or expect to hear more particularly when the child is asleep.
Right. And again, no second thought is given to it. But when you know what I know and you see
that in the movie, then you just face palm and just go, here's another time where as a society,
we've demonstrated our ignorance and our acceptance of a condition that has such a
deleterious effect on the development of children. It really does. Absolutely. And doing so, we have
created or manifested this pandemic, this huge issue that is global. That is 400 million children
right now and these children are becoming adults. And so now we're impacting the medical systems
across the board with a variety of chronic diseases, which we'll discuss that could have been prevented.
Yeah. And that's what I posted way early on back when this this year of,
I don't even like using the term COVID anymore. It's something we've all got a bit
fatigued with it. Right. But you know, I posted something said, imagine if there was an infection
that spread throughout children and it affected 20 to 25 percent of children and it caused brain
damage. Imagine there was an infection that did that. How proactive and urgent would we act to
address that problem? That's what sleep disorder breathing is. As adults, what we've heard, right?
We've all heard what's not sleeping can do to you and all the health impacts. But we really haven't,
until recently, talked about breathing and sleep and the way they correlate with children
and their health as they're growing. But then that's what's going to manifest and cause
all these health implications as they get older. So when we're talking about kids and we're talking
about let's just start with sleep specifically. Why is that so important for kids?
Well, you know what? You know the really interesting part about that, Rebecca? They don't
really know. We don't know why. We don't know the function of sleep in great detail. There's been
big volumes written. One of the best is by Matthew Walker. Why are we sleeping? Yes.
But even that's about adults. So the key about kids is so difficult to test. Sleep medicine came
around because of adult problems. Adults having troubles in hospitals. Adults being observed by
physicians. So the rules are written for measuring adults. The tools were developed to measure adults.
And somewhere along the way, of course, pediatricians and physicians said, look,
there's little kids out there that don't seem to be sleeping well either. And there's these behavioral
troubles. And in my practice, like for example, you know, I have 55-year-olds in my practice that
have chronic disease. Chronic inflammatory related diseases like cardiovascular disease and diabetes.
Where did that come from? It came from decades of struggling to breathe at night time. So if I
were 55-year-old in my practice, at one point they were 5.5-year-old. Right. And so could there be a
been a root cause of some of these adult problems in children? Well, it makes logical sense. But then
you kind of trying to go to medicine and science and think, how are we going to figure this out?
Right. And the only good way to figure it, the only, oh, not good, the only incontrovertible way of
doing this is to gather up a bunch of 5.5-year-olds. Get a figure, figure out whether they breathe
badly at night time. Put half of them into some kind of treatment to fix that. And leave the other
half untreated. And then wait until they're 55 and see what happens. Well, there's many things wrong
with that. You'll never be able to do that study because once you diagnose a child, especially with
a disease, they don't have the, they can't be the 55-year-old says, I'm not going to treat this.
They, you know, you can't ethically withhold treatment from them. So you can't do randomized
control trials. All we can do is we can look at populations of kids who were treated and
populations of kids whose families decided that treatment wasn't going to be possible for them
for whatever reason that is. And then look and see. So that makes matching populations a little
difficult. Some of it's been done. Karen Bonac has done a big study in a town in England that's now
about 20 years old. So we have some pretty good data about what goes on. But what we don't have
to rely upon is the fact that we can consider a child who doesn't breathe well to be less
healthy than a child who does breathe well. That makes sense. We don't need science to tell us
more than that. So let's figure out why they don't breathe well. And if they don't breathe well from
bad habits, like for some reason they just developed a mouth breathing habit, maybe we can fix that.
As a dentist and as well as I'm sure it's not just you at this point, it's you and your staff.
What signs are y'all looking for when they come in? Specifically children?
Yeah, yeah, for sure. There's so much. You know, when we have an adult with sleep issues,
I like to say I can fit them inside a box. Adults present with very specific signs and symptoms.
And you take those boxes, you know, for the snoring, the daytime sleepiness, the getting
up to use the bathroom multiple times a night, choking and gasping in your sleep. I can fit
typically you into a box. But as a child, I could have seven children with nine different symptoms
and they could all be positive for sleep disorder breathing, which is why it's so important, you
know, parents play a big role in our team here, because there's so much that they can observe at
home that we don't see the child asleep in our offices. And this is where the parents come in.
So what can you know, what do we look for? And what can parents look for?
Mouth breathing is a big one. Typically when you know, and my team is trained to do the same,
I walk into an laboratory and I immediately focus on the parent. In the reason I want to do that is
in our office, we have TVs on the ceiling. So the child is typically laying back and they're
watching TV or now, you know, today's day and age, even if you don't, they're what are they doing?
Typically they're on their phone. Right. What I want to see is because anytime you walk in and you
you're talking to somebody, we automatically come to attention. Don't we we sit upright, we adjust
our posture, all of that, right? That's not their normal resting posture. Normal resting posture,
remember, should be lips together, breathing through the nose, and the tongue resting in the
roof of the mouth passively. Well, when I walk in and introduce myself to the parent and completely
ignore the child, the child goes back to what it is that they're doing, which is, I don't know, watching
Dora on TV. And I catch this child either sitting with their mouth open, breathing through their
mouth, or whatever that posture looks like. And I can immediately focus that attention
to the parent and go, is this how she is or he is at home as well? And I'll get one of two responses,
right? I was like, Oh my gosh, yes, I have to remind him, her to close the mouth during, I don't
know, reading, playing puzzles, whatever it is that they're doing watching TV. And that's the
connection boom, we start right there. Or the parents gonna say, you know what, I haven't really
noticed. And for me, then it is, let's be attention. When you go home, now the parent is
dioden into what is it that I need to look for. So that is key number one. As a dentist, I will
look for my team will look for other telltale clues that tell us that something is going on
that's impacting their area. And typically, it will be growth and development, right? We look for
if this is a child that either has permanent teeth or has permanent teeth coming in, is there any
crowding? Crowding tells me there's just not enough room. There's a discrepancy between the size of
the jaw and the size of the teeth. Or a lot of times when those permanent teeth come in behind
the baby teeth, right? Shark teeth, as we call them, right? They just aren't there isn't enough
space in the jaw for those teeth to be able to do what they do, the permanent teeth erupt,
try to push themselves out. And that's what causes the baby teeth to get loose and fall out.
Well, guess something is not working the way it needs to and which is why these teeth are in all
different kinds of positions. So is there enough room for those permanent teeth to come in? Yeah,
there could be a discrepancy in the size of the teeth and the size of the jaw. You know, you got
dad's teeth and mom's jaw, smaller jaw, bigger teeth, sure. But at the end of the day, we still need
this space. Because I think when you're in relationship with your patients, you can discuss
anything. And that's how I felt and have felt is that I'm overlooking a pool of patients.
And when I see them doing things with their lifestyle or habits that I become aware of,
I had the opportunity to talk to them and tell them about what we now know and how that can impact
their dental health, their overall total body health, and how it impacts their longevity.
You know, and my goal has always been to help our patients have live a long and healthy health span,
not just a long lifespan. Yes, I love that. Yes, the amount of time that they're healthy during
their life and extend that. And so just that's my philosophy of care. I developed it. And
over time, I've shifted my mindset, my message, and my clinical habits to match the information,
the science-based evidence we know now, or the evidence-based science, excuse me,
that we now know. Right now, we have such a mismatch between our protocols,
our philosophy of care, how we're taking care of patients, what we're doing for them.
There's a mismatch between the science that we now know. What do you mean? Well, like,
many of us that are hygienists are still focusing on scraping and scaling tartar off a patient's teeth.
So my focus is helping my patients create a healthy biofilm because I have learned that
when you create a healthy biofilm, the localized diseases and problems of the mouth
go away. And also, the oral systemic impact of the biofilm creates a huge impact on the total
overall body health of the patients. Wow. And so you mentioned the CBT. So for people that don't
understand or have never, it's still kind of a new phrase. You know what? It's still really new.
So when I say CBT, I'm talking about basically a three-dimensional scan, the dentist take. It's
about 1⁄40 to 1⁄50th the amount of radiation. We get the results within five minutes for almost
immediately we get the results. We send everything out to radiologists, but it's just the most beautiful
images of not only the TM joints and of the face, but of the airway, the teeth, infections,
you know, what we can talk about oral systemic later. But because we're taking cuts through the
bone, we can often find infections that regular two-dimensional x-rays would never ever see.
So you go to a dentist, they say you don't have a problem, but we're able to cut the
tooth in sections like the $10 million machines do. We can do the same thing for a frack and other
price. It should be the standard of care in every office. It will become the standard of care
because if we want dentistry to move towards children's health, if we want dentistry to
move towards health and wellness, and of course all the healthcare specialties are supposed
to be about health and wellness. So we're not supposed to be repairmen. We're not supposed
to be fixing teeth. What dentistry is really about is supposed to be furthering and enhancing
our wellness. And this kind of leads me into something that I heard you say actually recently
in a YouTube video that Airway trumps everything else in dentistry, which to me,
you know, with somebody with a dental background, that's a pretty big statement to make. I mean,
well, why? You know, it's for people like me, it's, you know, it's fairly obvious, but
when we say that Airway trumps everything, so you can go two weeks
without eating. You can go maybe four or five days without drinking water.
You can go maybe four minutes without breathing, without oxygen, without air. And so
I believe the reason we have teeth, the teeth is the scaffolding that supports the Airway.
And because the dental profession, because we treat the upper and lower jaws and because the tongue
and the soft palate are attached to the jaws, basically 50% of the Airway are things that the
dentist encounters and works with every second of the day, every patient. And then the nose,
the other 25% of the Airway, which is the nose, is controlled by the upper jaw. So
the top of the upper jaw is the bottom of the nose. It's the same bone. But the reason that it
trumps everything is that when you breathe and you sleep, the way that you breathe at night
determines systemic inflammation, which is basically aging. It's aging, it's heart disease,
it's Alzheimer's. And in addition to systemic inflammation, when you get hypoxia and sleep
fragmentation, you get oxidative stress, you start rusting, endothelial dysfunction, which
means your blood vessels, blood vessels don't dilate the way they're supposed to. In addition
to that, your sympathetic nervous system, your fight or flight nervous system gets
up-regulated. You get increased sympathetic activation, which leads to high blood pressure,
which leads to more cortisol, which has very negative effects on your liver. And so if you
really look, you just think about it, that when you manage the Airway, now that I manage the Airway,
I'm able to get rid of people's anxiety. Because look, the patient's being choked,
the patient, the patient's being choked 100, 200 times a night. I'm not going to tell you what
time someone's going to come in and choke you, or they're going to pinch you in the nose. You're
going to get panic attacks, anxiety, depression. And by the way, that type of depression is drug
resistant very often. Really? Yeah. So those people out there, where they try all these different
antidepressants and they don't work, when you open the Airway, all of a sudden, either you
don't need the antidepressants or the antidepressants you were taking start to work. So if you look at
drug, high blood pressure, same thing, arrhythmia. But there's about an 85% correlation for people
that don't breathe well at night that have sleep apnea. 85% of people with cardiac arrhythmias have
sleep apnea. And if you want to lose weight, I mean, that's why they say if you want to treat
Airway and sleep, it's a lever. James Nestor says it gives you leverage or a lever to treat things
that you are never able to treat. So if you're trying to get rid of those. So my first message is from
no less than the highest medical officer in our U.S. Surgeon General way back in the year 2000 said
oral health is more than healthy tea. All right. So it's time to widen our view finders from
toothpaste commercials and, you know, water picks and brushing and flossing to expand it to
whole body health by mouth. If you think about it, that's how we all grow from the mouth from the
moment we're born, take that first breath. Okay. We breathe first, then we cry, then we get fed.
And what happens after babies are fed? They go to sleep, sleep, repeat the cycle, less the spanking
and not grow. Right. Yeah, right. We grow from the mouth. And I'm found the saying that the roots,
that the mouth is to humans what roots are to plants. Okay. So how the mouth operates is crucial to
whether or not this child or this human being thrives or wills and suffers. Okay. So my message
to all your parents out there now with this new book is that your child's best face is now within
within your power to actualize. All right. You're no longer sitting duck with orthodontist bills.
We know that's coming in 14 years just like you know college tuition is coming. Right. Right.
You know, you can actually grow kids now predictably. Okay. So they're healthy, vibrant, and
just a ton of fun to be with. I practice as an airway mouth doctor. That's what AMD stands for.
But this is how I practice. So you can see barely that the patient is smiling. There's no shots.
There's no drills. There's no pain. And there are only benefits because I work on this
like this here outside the patient's mouth. Okay. So my patients don't get any work done.
They don't get any work done inside the mouth. That's what an airway mouth doctor does. So the kid
won't be won't need to kick and scream as soon as they get there as if they were going to a dentist
office for a cavity failure or toothache. Okay. Yeah. This is an entirely new field within
dentistry. It's a new frontier, if you will. Okay. What I can tell you right now is that
this most important piece of research conclusion. This is out of Stanford. Yuxu Huang runs a
hospital with premature pediatric obstructive sleep apnea children. And
it's young Gary Minow is out of Stanford sleep center, the most premier research center on
pediatric obstructive sleep apnea in the world. And so the papers on the critical role of oral
facial growth and their conclusion is this pediatric obstructive sleep apnea, non obese
children is a disorder of oral facial growth. Failure to thrive here creates sleep apnea.
Okay. Pretty straightforward. Yeah. This is as as revolutionary as surgeon general statement that
I quoted earlier that a healthy mouse is more than healthy teeth, right? The mouth content is
way more than just teeth. Okay. Now we're talking about oral facial growth. Who's in charge of that?
Well, look at the number of cases that we have. The answer is so far nobody. And so there is a
serious need for what I call an airway mouth doctor who is trained to take charge of oral
facial growth. Airway dentistry for a lot of our listeners, parents especially, this is a newer
term. We're kind of hearing it, but still don't really understand what that means. So what all
does that encompass as far as what's the difference between an airway dentist and a regular dentist
and then what your practice might look like compared to traditional dentistry? Right, right.
Yes. Excellent. And so yeah, airway dentistry and those kind of terms are kind of newer. But
the idea is that if you think about dentistry, you think about teeth. And so, you know, dentistry
has a almost a tooth first philosophy, foundation and history. And that's fine. We do have to pay
attention to the teeth. The teeth are part of dentistry. However, there is a different way to
look at it. And so we're looking at things a little bit differently now because while we see the teeth
first, the teeth are held in by the jaws and we have this upper and lower jaw. So the upper and
lower jaw, it turns out that their development affects how well we can breathe through our nose.
So nose breathing isn't just automatic. It has to do with how well your jaws grew when you were
little. And the way we think about it now is, you know, maybe dentistry should have a little bit
of a paradigm shift to being growth and development first or foundation first teeth second. So in the
previous rendition of thinking about dentistry, you're thinking teeth first. But in what we're
trying to accomplish is dentistry, thinking about jaw growth and development first, foundation
first. So when the word airway dentistry kind of pops into play, what you're thinking about there
is well, if you hear airway dentistry or airway dentist or airway anything like that, now you
know, you're probably dealing with someone who's paying attention to the foundation first. And
when I say foundation, I mean jaws, the jaw structure first and the teeth second. So, you know,
just like you would build a house on a foundation, you don't try to build the house and then slide
the foundation under it. You want to put the foundation down and you have to have it mapped
out perfectly, then everything goes up beautifully from there. So we think about dentistry going
forward and we're thinking about airway dentistry, what it means to me and others as we're trying
to spread the word is that we're more focused on the foundation and its growth and development
so that you would have a better breather as well as really nice teeth where they belong. So the
good news is, if you guide the foundation to grow properly and you're focused on the airway, that's
the resulting benefit of foundation first philosophy. It turns out when your foundation
grows better and you have better jaw growth and development, your teeth go closer to where they
belong. So even though we say teeth are second, they're going to be in better shape when you
focus on the foundation first. Got it. And I saw something, I'll put a link in the show notes to
this, but I saw you explain this and I'd like to ask for you to just do that for the parents that
are listening now. The difference really between normal and abnormal when it comes to the foundation
and the growth. Sure. So the idea behind normal growth and development is it's something that we
don't see very often. So if we're thinking about normal childhood growth and development in the
jaw region, because we're talking about the head and neck for the jaws to grow, it used to be the
case that a child would grow up and have their jaw growth be perfectly happening along the way so
that all of their teeth would go to place and they would never need braces and they would have all
32 land, meaning the wisdom teeth would pop in when they were 18 to 20. So that used to be the
normal. Now that goes back several hundred years. Now today, the normal is that the jaw growth is
underdeveloped, the teeth are crowded with a bad bite. So teeth that aren't where they belong
and almost rare is it that a child could not need orthodontics to fix their teeth and very rare that
they can fit their wisdom teeth. So we think about what we consider today normal childhood growth
and development to have all of your teeth go to place, avoid having braces and get your wisdom
teeth to come in. That's still considered normal growth and development, but it doesn't happen
very often. In other words, that kind of child who grows perfectly, all the teeth go to place,
they never get braces and they get their wisdom teeth come in. I call that a unicorn today.
That we only see, we see that child one in several hundred. So I see a lot of children,
several hundred children a year. We only meet one child out of several hundred who will on their own
grow all the way up to have their wisdom teeth come in and not have any braces. So that's really
still normal growth and development, but it's not common. So we start thinking about normal versus
common. Now today it is common that children have underdeveloped jaws, crowded and or bad bites,
so crowded teeth and bad bites, common to need braces and common to have their wisdom teeth out,
meaning the maximum you would have is 28 teeth. And if you have four teeth taken out during braces
and your wisdom teeth out, you might only have 24 teeth. So the idea is while all of that is very
common, that doesn't make it normal. So common and normal are two different things.
So we're getting more of that kind of retracted, retreated jaw. Like when you turn sideways,
you can actually see it slanting in the profile. Yes, you know, that's exactly right. The profile
is a telltale kind of view of the face, its growth and what it means. And so when we have
normal growth and development, we're usually getting wide and forward, really nice wide and
forward growth. That's how the jaws should grow, wide and forward. And when the jaws grow wide
and forward, and we breathe in our nose, that air gets, it goes up and down. It's like an upside
down letter J, the airway kind of thing. So the air goes in our nostril, and it goes around a little
curve and goes right back down behind the tongue into our lungs. So that space is bigger when the
jaws grow wider and forward. So jaw growth that's wider and forward is excellent for us.
And it delivers a profile that I like to describe when we look at someone's profile, their lips are
well ahead of their eyes. If we look at a profile and we see today, it's more common that the lips
and the eyes are almost in the same plane. But that profile is labeled as a straight or flat
profile. And it's interesting that wording because a straight or flat profile when the eyes down to
the lips are in the same plane, those are the words that we find in the sleep disorder breathing
and obstructive sleep apnea literature that show you're at risk for bad breathing and sleeping
when you have a straight or flat profile. About a year ago, I found out that everything that happened
to our daughter, she's almost 20 years old now, could have been abated or treated and treated
when she was very young. So in talking parent to parent, I would just like to ask everybody
listening today, what if somebody told you that your child could be born with a condition or an
anomaly that's structural in their airway that would cause them to have hypoxic brain injuries,
innumerable comorbidities, including cancer, heart disease, autonomic disorders, you name it.
And with lower than IQ, by at least 10 points, would you not rush to your local pediatrician and
your possibly your local dentist and maybe just really know what to do? Right. Well, we had no idea
that our daughter had this issue. But it was present at birth and could be seen by a trained
eye. In fact, when she was 18 months old, I went to my cosmetic dentist and he took one look at
her and she's adorable. Look at her on her website. I mean, she's this gorgeous child. And he said,
you know what, she's going to need some work. And I'm thinking, huh, she's first of all, she's the
smartest kid ever born. We all think that about her kids, don't we? Right. And she's just cute as
what? What is he talking about? And he said, you're going to need to go see a doctor hang,
Dr. Bill hang in California when she's between six and nine. So we thought, well, she's 18 months
now. At that time, it's, it's all good. But what I've learned in the last year is that, that trained
I could have recognized it at birth. And what would they have been seeing? Number one, that she
was breathing through her mouth predominantly. And number two, if they had checked inside her
mouth, they would have noticed that she had a very high upper palate. And that palate was actually
impeding her nasal air airway so that she wasn't able to breathe through her nose because that
palate was up too high. And we also would have been told, Oh, and by the way, her chin is back a
little too far and the tongue is attached to that. And that tongue is falling back into her oral
pharynx, her oral airway. So even breathing through her mouth had a loss of oxygen that she
was trying to get. So all of that was possible to stand for. And one thing that we're fighting for
now with the Children's Airway first foundation is the opportunity for every child to have a complete
airway exam within the first 24 to 48 hours after birth. Because think about it, at least 20% of kids
are born with some type of airway issue. That's huge. That's astounding. That's huge. And you
can't even imagine that there are 11 million children under the age of 10 in the United States.
And usually it starts at birth. But let me tell you, if it isn't present right then and there at
birth, here's how it could show up for your child. Imagine if you bring your child home and you have
no idea that there's some black mold in your house. And we're in Texas. So sometimes that happens
here in Texas, right? You might have a cockroach infestation, you know, under your peer and being
that you don't even know about. But there are toxins in your home, or maybe you open the window
and there's a factory nearby. And that toxic chemical is blowing into your home. And maybe
within hours or days, your newborn child is breathing through his or her mouth. And when you
breathe through your mouth, instead of your nose, your jaws and your airway are going to
become compromised. They will develop differently. Who knew? I certainly found out it was mouth
breathing from the start. I thought, yeah, maybe she just does that because I'm nursing her and she's
kind of saying, hey, again, please. So we're finding that children have this mouth breathing going on
and we check them and we could see a high dent of arch, maybe a retreated chin so that tongue is
falling back into their oral pharynx. And other issues that you might look for is typically they
may have sort of an accentuated bow upper lip, you know, that cute little bow lip. And maybe the lower
lip is rolling forward. And those are also characteristics. With that, I kind of want to
segue and to Brad to talk about, you know, again, I come to this a little different. I didn't have
the journey with Savi. I know Savi now and I love her and I feel her journey, but I wasn't there.
But as a parent, you know, I think, oh, I've got insurance and I can do this for my kid and I can
do this for my kid and I'm doing such a great job. And come to find out, you know, even that's not
necessarily true because of the way it's structured. And, you know, Brad, I'd like to open it up to you
to speak a little bit more, you know, parent to parent on that. Well, you know, parent to parent,
it's very interesting. Candy, she alluded to the time when we actually were introduced to the
orthodontist who put the retracted braces on and of course, went through the story about
that I can give you a good smile. You know, Savi will need surgery when she's 17, which we've never
heard before. So we're kind of ready. And so, and I've worked for some pretty decent companies who've
got very good insurance plans. And so orthodontics and dental insurance was one of them. So,
what I wanted to do, you know, parent to parent, talk about what we would wish we could have asked
the orthodontist when we first signed, he was talking about this smile and, you know, the surgery
in the future. But we never ever mentioned our way, not once. So when you think about that,
we didn't know. And we just assumed that that was not an issue. Just assumed it. And that was a
probably a very, very critical mistake that we made. And now, if we were to start over and have
that same conversation, the first thing we would have been asking, well, what will this do to her
airway? And, which is at this point in time, if that person, if the doctor would have come back
and said, oh, she'll be fine, no big deal. Then asking, well, what proof do you have of that?
Let's feel a little more specific about that. And then get into the, you know, what really happens
to it. And our feeling was that then we would go refer her, Sally, to an airway, this is an airway
orthodontist, somebody who's actually claiming that they know something about this. And now,
back at that point in time, they're really working to my knowledge. I mean, you had Bill Hang,
you know, and Kevin was learning at that time, and Ben Merleau and some other people around who
are really good at this now and experts. And one of the things we wanted to do with the website is
to have a referral where we can, when we ask the group to see, you know, we're going to get to
that point. We're not there yet, but we want to get to their. Well, that concludes our year in
review. And what a great year 2022 was for the Children's Airway First Foundation and our Airway
First podcast. If you're new to our podcast, please don't forget to subscribe. And if you
enjoyed today's episode, please leave us a review or comment telling us about what you enjoyed most.
You can stay connected with the Children's Airway First Foundation by following us on Instagram,
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Parents Support Group, the Airway Heddle, at facebook.com, backslash, groups, backslash,
Airway Heddle. And if you haven't already, check out our YouTube channel. You can find a variety
of informative original video content pieces, as well as video recordings and excerpts from select
Airway First podcast episodes. If you'd like to be a guest or have an idea for an upcoming episode,
shoot us a note via the contacts page on our website or send us an email directly at infoatchildrensairwayfirst.org.
And finally, thanks to all the parents and the medical professionals that joined us on the
podcast in 2022. We appreciate all the information and knowledge that you shared.
On behalf of everybody at Children's Airway First Foundation, happy new year. Take care,
stay safe, and happy breathing, everyone.