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Hi everybody and welcome back to Airway First, the podcast from the Children's Airway First

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Foundation. I'm your host Rebecca Downing. In this episode, we'll continue to say goodbye

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to 2022 and look forward to the year ahead by reflecting on some of the amazing guests we've

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had on the program over the past year. In this part two episode of our hearing review, you'll

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hear excerpts from episodes with some of the leaders in airway-centric dentistry. As with part one

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in this series, I personally had a hard time pulling together and narrowing down the excerpts

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we wanted to use from the episodes because each episode was full of so much amazing information.

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I'll include links to every episode in the show notes so that if anything you hear resonates

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with you, you can easily click on the link and listen to the full episode. So let's jump into

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part two of our hearing review. The eight podcast excerpts you'll hear on today's episode are from

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some of the global leaders in airway-centric dentistry. They'll touch on the benefits of and

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advancements in airway-centric dentistry and sleep medicine. You'll hear from Dr. David Macintosh,

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Dr. Steve Carstensen, Dr. Magna Desani, Registered Dental High Genestine Coach Chris Duvall,

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Dr. Michael Gell, Dr. Felix Liao, and Dr. Ben Moraleo. We'll close the segment with an excerpt

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from our very first podcast ever with Kauff's very own Candy and Brad Sparks.

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So part of the complexity is actually just addressing the fact that people are just so unaware

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of the importance of proper breathing in the first place. And then the next step is particularly with

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sleep, is making parents in particular aware of the fact that snoring is not normal and that

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even noisy heavy breathing is not normal. So part of the challenge is actually just making people

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aware that there's a problem and that it's not normal. Yeah, absolutely. And it's got a criticism

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of parents. It's not like there's an instruction book. If this red light is on, then please go

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see ENT because breathing is a problem. So this is again, as you sort of alluded to is the education,

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but as we'll go ahead and obviously dig into the weeds as we discuss things, we've got to have a

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perspective here. So when we talk about snoring, mouth breathing, and then there's this thing

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called sleep apnea, if we're talking about it specifically in the pediatric population,

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we're talking about something that's affecting probably 20 to 25% of children

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in their developmental years. If you do the simple math on that, that makes this the most

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common chronic health condition of childhood. This is far more common than asthma, far more

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common than diabetes. I'll guarantee you most parents have heard those two words and have some

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sense of what those words mean. If I was to mention the overarching description of this condition,

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which is sleep disorder breathing, I'll guarantee you that just get a blank stare for most parents

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and go sleep disorder, breathing, what's that? And then if at a push, we might hit a mark on

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something called sleep apnea and they might go, oh yeah, I know about that. But that's the worst

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end of the spectrum of a condition that basically is founded on things that progress over time.

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We've all normalized this to some degree. We have this term called the terrible twos,

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for example. That's a term that society uses to write off behavioral issues in young kids.

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That's one of the manifestations of sleep disorder breathing. We've normalized things and

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snoring is a perfect example. There's plenty of movies that you can watch where they have kids

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snoring and it's all just representative of the fact that that's part of what you expect to see

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when the child is asleep or expect to hear more particularly when the child is asleep.

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Right. And again, no second thought is given to it. But when you know what I know and you see

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that in the movie, then you just face palm and just go, here's another time where as a society,

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we've demonstrated our ignorance and our acceptance of a condition that has such a

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deleterious effect on the development of children. It really does. Absolutely. And doing so, we have

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created or manifested this pandemic, this huge issue that is global. That is 400 million children

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right now and these children are becoming adults. And so now we're impacting the medical systems

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across the board with a variety of chronic diseases, which we'll discuss that could have been prevented.

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Yeah. And that's what I posted way early on back when this this year of,

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I don't even like using the term COVID anymore. It's something we've all got a bit

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fatigued with it. Right. But you know, I posted something said, imagine if there was an infection

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that spread throughout children and it affected 20 to 25 percent of children and it caused brain

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damage. Imagine there was an infection that did that. How proactive and urgent would we act to

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address that problem? That's what sleep disorder breathing is. As adults, what we've heard, right?

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We've all heard what's not sleeping can do to you and all the health impacts. But we really haven't,

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until recently, talked about breathing and sleep and the way they correlate with children

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and their health as they're growing. But then that's what's going to manifest and cause

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all these health implications as they get older. So when we're talking about kids and we're talking

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about let's just start with sleep specifically. Why is that so important for kids?

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Well, you know what? You know the really interesting part about that, Rebecca? They don't

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really know. We don't know why. We don't know the function of sleep in great detail. There's been

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big volumes written. One of the best is by Matthew Walker. Why are we sleeping? Yes.

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But even that's about adults. So the key about kids is so difficult to test. Sleep medicine came

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around because of adult problems. Adults having troubles in hospitals. Adults being observed by

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physicians. So the rules are written for measuring adults. The tools were developed to measure adults.

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And somewhere along the way, of course, pediatricians and physicians said, look,

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there's little kids out there that don't seem to be sleeping well either. And there's these behavioral

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troubles. And in my practice, like for example, you know, I have 55-year-olds in my practice that

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have chronic disease. Chronic inflammatory related diseases like cardiovascular disease and diabetes.

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Where did that come from? It came from decades of struggling to breathe at night time. So if I

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were 55-year-old in my practice, at one point they were 5.5-year-old. Right. And so could there be a

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been a root cause of some of these adult problems in children? Well, it makes logical sense. But then

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you kind of trying to go to medicine and science and think, how are we going to figure this out?

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Right. And the only good way to figure it, the only, oh, not good, the only incontrovertible way of

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doing this is to gather up a bunch of 5.5-year-olds. Get a figure, figure out whether they breathe

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badly at night time. Put half of them into some kind of treatment to fix that. And leave the other

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half untreated. And then wait until they're 55 and see what happens. Well, there's many things wrong

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with that. You'll never be able to do that study because once you diagnose a child, especially with

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a disease, they don't have the, they can't be the 55-year-old says, I'm not going to treat this.

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They, you know, you can't ethically withhold treatment from them. So you can't do randomized

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control trials. All we can do is we can look at populations of kids who were treated and

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populations of kids whose families decided that treatment wasn't going to be possible for them

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for whatever reason that is. And then look and see. So that makes matching populations a little

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difficult. Some of it's been done. Karen Bonac has done a big study in a town in England that's now

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about 20 years old. So we have some pretty good data about what goes on. But what we don't have

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to rely upon is the fact that we can consider a child who doesn't breathe well to be less

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healthy than a child who does breathe well. That makes sense. We don't need science to tell us

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more than that. So let's figure out why they don't breathe well. And if they don't breathe well from

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bad habits, like for some reason they just developed a mouth breathing habit, maybe we can fix that.

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As a dentist and as well as I'm sure it's not just you at this point, it's you and your staff.

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What signs are y'all looking for when they come in? Specifically children?

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Yeah, yeah, for sure. There's so much. You know, when we have an adult with sleep issues,

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I like to say I can fit them inside a box. Adults present with very specific signs and symptoms.

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And you take those boxes, you know, for the snoring, the daytime sleepiness, the getting

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up to use the bathroom multiple times a night, choking and gasping in your sleep. I can fit

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typically you into a box. But as a child, I could have seven children with nine different symptoms

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and they could all be positive for sleep disorder breathing, which is why it's so important, you

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know, parents play a big role in our team here, because there's so much that they can observe at

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home that we don't see the child asleep in our offices. And this is where the parents come in.

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So what can you know, what do we look for? And what can parents look for?

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Mouth breathing is a big one. Typically when you know, and my team is trained to do the same,

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I walk into an laboratory and I immediately focus on the parent. In the reason I want to do that is

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in our office, we have TVs on the ceiling. So the child is typically laying back and they're

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watching TV or now, you know, today's day and age, even if you don't, they're what are they doing?

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Typically they're on their phone. Right. What I want to see is because anytime you walk in and you

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you're talking to somebody, we automatically come to attention. Don't we we sit upright, we adjust

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our posture, all of that, right? That's not their normal resting posture. Normal resting posture,

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remember, should be lips together, breathing through the nose, and the tongue resting in the

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roof of the mouth passively. Well, when I walk in and introduce myself to the parent and completely

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ignore the child, the child goes back to what it is that they're doing, which is, I don't know, watching

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Dora on TV. And I catch this child either sitting with their mouth open, breathing through their

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mouth, or whatever that posture looks like. And I can immediately focus that attention

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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,

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right? I was like, Oh my gosh, yes, I have to remind him, her to close the mouth during, I don't

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know, reading, playing puzzles, whatever it is that they're doing watching TV. And that's the

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connection boom, we start right there. Or the parents gonna say, you know what, I haven't really

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noticed. And for me, then it is, let's be attention. When you go home, now the parent is

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dioden into what is it that I need to look for. So that is key number one. As a dentist, I will

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look for my team will look for other telltale clues that tell us that something is going on

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that's impacting their area. And typically, it will be growth and development, right? We look for

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if this is a child that either has permanent teeth or has permanent teeth coming in, is there any

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crowding? Crowding tells me there's just not enough room. There's a discrepancy between the size of

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the jaw and the size of the teeth. Or a lot of times when those permanent teeth come in behind

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the baby teeth, right? Shark teeth, as we call them, right? They just aren't there isn't enough

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space in the jaw for those teeth to be able to do what they do, the permanent teeth erupt,

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try to push themselves out. And that's what causes the baby teeth to get loose and fall out.

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Well, guess something is not working the way it needs to and which is why these teeth are in all

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different kinds of positions. So is there enough room for those permanent teeth to come in? Yeah,

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there could be a discrepancy in the size of the teeth and the size of the jaw. You know, you got

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dad's teeth and mom's jaw, smaller jaw, bigger teeth, sure. But at the end of the day, we still need

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this space. Because I think when you're in relationship with your patients, you can discuss

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anything. And that's how I felt and have felt is that I'm overlooking a pool of patients.

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And when I see them doing things with their lifestyle or habits that I become aware of,

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I had the opportunity to talk to them and tell them about what we now know and how that can impact

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their dental health, their overall total body health, and how it impacts their longevity.

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You know, and my goal has always been to help our patients have live a long and healthy health span,

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not just a long lifespan. Yes, I love that. Yes, the amount of time that they're healthy during

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their life and extend that. And so just that's my philosophy of care. I developed it. And

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over time, I've shifted my mindset, my message, and my clinical habits to match the information,

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the science-based evidence we know now, or the evidence-based science, excuse me,

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that we now know. Right now, we have such a mismatch between our protocols,

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our philosophy of care, how we're taking care of patients, what we're doing for them.

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There's a mismatch between the science that we now know. What do you mean? Well, like,

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many of us that are hygienists are still focusing on scraping and scaling tartar off a patient's teeth.

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So my focus is helping my patients create a healthy biofilm because I have learned that

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when you create a healthy biofilm, the localized diseases and problems of the mouth

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go away. And also, the oral systemic impact of the biofilm creates a huge impact on the total

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overall body health of the patients. Wow. And so you mentioned the CBT. So for people that don't

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understand or have never, it's still kind of a new phrase. You know what? It's still really new.

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So when I say CBT, I'm talking about basically a three-dimensional scan, the dentist take. It's

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about 1⁄40 to 1⁄50th the amount of radiation. We get the results within five minutes for almost

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immediately we get the results. We send everything out to radiologists, but it's just the most beautiful

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images of not only the TM joints and of the face, but of the airway, the teeth, infections,

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you know, what we can talk about oral systemic later. But because we're taking cuts through the

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bone, we can often find infections that regular two-dimensional x-rays would never ever see.

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So you go to a dentist, they say you don't have a problem, but we're able to cut the

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tooth in sections like the $10 million machines do. We can do the same thing for a frack and other

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price. It should be the standard of care in every office. It will become the standard of care

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because if we want dentistry to move towards children's health, if we want dentistry to

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move towards health and wellness, and of course all the healthcare specialties are supposed

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to be about health and wellness. So we're not supposed to be repairmen. We're not supposed

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to be fixing teeth. What dentistry is really about is supposed to be furthering and enhancing

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our wellness. And this kind of leads me into something that I heard you say actually recently

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in a YouTube video that Airway trumps everything else in dentistry, which to me,

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you know, with somebody with a dental background, that's a pretty big statement to make. I mean,

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well, why? You know, it's for people like me, it's, you know, it's fairly obvious, but

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when we say that Airway trumps everything, so you can go two weeks

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without eating. You can go maybe four or five days without drinking water.

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You can go maybe four minutes without breathing, without oxygen, without air. And so

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I believe the reason we have teeth, the teeth is the scaffolding that supports the Airway.

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And because the dental profession, because we treat the upper and lower jaws and because the tongue

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and the soft palate are attached to the jaws, basically 50% of the Airway are things that the

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dentist encounters and works with every second of the day, every patient. And then the nose,

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the other 25% of the Airway, which is the nose, is controlled by the upper jaw. So

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the top of the upper jaw is the bottom of the nose. It's the same bone. But the reason that it

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trumps everything is that when you breathe and you sleep, the way that you breathe at night

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determines systemic inflammation, which is basically aging. It's aging, it's heart disease,

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it's Alzheimer's. And in addition to systemic inflammation, when you get hypoxia and sleep

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fragmentation, you get oxidative stress, you start rusting, endothelial dysfunction, which

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means your blood vessels, blood vessels don't dilate the way they're supposed to. In addition

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to that, your sympathetic nervous system, your fight or flight nervous system gets

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up-regulated. You get increased sympathetic activation, which leads to high blood pressure,

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which leads to more cortisol, which has very negative effects on your liver. And so if you

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really look, you just think about it, that when you manage the Airway, now that I manage the Airway,

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I'm able to get rid of people's anxiety. Because look, the patient's being choked,

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the patient, the patient's being choked 100, 200 times a night. I'm not going to tell you what

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time someone's going to come in and choke you, or they're going to pinch you in the nose. You're

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going to get panic attacks, anxiety, depression. And by the way, that type of depression is drug

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resistant very often. Really? Yeah. So those people out there, where they try all these different

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antidepressants and they don't work, when you open the Airway, all of a sudden, either you

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don't need the antidepressants or the antidepressants you were taking start to work. So if you look at

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drug, high blood pressure, same thing, arrhythmia. But there's about an 85% correlation for people

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that don't breathe well at night that have sleep apnea. 85% of people with cardiac arrhythmias have

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sleep apnea. And if you want to lose weight, I mean, that's why they say if you want to treat

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Airway and sleep, it's a lever. James Nestor says it gives you leverage or a lever to treat things

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that you are never able to treat. So if you're trying to get rid of those. So my first message is from

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no less than the highest medical officer in our U.S. Surgeon General way back in the year 2000 said

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oral health is more than healthy tea. All right. So it's time to widen our view finders from

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toothpaste commercials and, you know, water picks and brushing and flossing to expand it to

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whole body health by mouth. If you think about it, that's how we all grow from the mouth from the

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moment we're born, take that first breath. Okay. We breathe first, then we cry, then we get fed.

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And what happens after babies are fed? They go to sleep, sleep, repeat the cycle, less the spanking

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and not grow. Right. Yeah, right. We grow from the mouth. And I'm found the saying that the roots,

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that the mouth is to humans what roots are to plants. Okay. So how the mouth operates is crucial to

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whether or not this child or this human being thrives or wills and suffers. Okay. So my message

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to all your parents out there now with this new book is that your child's best face is now within

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within your power to actualize. All right. You're no longer sitting duck with orthodontist bills.

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We know that's coming in 14 years just like you know college tuition is coming. Right. Right.

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You know, you can actually grow kids now predictably. Okay. So they're healthy, vibrant, and

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just a ton of fun to be with. I practice as an airway mouth doctor. That's what AMD stands for.

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But this is how I practice. So you can see barely that the patient is smiling. There's no shots.

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There's no drills. There's no pain. And there are only benefits because I work on this

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like this here outside the patient's mouth. Okay. So my patients don't get any work done.

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They don't get any work done inside the mouth. That's what an airway mouth doctor does. So the kid

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won't be won't need to kick and scream as soon as they get there as if they were going to a dentist

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office for a cavity failure or toothache. Okay. Yeah. This is an entirely new field within

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dentistry. It's a new frontier, if you will. Okay. What I can tell you right now is that

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this most important piece of research conclusion. This is out of Stanford. Yuxu Huang runs a

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hospital with premature pediatric obstructive sleep apnea children. And

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it's young Gary Minow is out of Stanford sleep center, the most premier research center on

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pediatric obstructive sleep apnea in the world. And so the papers on the critical role of oral

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facial growth and their conclusion is this pediatric obstructive sleep apnea, non obese

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children is a disorder of oral facial growth. Failure to thrive here creates sleep apnea.

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Okay. Pretty straightforward. Yeah. This is as as revolutionary as surgeon general statement that

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I quoted earlier that a healthy mouse is more than healthy teeth, right? The mouth content is

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way more than just teeth. Okay. Now we're talking about oral facial growth. Who's in charge of that?

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Well, look at the number of cases that we have. The answer is so far nobody. And so there is a

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serious need for what I call an airway mouth doctor who is trained to take charge of oral

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facial growth. Airway dentistry for a lot of our listeners, parents especially, this is a newer

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term. We're kind of hearing it, but still don't really understand what that means. So what all

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does that encompass as far as what's the difference between an airway dentist and a regular dentist

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and then what your practice might look like compared to traditional dentistry? Right, right.

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Yes. Excellent. And so yeah, airway dentistry and those kind of terms are kind of newer. But

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the idea is that if you think about dentistry, you think about teeth. And so, you know, dentistry

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has a almost a tooth first philosophy, foundation and history. And that's fine. We do have to pay

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attention to the teeth. The teeth are part of dentistry. However, there is a different way to

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look at it. And so we're looking at things a little bit differently now because while we see the teeth

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first, the teeth are held in by the jaws and we have this upper and lower jaw. So the upper and

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lower jaw, it turns out that their development affects how well we can breathe through our nose.

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So nose breathing isn't just automatic. It has to do with how well your jaws grew when you were

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little. And the way we think about it now is, you know, maybe dentistry should have a little bit

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of a paradigm shift to being growth and development first or foundation first teeth second. So in the

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previous rendition of thinking about dentistry, you're thinking teeth first. But in what we're

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trying to accomplish is dentistry, thinking about jaw growth and development first, foundation

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first. So when the word airway dentistry kind of pops into play, what you're thinking about there

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is well, if you hear airway dentistry or airway dentist or airway anything like that, now you

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know, you're probably dealing with someone who's paying attention to the foundation first. And

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when I say foundation, I mean jaws, the jaw structure first and the teeth second. So, you know,

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just like you would build a house on a foundation, you don't try to build the house and then slide

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the foundation under it. You want to put the foundation down and you have to have it mapped

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out perfectly, then everything goes up beautifully from there. So we think about dentistry going

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forward and we're thinking about airway dentistry, what it means to me and others as we're trying

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to spread the word is that we're more focused on the foundation and its growth and development

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so that you would have a better breather as well as really nice teeth where they belong. So the

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good news is, if you guide the foundation to grow properly and you're focused on the airway, that's

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the resulting benefit of foundation first philosophy. It turns out when your foundation

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grows better and you have better jaw growth and development, your teeth go closer to where they

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belong. So even though we say teeth are second, they're going to be in better shape when you

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focus on the foundation first. Got it. And I saw something, I'll put a link in the show notes to

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this, but I saw you explain this and I'd like to ask for you to just do that for the parents that

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are listening now. The difference really between normal and abnormal when it comes to the foundation

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and the growth. Sure. So the idea behind normal growth and development is it's something that we

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don't see very often. So if we're thinking about normal childhood growth and development in the

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jaw region, because we're talking about the head and neck for the jaws to grow, it used to be the

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case that a child would grow up and have their jaw growth be perfectly happening along the way so

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that all of their teeth would go to place and they would never need braces and they would have all

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32 land, meaning the wisdom teeth would pop in when they were 18 to 20. So that used to be the

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normal. Now that goes back several hundred years. Now today, the normal is that the jaw growth is

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underdeveloped, the teeth are crowded with a bad bite. So teeth that aren't where they belong

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and almost rare is it that a child could not need orthodontics to fix their teeth and very rare that

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they can fit their wisdom teeth. So we think about what we consider today normal childhood growth

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and development to have all of your teeth go to place, avoid having braces and get your wisdom

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teeth to come in. That's still considered normal growth and development, but it doesn't happen

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very often. In other words, that kind of child who grows perfectly, all the teeth go to place,

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they never get braces and they get their wisdom teeth come in. I call that a unicorn today.

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That we only see, we see that child one in several hundred. So I see a lot of children,

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several hundred children a year. We only meet one child out of several hundred who will on their own

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grow all the way up to have their wisdom teeth come in and not have any braces. So that's really

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still normal growth and development, but it's not common. So we start thinking about normal versus

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common. Now today it is common that children have underdeveloped jaws, crowded and or bad bites,

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so crowded teeth and bad bites, common to need braces and common to have their wisdom teeth out,

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meaning the maximum you would have is 28 teeth. And if you have four teeth taken out during braces

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and your wisdom teeth out, you might only have 24 teeth. So the idea is while all of that is very

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common, that doesn't make it normal. So common and normal are two different things.

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So we're getting more of that kind of retracted, retreated jaw. Like when you turn sideways,

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you can actually see it slanting in the profile. Yes, you know, that's exactly right. The profile

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is a telltale kind of view of the face, its growth and what it means. And so when we have

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normal growth and development, we're usually getting wide and forward, really nice wide and

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forward growth. That's how the jaws should grow, wide and forward. And when the jaws grow wide

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and forward, and we breathe in our nose, that air gets, it goes up and down. It's like an upside

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down letter J, the airway kind of thing. So the air goes in our nostril, and it goes around a little

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curve and goes right back down behind the tongue into our lungs. So that space is bigger when the

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jaws grow wider and forward. So jaw growth that's wider and forward is excellent for us.

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And it delivers a profile that I like to describe when we look at someone's profile, their lips are

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well ahead of their eyes. If we look at a profile and we see today, it's more common that the lips

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and the eyes are almost in the same plane. But that profile is labeled as a straight or flat

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profile. And it's interesting that wording because a straight or flat profile when the eyes down to

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the lips are in the same plane, those are the words that we find in the sleep disorder breathing

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and obstructive sleep apnea literature that show you're at risk for bad breathing and sleeping

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when you have a straight or flat profile. About a year ago, I found out that everything that happened

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to our daughter, she's almost 20 years old now, could have been abated or treated and treated

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when she was very young. So in talking parent to parent, I would just like to ask everybody

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listening today, what if somebody told you that your child could be born with a condition or an

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anomaly that's structural in their airway that would cause them to have hypoxic brain injuries,

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innumerable comorbidities, including cancer, heart disease, autonomic disorders, you name it.

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And with lower than IQ, by at least 10 points, would you not rush to your local pediatrician and

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your possibly your local dentist and maybe just really know what to do? Right. Well, we had no idea

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that our daughter had this issue. But it was present at birth and could be seen by a trained

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eye. In fact, when she was 18 months old, I went to my cosmetic dentist and he took one look at

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her and she's adorable. Look at her on her website. I mean, she's this gorgeous child. And he said,

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you know what, she's going to need some work. And I'm thinking, huh, she's first of all, she's the

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smartest kid ever born. We all think that about her kids, don't we? Right. And she's just cute as

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what? What is he talking about? And he said, you're going to need to go see a doctor hang,

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Dr. Bill hang in California when she's between six and nine. So we thought, well, she's 18 months

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now. At that time, it's, it's all good. But what I've learned in the last year is that, that trained

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I could have recognized it at birth. And what would they have been seeing? Number one, that she

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was breathing through her mouth predominantly. And number two, if they had checked inside her

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mouth, they would have noticed that she had a very high upper palate. And that palate was actually

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impeding her nasal air airway so that she wasn't able to breathe through her nose because that

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palate was up too high. And we also would have been told, Oh, and by the way, her chin is back a

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little too far and the tongue is attached to that. And that tongue is falling back into her oral

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pharynx, her oral airway. So even breathing through her mouth had a loss of oxygen that she

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was trying to get. So all of that was possible to stand for. And one thing that we're fighting for

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now with the Children's Airway first foundation is the opportunity for every child to have a complete

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airway exam within the first 24 to 48 hours after birth. Because think about it, at least 20% of kids

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are born with some type of airway issue. That's huge. That's astounding. That's huge. And you

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can't even imagine that there are 11 million children under the age of 10 in the United States.

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And usually it starts at birth. But let me tell you, if it isn't present right then and there at

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birth, here's how it could show up for your child. Imagine if you bring your child home and you have

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no idea that there's some black mold in your house. And we're in Texas. So sometimes that happens

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here in Texas, right? You might have a cockroach infestation, you know, under your peer and being

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that you don't even know about. But there are toxins in your home, or maybe you open the window

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and there's a factory nearby. And that toxic chemical is blowing into your home. And maybe

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within hours or days, your newborn child is breathing through his or her mouth. And when you

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breathe through your mouth, instead of your nose, your jaws and your airway are going to

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become compromised. They will develop differently. Who knew? I certainly found out it was mouth

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breathing from the start. I thought, yeah, maybe she just does that because I'm nursing her and she's

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kind of saying, hey, again, please. So we're finding that children have this mouth breathing going on

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and we check them and we could see a high dent of arch, maybe a retreated chin so that tongue is

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falling back into their oral pharynx. And other issues that you might look for is typically they

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may have sort of an accentuated bow upper lip, you know, that cute little bow lip. And maybe the lower

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lip is rolling forward. And those are also characteristics. With that, I kind of want to

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segue and to Brad to talk about, you know, again, I come to this a little different. I didn't have

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the journey with Savi. I know Savi now and I love her and I feel her journey, but I wasn't there.

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But as a parent, you know, I think, oh, I've got insurance and I can do this for my kid and I can

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do this for my kid and I'm doing such a great job. And come to find out, you know, even that's not

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necessarily true because of the way it's structured. And, you know, Brad, I'd like to open it up to you

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to speak a little bit more, you know, parent to parent on that. Well, you know, parent to parent,

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it's very interesting. Candy, she alluded to the time when we actually were introduced to the

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orthodontist who put the retracted braces on and of course, went through the story about

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that I can give you a good smile. You know, Savi will need surgery when she's 17, which we've never

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heard before. So we're kind of ready. And so, and I've worked for some pretty decent companies who've

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got very good insurance plans. And so orthodontics and dental insurance was one of them. So,

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what I wanted to do, you know, parent to parent, talk about what we would wish we could have asked

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the orthodontist when we first signed, he was talking about this smile and, you know, the surgery

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in the future. But we never ever mentioned our way, not once. So when you think about that,

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we didn't know. And we just assumed that that was not an issue. Just assumed it. And that was a

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probably a very, very critical mistake that we made. And now, if we were to start over and have

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that same conversation, the first thing we would have been asking, well, what will this do to her

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airway? And, which is at this point in time, if that person, if the doctor would have come back

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and said, oh, she'll be fine, no big deal. Then asking, well, what proof do you have of that?

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Let's feel a little more specific about that. And then get into the, you know, what really happens

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to it. And our feeling was that then we would go refer her, Sally, to an airway, this is an airway

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orthodontist, somebody who's actually claiming that they know something about this. And now,

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back at that point in time, they're really working to my knowledge. I mean, you had Bill Hang,

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you know, and Kevin was learning at that time, and Ben Merleau and some other people around who

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are really good at this now and experts. And one of the things we wanted to do with the website is

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to have a referral where we can, when we ask the group to see, you know, we're going to get to

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that point. We're not there yet, but we want to get to their. Well, that concludes our year in

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review. And what a great year 2022 was for the Children's Airway First Foundation and our Airway

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First podcast. If you're new to our podcast, please don't forget to subscribe. And if you

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enjoyed today's episode, please leave us a review or comment telling us about what you enjoyed most.

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You can stay connected with the Children's Airway First Foundation by following us on Instagram,

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Facebook, Twitter, and LinkedIn. Parents, we also invite you to join us on our Facebook

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Parents Support Group, the Airway Heddle, at facebook.com, backslash, groups, backslash,

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Airway Heddle. And if you haven't already, check out our YouTube channel. You can find a variety

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of informative original video content pieces, as well as video recordings and excerpts from select

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Airway First podcast episodes. If you'd like to be a guest or have an idea for an upcoming episode,

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shoot us a note via the contacts page on our website or send us an email directly at infoatchildrensairwayfirst.org.

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And finally, thanks to all the parents and the medical professionals that joined us on the

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podcast in 2022. We appreciate all the information and knowledge that you shared.

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On behalf of everybody at Children's Airway First Foundation, happy new year. Take care,

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stay safe, and happy breathing, everyone.