1 00:00:00,000 --> 00:00:23,280 Hi everyone and welcome back to Airway First, the podcast from the Children's Airway First 2 00:00:23,280 --> 00:00:24,280 Foundation. 3 00:00:24,280 --> 00:00:27,520 I'm your host, Rebecca Downing. 4 00:00:27,520 --> 00:00:31,360 Our podcast today is a little different than our usual interview. 5 00:00:31,360 --> 00:00:37,720 Today we have two guests in studio, Dr. Gerald Simmons and Dr. Kevin Boy. 6 00:00:37,720 --> 00:00:44,200 Both are renowned doctors focused on sleep and airway health for children. 7 00:00:44,200 --> 00:00:49,520 Today I'm going to open the mic for them to talk a little bit about why it's so important 8 00:00:49,520 --> 00:00:54,920 that the medical side works with the dental side and about possible continuing education 9 00:00:54,920 --> 00:00:58,040 opportunities for both. 10 00:00:58,040 --> 00:01:01,640 So please welcome Dr. Gerald Simmons and Dr. Kevin Boyd. 11 00:01:01,640 --> 00:01:09,520 I want to thank you Dr. Simmons and Dr. Boyd or Dr. Kevin as it is for being on the podcast 12 00:01:09,520 --> 00:01:11,040 today. 13 00:01:11,040 --> 00:01:17,040 And our topic today, obviously this is a little more widespread than children, but we want 14 00:01:17,040 --> 00:01:23,840 to focus a little on pediatric sleep issues and how it relates to airway and the lack 15 00:01:23,840 --> 00:01:28,000 of education that we're finding in the medical profession at large. 16 00:01:28,000 --> 00:01:29,500 So Dr. Simmons. 17 00:01:29,500 --> 00:01:34,720 Well thank you for the opportunity to be here today. 18 00:01:34,720 --> 00:01:39,760 We have an annual conference, the Sleep Education Consortium, which is trying to address the 19 00:01:39,760 --> 00:01:42,720 deficit in the health care education. 20 00:01:42,720 --> 00:01:48,040 Most physicians and dentists have almost no education on sleep. 21 00:01:48,040 --> 00:01:54,040 On the four years of medical school, only two to four hours are spent teaching medical 22 00:01:54,040 --> 00:01:57,880 students anything on sleep physiology or sleep pathology. 23 00:01:57,880 --> 00:02:00,560 And yet we spent a third of our life sleeping. 24 00:02:00,560 --> 00:02:07,600 So there's a big deficit and we now know that sleep disorders have a significant impact 25 00:02:07,600 --> 00:02:09,960 on other health care issues. 26 00:02:09,960 --> 00:02:14,920 Diabetes, hypertension, stroke, Alzheimer's, just so many things. 27 00:02:14,920 --> 00:02:19,880 And so the consortium functions as a way of bringing all this information in and packaging 28 00:02:19,880 --> 00:02:24,760 it so that a health care provider that never really received any education can get up to 29 00:02:24,760 --> 00:02:33,760 speed and learn pretty quickly how important sleep is and give them an approach to where 30 00:02:33,760 --> 00:02:36,920 they can then implement it into their practice. 31 00:02:36,920 --> 00:02:47,040 So today Dr. Kevin Boyd is joining us from his vacation with his family skiing. 32 00:02:47,040 --> 00:02:51,480 We're fortunate to have him so we want to be respectful of his time. 33 00:02:51,480 --> 00:03:00,800 But I'm a neurologist, I deal with kids and adults, but a lot of these issues with adults, 34 00:03:00,800 --> 00:03:02,680 it doesn't start in their adulthood. 35 00:03:02,680 --> 00:03:07,400 It's not like someone has sleep apnea that's diagnosed when the person's 30 or 40, it didn't 36 00:03:07,400 --> 00:03:09,560 start when they were 30 or 40. 37 00:03:09,560 --> 00:03:13,160 We can trace it back to it started actually when they were born. 38 00:03:13,160 --> 00:03:18,920 A lot of the individuals just have deficiencies of the cranial facial anatomy and we're now 39 00:03:18,920 --> 00:03:23,400 becoming more sensitive to what those cranial facial deficiencies are. 40 00:03:23,400 --> 00:03:30,520 And there are things that can be done to intervene at an early, early age to open up the airway. 41 00:03:30,520 --> 00:03:37,920 And a lot of what's been done within orthodontics and dentistry has really, up till now, has 42 00:03:37,920 --> 00:03:41,360 been really wrong because we didn't understand what was going on. 43 00:03:41,360 --> 00:03:44,880 But there's a trend to try to now improve things. 44 00:03:44,880 --> 00:03:52,120 So I included Dr. Boyd into our Sleep Education Consortium back to a couple of years ago because 45 00:03:52,120 --> 00:03:59,880 of what he's really recognized and where his role comes in in terms of teaching dentists 46 00:03:59,880 --> 00:04:06,680 and other health care professionals, myofunctional therapists, how to identify early on the deficiencies 47 00:04:06,680 --> 00:04:11,640 and what can be done and teaches things that can be done to open up the airway. 48 00:04:11,640 --> 00:04:14,880 So Kevin, thanks for joining us on your vacation. 49 00:04:14,880 --> 00:04:18,040 I'm going to pass it over to you to talk for me. 50 00:04:18,040 --> 00:04:19,040 Thank you. 51 00:04:19,040 --> 00:04:20,040 Thank you, Jerry. 52 00:04:20,040 --> 00:04:22,520 And thanks for being patient with me. 53 00:04:22,520 --> 00:04:27,400 Yeah, I think you said it all is assessing risk. 54 00:04:27,400 --> 00:04:28,400 Risk for what? 55 00:04:28,400 --> 00:04:31,400 Well, comorbidities with malocclusion. 56 00:04:31,400 --> 00:04:33,960 Well, what is malocclusion? 57 00:04:33,960 --> 00:04:40,280 You know, that's the term that our dental profession uses to describe jaws and teeth. 58 00:04:40,280 --> 00:04:42,560 They don't line up correctly. 59 00:04:42,560 --> 00:04:45,160 And at some point, you'll need braces. 60 00:04:45,160 --> 00:04:52,240 Well, that's like an ophthalmologist saying, boy, if you recognize the early signs of nearsightedness 61 00:04:52,240 --> 00:04:58,120 in a four-year-old, boy, you can say, hey, let's be prepared to fix it when they're 62 00:04:58,120 --> 00:05:01,160 driving a car, which is ridiculous. 63 00:05:01,160 --> 00:05:06,280 When you see the signs of malocclusion in a three-year-old that jaws and teeth don't 64 00:05:06,280 --> 00:05:10,080 line up correctly, it never self-corrects. 65 00:05:10,080 --> 00:05:11,560 Hear that again, please. 66 00:05:11,560 --> 00:05:13,080 It never self-corrects. 67 00:05:13,080 --> 00:05:16,240 And it will always worsen. 68 00:05:16,240 --> 00:05:22,240 And it will usually be or become comorbidities with sleep and breathing disorders. 69 00:05:22,240 --> 00:05:23,920 You can take that to the bank. 70 00:05:23,920 --> 00:05:24,920 It's true. 71 00:05:24,920 --> 00:05:27,840 And it's been known for 100 years. 72 00:05:27,840 --> 00:05:29,960 So that's it. 73 00:05:29,960 --> 00:05:37,200 It doesn't mean we need to treat every three-year-old with a narrow jaw, with a protruded mandibles 74 00:05:37,200 --> 00:05:39,320 or protruded upper jaw. 75 00:05:39,320 --> 00:05:43,160 It means we need to recognize it and bring it to the attention. 76 00:05:43,160 --> 00:05:46,060 First, are you ready for this? 77 00:05:46,060 --> 00:05:53,320 Not the pediatricians, not the dentists, to the mother if the child is so lucky to have 78 00:05:53,320 --> 00:05:54,320 a mother. 79 00:05:54,320 --> 00:05:59,080 There are a lot of kids who have these problems that don't have a mom, that don't have a 80 00:05:59,080 --> 00:06:00,080 dad. 81 00:06:00,080 --> 00:06:02,480 But let's just say adult caregivers. 82 00:06:02,480 --> 00:06:09,120 And if you're lucky to have the female adult caregiver who has an instinct that's different 83 00:06:09,120 --> 00:06:15,480 from what we with a Y chromosome have, we care, we love, but nobody knows a kid like 84 00:06:15,480 --> 00:06:16,480 a mom. 85 00:06:16,480 --> 00:06:21,920 And so many times, when mothers bring their kids to me with sleep and breathing disorders, 86 00:06:21,920 --> 00:06:24,080 malocclusion, comorbidity. 87 00:06:24,080 --> 00:06:25,920 And I say these things are related. 88 00:06:25,920 --> 00:06:29,480 The most common response is, I thought so. 89 00:06:29,480 --> 00:06:31,720 I thought so. 90 00:06:31,720 --> 00:06:38,160 And I tell you, if that's one thing that everybody can take away from the SEC conference, we 91 00:06:38,160 --> 00:06:44,840 must get to adult caregivers, especially the moms, about the fact that it's their child's 92 00:06:44,840 --> 00:06:51,800 jaw isn't right for feeding, isn't right for swallowing, isn't right for breathing through 93 00:06:51,800 --> 00:06:54,800 the nose while they're awake in a sleep. 94 00:06:54,800 --> 00:07:00,920 habitually, from birth, we got a problem, Houston, where we will be. 95 00:07:00,920 --> 00:07:02,880 We have a problem. 96 00:07:02,880 --> 00:07:03,880 I just made that up. 97 00:07:03,880 --> 00:07:04,880 It's pretty good. 98 00:07:04,880 --> 00:07:05,880 Okay. 99 00:07:05,880 --> 00:07:08,400 Well, that's all I got. 100 00:07:08,400 --> 00:07:09,400 That's all I got. 101 00:07:09,400 --> 00:07:11,400 I can't wait until April. 102 00:07:11,400 --> 00:07:12,520 Well, great. 103 00:07:12,520 --> 00:07:20,080 So so you sort of look at this conference as being a way to fill some of the void that 104 00:07:20,080 --> 00:07:22,320 exists in our healthcare education. 105 00:07:22,320 --> 00:07:23,320 Yep. 106 00:07:23,320 --> 00:07:29,840 And if moms get it, believe me, you get a pissed off mom, sorry, we use the vernacular, 107 00:07:29,840 --> 00:07:32,880 but angry moms get sucked on. 108 00:07:32,880 --> 00:07:37,120 And the rest of our healthcare provider colleagues, they'll get it. 109 00:07:37,120 --> 00:07:42,320 Even if for fear of losing market share, they're going to get it if moms demand it. 110 00:07:42,320 --> 00:07:44,880 So talk a little bit about the hands-on portion. 111 00:07:44,880 --> 00:07:49,160 I know last time we did the conference, you were part of the faculty that also was in 112 00:07:49,160 --> 00:07:53,520 the breakout sessions where we're teaching people how to do the exams. 113 00:07:53,520 --> 00:07:56,440 Real quickly, you look at a face. 114 00:07:56,440 --> 00:07:58,640 A face is the front of the airway. 115 00:07:58,640 --> 00:08:01,680 And there are certain components that I will discuss. 116 00:08:01,680 --> 00:08:06,960 This isn't a tech meet scores, but there's going to be a lot of healthcare providers 117 00:08:06,960 --> 00:08:11,920 there that don't treat kids, but they treat former kids, they're called adults. 118 00:08:11,920 --> 00:08:15,520 And there could be genetic predisposition to the problems that you're trying to solve 119 00:08:15,520 --> 00:08:21,440 on the adults, so you might be the first healthcare provider to make them aware that 120 00:08:21,440 --> 00:08:28,120 their grand kid, great grand kid, niece or nephew, son or daughter might be being set 121 00:08:28,120 --> 00:08:30,200 up for future problems. 122 00:08:30,200 --> 00:08:31,200 So what do you do? 123 00:08:31,200 --> 00:08:32,760 Well, just look at the kid. 124 00:08:32,760 --> 00:08:34,760 Is their mouth open all the time? 125 00:08:34,760 --> 00:08:36,880 How often should you breathe through your mouth? 126 00:08:36,880 --> 00:08:39,080 As often as you eat with your nose. 127 00:08:39,080 --> 00:08:40,080 Just tell them that. 128 00:08:40,080 --> 00:08:43,760 If they're mouth breathing, looks apart, you got a problem. 129 00:08:43,760 --> 00:08:49,240 But more specifically, I think during the conference, I think you go over certain measurements 130 00:08:49,240 --> 00:08:52,760 that should be taken and how to make some of those measurements. 131 00:08:52,760 --> 00:08:53,760 Yes. 132 00:08:53,760 --> 00:08:56,480 Well, one of them was called the Bogue in Dentist. 133 00:08:56,480 --> 00:09:02,880 TA Bogue was a physician dentist in the late 19th, early 20th century who limited his dental 134 00:09:02,880 --> 00:09:03,880 practice. 135 00:09:03,880 --> 00:09:06,320 He didn't even practice medicine. 136 00:09:06,320 --> 00:09:11,160 His dental practice to kids under six years old who had malaclusion and sleep and breathing 137 00:09:11,160 --> 00:09:12,160 problems. 138 00:09:12,160 --> 00:09:17,640 He said, we need to spread the visciduous arch, that's the language they use back then, 139 00:09:17,640 --> 00:09:24,720 for the purpose not of correcting irregularities of fatigue, but to give them nasal respiratory 140 00:09:24,720 --> 00:09:25,720 advantage. 141 00:09:25,720 --> 00:09:30,640 And there's all kinds of articles like in the New England Journal of Medicine before 142 00:09:30,640 --> 00:09:37,400 it was called that, in 1910, in the Boston Journal of Surgery and Medicine, TA Bogue talked 143 00:09:37,400 --> 00:09:44,120 about nasal respiratory advantage from dental facial orthopedic or, you know, they didn't 144 00:09:44,120 --> 00:09:45,120 call it that either. 145 00:09:45,120 --> 00:09:48,800 They just called it, the Siduous Maxillary Expansion. 146 00:09:48,800 --> 00:09:50,520 So I'm bringing this back. 147 00:09:50,520 --> 00:09:52,480 It fell out of favor in World War II. 148 00:09:52,480 --> 00:09:53,480 We don't know why. 149 00:09:53,480 --> 00:09:55,640 It's coming back with a vengeance. 150 00:09:55,640 --> 00:09:57,440 You don't have to treat these kids. 151 00:09:57,440 --> 00:09:59,560 You need to know how to assess the risk. 152 00:09:59,560 --> 00:10:05,160 You don't have to be a dentist to measure the width of their upper second baby molars 153 00:10:05,160 --> 00:10:07,120 prior to age six. 154 00:10:07,120 --> 00:10:09,480 It should be 24 millimeters per age. 155 00:10:09,480 --> 00:10:10,480 Okay. 156 00:10:10,480 --> 00:10:11,680 But now, so what? 157 00:10:11,680 --> 00:10:16,120 We go when we identify these problems on three or four years old, four year olds. 158 00:10:16,120 --> 00:10:17,120 Can we do anything? 159 00:10:17,120 --> 00:10:19,880 Can you do anything about those? 160 00:10:19,880 --> 00:10:21,200 You can make the parents aware. 161 00:10:21,200 --> 00:10:22,200 And you can decide that. 162 00:10:22,200 --> 00:10:24,200 No, but besides that, are there any interventions? 163 00:10:24,200 --> 00:10:30,920 I basically want to talk about what you do professionally in terms of your population that you're treating. 164 00:10:30,920 --> 00:10:31,920 Yes. 165 00:10:31,920 --> 00:10:34,640 There are all kinds of things out there. 166 00:10:34,640 --> 00:10:40,960 There are, well, first of all, myofunctional therapy, nursing and weaning. 167 00:10:40,960 --> 00:10:43,360 Even before a kid's born, there's things you can do. 168 00:10:43,360 --> 00:10:49,880 It's called pregnancy wellness, not just pregnancy vitamins and not just yoga, but better sleep 169 00:10:49,880 --> 00:10:51,720 for moms, better breathing for moms. 170 00:10:51,720 --> 00:10:52,720 Right. 171 00:10:52,720 --> 00:10:53,720 But also- 172 00:10:53,720 --> 00:10:56,560 Wouldn't you typically intervene orthodontically? 173 00:10:56,560 --> 00:10:58,480 I want 20 teeth. 174 00:10:58,480 --> 00:11:00,760 That's about two and a half to three years old. 175 00:11:00,760 --> 00:11:07,680 That's in JAMA 1922, that 30 months of age is the ideal time to begin spreading the deciduous 176 00:11:07,680 --> 00:11:08,680 arcs. 177 00:11:08,680 --> 00:11:10,560 But there are obstacles to that. 178 00:11:10,560 --> 00:11:16,720 And one of the greatest obstacles is that most orthodontists do not want to treat. 179 00:11:16,720 --> 00:11:19,680 They don't even want to look at kids until seven years old and much less treat them 180 00:11:19,680 --> 00:11:21,400 until after 10. 181 00:11:21,400 --> 00:11:25,960 It doesn't mean they're all not doing that, but that's the majority because their curriculum 182 00:11:25,960 --> 00:11:35,240 says, we don't really teach behavior guidance of little kids being fearful in a dental setting 183 00:11:35,240 --> 00:11:37,240 because we don't treat them at that age. 184 00:11:37,240 --> 00:11:39,240 That's what the implication is. 185 00:11:39,240 --> 00:11:47,320 We have to demonstrate a huge competence in managing anxiety in children and parents 186 00:11:47,320 --> 00:11:52,440 that are associated with receiving treatments in a novel healthcare setting like a dental 187 00:11:52,440 --> 00:11:53,440 office. 188 00:11:53,440 --> 00:11:54,440 We know how to do that. 189 00:11:54,440 --> 00:12:00,880 Listen, kids are hardwired to want to please their parents and their adult care gives, 190 00:12:00,880 --> 00:12:02,600 especially the moms. 191 00:12:02,600 --> 00:12:06,000 If the parents get it, the kids will do it. 192 00:12:06,000 --> 00:12:07,960 Best kept secret north of us. 193 00:12:07,960 --> 00:12:10,160 So there's a lot you can do. 194 00:12:10,160 --> 00:12:11,280 Why is it 30 months? 195 00:12:11,280 --> 00:12:14,880 Is it because it's been long enough that it's solid enough? 196 00:12:14,880 --> 00:12:17,080 No, why not early? 197 00:12:17,080 --> 00:12:20,720 Two and a half, no, there's things you can do earlier. 198 00:12:20,720 --> 00:12:22,800 But that's when 20 teeth are in. 199 00:12:22,800 --> 00:12:23,800 Okay? 200 00:12:23,800 --> 00:12:25,520 So you can do that really by two and a half or three years old. 201 00:12:25,520 --> 00:12:29,480 Kids have 20 teeth and you can fit an expander in them. 202 00:12:29,480 --> 00:12:37,440 But before that, you can do things like shawty mouth, mild munchy, infant trainers, healthy 203 00:12:37,440 --> 00:12:44,960 start, just mild functional, just by talking to your child and preparing them for something 204 00:12:44,960 --> 00:12:47,680 that's going to be fun. 205 00:12:47,680 --> 00:12:50,360 That is a form of treatment. 206 00:12:50,360 --> 00:12:52,560 You help the parents understand. 207 00:12:52,560 --> 00:12:56,600 This is in the best one and short term health interest of their child. 208 00:12:56,600 --> 00:13:04,680 There's evidence now that, yes, that children who have good self control, which was associated 209 00:13:04,680 --> 00:13:10,240 with good sleep and breathing before 11 years old will live longer than kids who don't. 210 00:13:10,240 --> 00:13:19,160 Before 11 years old, validated metrics were taken on 1,037 babies born in 1973 in Dunedin, 211 00:13:19,160 --> 00:13:23,960 New Zealand and have been followed since for over 15 years. 212 00:13:23,960 --> 00:13:27,400 I know that because my 1973 high school union's coming up. 213 00:13:27,400 --> 00:13:33,360 50 years and a thousand of these kids now adults are being followed. 214 00:13:33,360 --> 00:13:38,960 And those that demonstrated good self control before the age of 11, they managed wealth 215 00:13:38,960 --> 00:13:39,960 better. 216 00:13:39,960 --> 00:13:42,280 There's less criminal and addictive behaviors. 217 00:13:42,280 --> 00:13:46,680 They're more resistant to chronic disease and they've looked 10 years younger. 218 00:13:46,680 --> 00:13:56,400 If you just Google Dunedin study self control, you will find a myriad of information concerning 219 00:13:56,400 --> 00:14:01,220 this expanding a kid and getting them to breathe out some of them meaning to their nose 220 00:14:01,220 --> 00:14:04,440 habitually during sleep and wakefulness. 221 00:14:04,440 --> 00:14:07,440 This portends that they will live longer. 222 00:14:07,440 --> 00:14:10,040 They'll probably live to be 100. 223 00:14:10,040 --> 00:14:15,040 Can't promise that, but minimize risk if you get them sleeping, breathing well. 224 00:14:15,040 --> 00:14:18,600 And they're just going to have a better quality of life. 225 00:14:18,600 --> 00:14:23,360 And there's loads of research already in the public domain in the scientific body that 226 00:14:23,360 --> 00:14:31,520 says just maxillary expansion alone will improve the kids quality of life was much better systemic 227 00:14:31,520 --> 00:14:32,920 health. 228 00:14:32,920 --> 00:14:40,040 And it now from the group from Stanford, Audrey Yoon and company have shown that when you do 229 00:14:40,040 --> 00:14:46,760 transfer expansion that are sadly the transfer sufficient child with or without a cross fight, 230 00:14:46,760 --> 00:14:50,720 you can increase the nasal pharyngeal corridor. 231 00:14:50,720 --> 00:14:55,400 You can help shrink the ad noise, normalize the lymph tissue. 232 00:14:55,400 --> 00:14:59,320 It's published in the journal sleep 2021. 233 00:14:59,320 --> 00:15:02,760 So anyway, so much to be optimistic about. 234 00:15:02,760 --> 00:15:04,120 And that's what I tell parents. 235 00:15:04,120 --> 00:15:05,880 I'm not promising you. 236 00:15:05,880 --> 00:15:11,000 I'm the dental, I'm going to solve the malocclusion to the best of my ability. 237 00:15:11,000 --> 00:15:17,600 And I am going to give you optimism that your child will benefit from this, not just from 238 00:15:17,600 --> 00:15:18,600 a better looking smile. 239 00:15:18,600 --> 00:15:19,800 Oh, they'll get that. 240 00:15:19,800 --> 00:15:22,280 You know, they'll need an invisible line someday. 241 00:15:22,280 --> 00:15:28,560 But they're adult P. This is something we do in early childhood, just like correcting 242 00:15:28,560 --> 00:15:29,560 your side of this. 243 00:15:29,560 --> 00:15:32,000 You don't let it go till they're driving a car. 244 00:15:32,000 --> 00:15:38,000 You don't let a non self-correcting malocclusion go until they have more permanent teeth. 245 00:15:38,000 --> 00:15:43,320 So you're saying it's not really about the teeth, but it's about the cranial facial 246 00:15:43,320 --> 00:15:44,320 structure. 247 00:15:44,320 --> 00:15:49,160 And so just because the adult teeth aren't in, it doesn't mean you shouldn't do orthodontics 248 00:15:49,160 --> 00:15:55,000 because you could change the skull, the skeletal anatomy, even when the baby teeth are there. 249 00:15:55,000 --> 00:15:59,280 Yes, it's the field where the teeth grow. 250 00:15:59,280 --> 00:16:04,200 You know, the field being the alveolar bone and the apical base of the alveolar bone. 251 00:16:04,200 --> 00:16:06,160 That needs to be shaped early. 252 00:16:06,160 --> 00:16:07,800 That needs to be optimized early. 253 00:16:07,800 --> 00:16:14,160 Mother Nature used to do it for us 300,000 years of anatomically modern human existence 254 00:16:14,160 --> 00:16:16,400 without malocclusion. 255 00:16:16,400 --> 00:16:17,400 Go figure. 256 00:16:17,400 --> 00:16:20,640 Then three or 400 years ago, here we go. 257 00:16:20,640 --> 00:16:22,600 That is not genetic. 258 00:16:22,600 --> 00:16:27,240 The genome takes thousands of generations to incorporate a mutation. 259 00:16:27,240 --> 00:16:34,720 This is something that every child born has potential for optimal occlusion of the cranial 260 00:16:34,720 --> 00:16:38,800 facial and interconnected respiratory complexes. 261 00:16:38,800 --> 00:16:45,040 This is really becoming common knowledge, but not enough. 262 00:16:45,040 --> 00:16:46,840 Not enough stuff. 263 00:16:46,840 --> 00:16:52,560 So looking forward to seeing everyone in Houston got lots of information, lots of case studies 264 00:16:52,560 --> 00:16:57,720 to show evidence of what I'm talking about here. 265 00:16:57,720 --> 00:16:58,720 Great. 266 00:16:58,720 --> 00:17:00,760 Well, listen, I want to be respectful of your time. 267 00:17:00,760 --> 00:17:05,120 I know you're with your family skiing, and so I want you to get out, back out on the 268 00:17:05,120 --> 00:17:06,120 slopes. 269 00:17:06,120 --> 00:17:11,560 I really appreciate that you were able to connect with us so we can get the word out there. 270 00:17:11,560 --> 00:17:14,840 I'm honored to be part of your faculty, you guys. 271 00:17:14,840 --> 00:17:15,840 Thanks. 272 00:17:15,840 --> 00:17:16,840 All good. 273 00:17:16,840 --> 00:17:17,840 All right. 274 00:17:17,840 --> 00:17:18,840 See you around like a donut. 275 00:17:18,840 --> 00:17:19,840 Take care. 276 00:17:19,840 --> 00:17:20,840 Bye. 277 00:17:20,840 --> 00:17:21,840 Bye. 278 00:17:21,840 --> 00:17:22,840 Well, that's great. 279 00:17:22,840 --> 00:17:23,840 Yeah. 280 00:17:23,840 --> 00:17:28,440 So, you know, I think having Dr. Boyd is part of the faculty, clearly you can see as a lot 281 00:17:28,440 --> 00:17:33,680 of energy and a lot of passion for what he does. 282 00:17:33,680 --> 00:17:34,960 But he's leading the pack. 283 00:17:34,960 --> 00:17:44,000 I mean, he's really helping to expand the awareness of what can be done in the pediatric 284 00:17:44,000 --> 00:17:45,360 population. 285 00:17:45,360 --> 00:17:53,800 And so it's really a great thing, but there's other faculty members who cover so many things 286 00:17:53,800 --> 00:17:54,800 in the conference. 287 00:17:54,800 --> 00:18:01,120 We talk about surgical interventions, different things that can be done from an ENT standpoint 288 00:18:01,120 --> 00:18:02,440 to open up the airway. 289 00:18:02,440 --> 00:18:10,120 We're talking about inspired news, the newer methods of treating obstructive sleep apnea. 290 00:18:10,120 --> 00:18:16,560 And also talk about frenulum release, the tongue tie, and things can be done surgically 291 00:18:16,560 --> 00:18:18,200 along those lines. 292 00:18:18,200 --> 00:18:25,480 And maxillofacial surgery, you know, having mandibular, maxillomindibular osteotomies, 293 00:18:25,480 --> 00:18:26,480 bringing the face forward. 294 00:18:26,480 --> 00:18:27,840 And there's some new techniques. 295 00:18:27,840 --> 00:18:34,880 Dr. Alfie's going to be presenting about some new methods where the time it takes to do 296 00:18:34,880 --> 00:18:41,200 the surgery has been drastically reduced and outcomes have really improved with some of 297 00:18:41,200 --> 00:18:47,280 the newer methods to do these more extensive surgical interventions, which as time goes 298 00:18:47,280 --> 00:18:50,720 on, these are going to be done more commonly, but that's to change the structure. 299 00:18:50,720 --> 00:18:54,760 So for the individual where you don't catch it in their infancy, and then now they're 300 00:18:54,760 --> 00:18:59,720 an adult, there are certain things that can be done surgically to try to open up the airway. 301 00:18:59,720 --> 00:19:02,800 And another important thing is we're not just talking about the airway. 302 00:19:02,800 --> 00:19:07,400 We're going to be talking about other types of sleep disorders, narcolepsy, insomnia, 303 00:19:07,400 --> 00:19:09,240 restless leg syndrome. 304 00:19:09,240 --> 00:19:12,280 You know, if someone is a dentist and then they're going to start talking about sleep 305 00:19:12,280 --> 00:19:16,480 disorders to their patients, they're opening up a can of worms, and there's all different 306 00:19:16,480 --> 00:19:20,760 kinds of things that are going to become apparent. 307 00:19:20,760 --> 00:19:27,400 And the dentist needs to know something about these conditions. 308 00:19:27,400 --> 00:19:29,960 Not because they're going to treat it, but they're sensitive enough that they're going 309 00:19:29,960 --> 00:19:36,520 to get the patient locked in or linked into a physician that can handle these other kinds 310 00:19:36,520 --> 00:19:38,760 of medical problems. 311 00:19:38,760 --> 00:19:43,400 But it also strengthens the credibility that the patient has, that the dentist has with 312 00:19:43,400 --> 00:19:49,000 the patient, when the dentist seems to be aware and have some understanding of these 313 00:19:49,000 --> 00:19:52,280 other sleep-related conditions. 314 00:19:52,280 --> 00:20:00,000 And you can't go into dealing with sleep with just a tunnel of vision saying, this is the 315 00:20:00,000 --> 00:20:03,120 only thing. 316 00:20:03,120 --> 00:20:08,200 Every sleep problem is an airway problem, and the way to treat it is with an oral appliance. 317 00:20:08,200 --> 00:20:12,680 I mean, that's not correct. 318 00:20:12,680 --> 00:20:17,640 So the dentist coming to this conference is going to learn, along with physicians, in 319 00:20:17,640 --> 00:20:18,640 the same group. 320 00:20:18,640 --> 00:20:22,520 I would say it's not just dentists because this is one of the things the conference is 321 00:20:22,520 --> 00:20:23,520 doing. 322 00:20:23,520 --> 00:20:27,040 It is a holistic approach because that's one of the things you're rallying for, especially 323 00:20:27,040 --> 00:20:29,080 with pediatrics. 324 00:20:29,080 --> 00:20:32,880 You've got my own functional therapists that are going to be their speech pathologist, 325 00:20:32,880 --> 00:20:33,960 dentist, physicians. 326 00:20:33,960 --> 00:20:38,120 I mean, it's not just dentists that should be attending and learning. 327 00:20:38,120 --> 00:20:39,120 Right? 328 00:20:39,120 --> 00:20:40,120 Right. 329 00:20:40,120 --> 00:20:41,120 It's about collaboration. 330 00:20:41,120 --> 00:20:48,480 And we're working with the AAPMD, American Academy of Physiologic Medicine and Dentistry. 331 00:20:48,480 --> 00:20:53,680 They're integrally involved with this conference. 332 00:20:53,680 --> 00:21:00,760 And their main theme and mission is collaboration cures. 333 00:21:00,760 --> 00:21:08,760 And that's really when I started the Sleep Education Consortium 19 years ago, that was 334 00:21:08,760 --> 00:21:11,440 really the idea that we want to collaborate. 335 00:21:11,440 --> 00:21:17,120 And I was getting chastised by a lot of my physician colleagues and said, why are you 336 00:21:17,120 --> 00:21:25,400 trying to enable the dentist to go out there to do all these things that on their own and 337 00:21:25,400 --> 00:21:26,400 do inappropriate things? 338 00:21:26,400 --> 00:21:28,200 They go, no, that's not the concept here. 339 00:21:28,200 --> 00:21:33,640 The concept here is to, these dentists want to get involved and I'm trying to give them 340 00:21:33,640 --> 00:21:36,880 proper knowledge so they do it correctly. 341 00:21:36,880 --> 00:21:38,920 And what does a dentist do? 342 00:21:38,920 --> 00:21:39,920 They look at the mouth. 343 00:21:39,920 --> 00:21:40,920 Right? 344 00:21:40,920 --> 00:21:42,520 That's the beginning of the airway. 345 00:21:42,520 --> 00:21:46,480 And so one of their patients, so imagine if they start screening for sleep apnea. 346 00:21:46,480 --> 00:21:57,000 I mean, I realized years ago that the dentist can be a great group to collaborate with to 347 00:21:57,000 --> 00:22:01,880 help screen for sleep apnea because they're looking in the mouth of it. 348 00:22:01,880 --> 00:22:03,480 It's the first line of defense, yeah. 349 00:22:03,480 --> 00:22:04,480 Yeah. 350 00:22:04,480 --> 00:22:09,160 And if they knew what they were looking at and they could understand how certain features 351 00:22:09,160 --> 00:22:15,400 are going to increase the likelihood of obstructive breathing during sleep, then they're going 352 00:22:15,400 --> 00:22:22,840 to start referring these patients on to get proper treatment or they'll implement it on 353 00:22:22,840 --> 00:22:23,840 their own. 354 00:22:23,840 --> 00:22:27,640 But really, if they're going to do that, my position is that they should do it in conjunction 355 00:22:27,640 --> 00:22:31,040 with a physician because of all the comorbidities involved. 356 00:22:31,040 --> 00:22:38,520 And it should be really a physician identifying the efficacy of treatment because it's not 357 00:22:38,520 --> 00:22:42,600 just wearing an appliance and it's not just about wearing a CPAP mask. 358 00:22:42,600 --> 00:22:45,680 It's not just about keeping the oxygen level from dropping. 359 00:22:45,680 --> 00:22:49,440 It's about improving overall quality of sleep. 360 00:22:49,440 --> 00:22:54,880 But years ago, when I was on faculty at UCLA, I submitted a grant to the NIH, one of the 361 00:22:54,880 --> 00:22:59,640 sleep education grants submitted it from UCLA. 362 00:22:59,640 --> 00:23:07,120 And about a third to a half of the grant was focused on educating dentists on sleep disorders. 363 00:23:07,120 --> 00:23:10,480 And half the reviewers thought it was a great idea. 364 00:23:10,480 --> 00:23:11,840 They thought I was a genius. 365 00:23:11,840 --> 00:23:15,600 The other half of the reviewers thought I was a misguided physician. 366 00:23:15,600 --> 00:23:19,840 And I really needed to spend more time focusing just on teaching physicians. 367 00:23:19,840 --> 00:23:21,480 Well, here we are now. 368 00:23:21,480 --> 00:23:22,840 This was like in 1996. 369 00:23:22,840 --> 00:23:23,840 Right? 370 00:23:23,840 --> 00:23:33,960 So here we are years later, almost, you know, so where are we with all this? 371 00:23:33,960 --> 00:23:38,560 Right now, sleep dentistry is in vogue. 372 00:23:38,560 --> 00:23:45,200 And to the point where the ADA has now taken on as a statement saying that all dentists 373 00:23:45,200 --> 00:23:48,560 should be screening for sleep apnea. 374 00:23:48,560 --> 00:23:55,040 So music to my ears because I've been saying this for my entire professional career really. 375 00:23:55,040 --> 00:23:56,760 We need to work collaboratively. 376 00:23:56,760 --> 00:23:58,720 Yeah, absolutely. 377 00:23:58,720 --> 00:24:04,600 And you have available for people a free sleep questionnaire, correct? 378 00:24:04,600 --> 00:24:05,600 Yes. 379 00:24:05,600 --> 00:24:10,400 So if you go to the webpage for the Sleep Education Consortium, my practice, which is 380 00:24:10,400 --> 00:24:14,960 Comprehensive Sleep Medicine Associates, we've been using a one-page sleep questionnaire 381 00:24:14,960 --> 00:24:17,560 for 20 years. 382 00:24:17,560 --> 00:24:24,760 And so, and it's really a good overview for taking a sleep history. 383 00:24:24,760 --> 00:24:28,120 Well, basically, we gave this to the Sleep Education Consortium so they could put it 384 00:24:28,120 --> 00:24:33,720 out there and someone could download that questionnaire and start incorporating it to 385 00:24:33,720 --> 00:24:34,720 the practice. 386 00:24:34,720 --> 00:24:39,040 And then coming to the consortium is going to help them understand how to deal with those 387 00:24:39,040 --> 00:24:44,120 responses that a patient is going to fill out on there because there are questions about 388 00:24:44,120 --> 00:24:47,800 unusual behaviors during sleep, parasomnias. 389 00:24:47,800 --> 00:24:51,440 So if someone starts kicking and yelling and screaming in their sleep, what is that? 390 00:24:51,440 --> 00:24:53,360 Could it be REM behavior disorder? 391 00:24:53,360 --> 00:24:55,560 Is it part of a post-traumatic stress disorder? 392 00:24:55,560 --> 00:24:58,840 Is it part of nocturnal seizures? 393 00:24:58,840 --> 00:25:02,600 So again, it's not all breathing. 394 00:25:02,600 --> 00:25:06,520 Someone has uncomfortable sensations in their legs when they're lying in bed still. 395 00:25:06,520 --> 00:25:08,000 I mean, that's a question there. 396 00:25:08,000 --> 00:25:11,160 It pertains to restless leg syndrome. 397 00:25:11,160 --> 00:25:17,320 So the questionnaire, it's available for people to go to the webpage, download, look at it, 398 00:25:17,320 --> 00:25:20,600 incorporate it into your practice, come to the consortium and learn more about it. 399 00:25:20,600 --> 00:25:21,600 Yep. 400 00:25:21,600 --> 00:25:25,480 And we'll put a link to both because there are, there's two sides. 401 00:25:25,480 --> 00:25:28,320 So for the dental track, I'll include the link for that. 402 00:25:28,320 --> 00:25:31,800 And then there's one for the physicians and their staff. 403 00:25:31,800 --> 00:25:36,080 So listeners can take either, either one. 404 00:25:36,080 --> 00:25:41,920 And just, you know, real fast, in your opinion, I mean, how have we missed this? 405 00:25:41,920 --> 00:25:46,400 How has the education so far off on this? 406 00:25:46,400 --> 00:25:52,400 Well, a lot of it's based on the technology and the development of, you know, like when 407 00:25:52,400 --> 00:25:55,560 did we really start understanding more about sleep? 408 00:25:55,560 --> 00:25:57,120 And it says our technology developed. 409 00:25:57,120 --> 00:26:02,080 So when we had like an EEG, when we started measuring brain waves, we started realizing 410 00:26:02,080 --> 00:26:06,640 that when you're asleep, your brain waves have certain characteristics that are different 411 00:26:06,640 --> 00:26:07,640 than when you're awake. 412 00:26:07,640 --> 00:26:14,160 And then looking at other physiologic aspects and REM sleep was recognized, you know. 413 00:26:14,160 --> 00:26:22,440 And so basically in the 1960s is really when a lot of the basic physiology was being identified 414 00:26:22,440 --> 00:26:25,200 and realizing that sleep is divided up into different stages. 415 00:26:25,200 --> 00:26:30,240 But then it's a matter of tying that in with respiration and the identification of obstructive 416 00:26:30,240 --> 00:26:31,880 sleep apnea. 417 00:26:31,880 --> 00:26:35,080 And then so once it was being identified, then what can you do about it? 418 00:26:35,080 --> 00:26:38,960 Well, then CPAP was developed, continuous positive airway pressure, which could make 419 00:26:38,960 --> 00:26:44,200 a drastic improvement in treating patients with obstructive sleep apnea. 420 00:26:44,200 --> 00:26:55,560 So but we basically we've been unable to really assess the sleeping process until relatively 421 00:26:55,560 --> 00:26:57,360 speaking more recently. 422 00:26:57,360 --> 00:26:58,680 Okay. 423 00:26:58,680 --> 00:27:04,520 And as our technology has developed, our understanding is developed. 424 00:27:04,520 --> 00:27:08,400 And now it's a matter of getting the education out there. 425 00:27:08,400 --> 00:27:13,920 And in a medical school environment, there's so much competition for educational real estate, 426 00:27:13,920 --> 00:27:16,960 if you will, you know, there's only a certain amount of time. 427 00:27:16,960 --> 00:27:22,240 And there's everyone, all the faculty, they want to get their topic into the curriculum. 428 00:27:22,240 --> 00:27:27,560 And so, you know, you've got Nobel Prize winners or people that are really passionate 429 00:27:27,560 --> 00:27:32,080 about their very narrow area and they want a lecture on it. 430 00:27:32,080 --> 00:27:39,160 And it's hard to get things incorporated into the into the curriculum. 431 00:27:39,160 --> 00:27:43,520 And if you look at epidemiology and say, well, what are the most common problems? 432 00:27:43,520 --> 00:27:47,600 I mean, insomnia or excessive daytime sleepiness. 433 00:27:47,600 --> 00:27:53,480 I mean, those conditions affect about a third of our society will have some degree of excessive 434 00:27:53,480 --> 00:27:56,280 sleepiness or difficulties with their sleep. 435 00:27:56,280 --> 00:27:57,280 Right. 436 00:27:57,280 --> 00:28:00,640 Third of society, why isn't this taking up more time? 437 00:28:00,640 --> 00:28:03,240 Why isn't this giving more time in our medical education? 438 00:28:03,240 --> 00:28:12,280 And that's because we don't necessarily develop the education curriculum based on the epidemiology. 439 00:28:12,280 --> 00:28:16,440 And so, but it needs to take more of that even nutrition. 440 00:28:16,440 --> 00:28:21,760 We talk about how there's such a lack of education and nutrition in medical schools, but yet 441 00:28:21,760 --> 00:28:22,760 everyone needs. 442 00:28:22,760 --> 00:28:28,400 And so, it's hard to change the curriculum. 443 00:28:28,400 --> 00:28:32,600 And until we change the educational curriculum, physicians aren't going to know. 444 00:28:32,600 --> 00:28:36,560 So if you have a patient that's all excited, they think they have a condition, they're 445 00:28:36,560 --> 00:28:40,400 learning about something, they watch a podcast, they go right to their physician and they 446 00:28:40,400 --> 00:28:42,920 try to get validation of this concept. 447 00:28:42,920 --> 00:28:44,080 And the physician, they don't know. 448 00:28:44,080 --> 00:28:48,480 I'm going to say, oh, no, you know, yeah, don't worry. 449 00:28:48,480 --> 00:28:50,640 Or that happens with dentists a lot of times. 450 00:28:50,640 --> 00:28:54,320 The dentist is going to take a course, be all excited about all the sleep stuff that they've 451 00:28:54,320 --> 00:28:55,320 learned. 452 00:28:55,320 --> 00:28:58,360 And they probably know more than at that point than a lot of physicians. 453 00:28:58,360 --> 00:29:01,360 So they're going to tell their patient, I think you have X, Y and Z. 454 00:29:01,360 --> 00:29:02,360 Right. 455 00:29:02,360 --> 00:29:05,320 They're going to go into your physician and then they don't know. 456 00:29:05,320 --> 00:29:06,320 Right. 457 00:29:06,320 --> 00:29:14,560 And the physician is going to totally discredit what the dentist had just said to that patient. 458 00:29:14,560 --> 00:29:16,880 So then, so it's a problem. 459 00:29:16,880 --> 00:29:22,320 And that's why I think for my, you know, what can I do to contribute part of the solution? 460 00:29:22,320 --> 00:29:26,600 And that's by enhancing the education of the healthcare system, because now I was fortunate 461 00:29:26,600 --> 00:29:29,800 enough to do a fellowship. 462 00:29:29,800 --> 00:29:33,480 After I did my neurology training, I did a fellowship at sleep at Stanford University, 463 00:29:33,480 --> 00:29:34,480 top rated place. 464 00:29:34,480 --> 00:29:40,800 And I was back in 1991 where sleep was when I was the first neurology resident that finished 465 00:29:40,800 --> 00:29:46,320 the program at Washington University that went on to do a fellowship in sleep medicine. 466 00:29:46,320 --> 00:29:51,960 And I remember telling most of my colleagues, you know, that I was going to go and this 467 00:29:51,960 --> 00:29:56,280 was actually 1990 when I finished my residency, when I told them I was going to do a fellowship 468 00:29:56,280 --> 00:29:57,280 in sleep. 469 00:29:57,280 --> 00:29:58,280 A lot of them looked at me like sleep. 470 00:29:58,280 --> 00:29:59,280 What do you mean? 471 00:29:59,280 --> 00:30:00,280 I don't know. 472 00:30:00,280 --> 00:30:06,880 And I mean, I had sort of vision, recognize, you know, I realized this is an upcoming area 473 00:30:06,880 --> 00:30:09,440 because I saw the physiology, the way it all interrelated. 474 00:30:09,440 --> 00:30:11,640 And it was fascinating to me. 475 00:30:11,640 --> 00:30:15,640 But when I was doing my fellowship, I learned certain things. 476 00:30:15,640 --> 00:30:19,080 I said, like, why didn't I learn these things earlier? 477 00:30:19,080 --> 00:30:21,800 They're not that conceptually difficult to understand. 478 00:30:21,800 --> 00:30:26,040 And yet I see the impact that it's having on patients lives. 479 00:30:26,040 --> 00:30:28,440 This should be part of the regular curriculum. 480 00:30:28,440 --> 00:30:29,440 And it's not. 481 00:30:29,440 --> 00:30:34,160 So I'm no longer on a teaching faculty in a teaching institution. 482 00:30:34,160 --> 00:30:38,040 I used to be on faculty at UCLA, but then moved on into private practice, but still 483 00:30:38,040 --> 00:30:42,600 like to teach and help spread the education. 484 00:30:42,600 --> 00:30:46,960 And I'm really happy to what's evolved with the sleep education consortium. 485 00:30:46,960 --> 00:30:54,600 And I have a great panel of other clinicians working with me to educate and hope people 486 00:30:54,600 --> 00:30:58,960 can attend and gain more knowledge and will definitely impact your practice. 487 00:30:58,960 --> 00:30:59,960 Absolutely. 488 00:30:59,960 --> 00:31:05,920 And so again, the dates are April 27th, 28th, 29th. 489 00:31:05,920 --> 00:31:06,920 For the dentist. 490 00:31:06,920 --> 00:31:07,920 Yeah. 491 00:31:07,920 --> 00:31:12,560 And for the physicians, it's the 28th and 29th of April. 492 00:31:12,560 --> 00:31:18,520 And the reason for the differences, the first day is focused specifically for the dentist, 493 00:31:18,520 --> 00:31:23,600 who we talked about appliances. 494 00:31:23,600 --> 00:31:26,120 They're going to, the dentist is going to get a chance to work with appliances. 495 00:31:26,120 --> 00:31:31,120 We go over the oral exam, some of the things that Kevin was talking about. 496 00:31:31,120 --> 00:31:34,240 They learn about how to do digital scanning. 497 00:31:34,240 --> 00:31:39,360 That's a big area now to take a scan of the, instead of doing the impressions, the way 498 00:31:39,360 --> 00:31:43,280 they used to in the molds now, they're done digitally. 499 00:31:43,280 --> 00:31:48,760 So these are parts of the breakout session and learning the importance of making a morning 500 00:31:48,760 --> 00:31:52,640 reposition or any patients going to be on a mandibular advancing dental appliance in 501 00:31:52,640 --> 00:31:59,620 the morning should be in a morning reposition or to bring the job back to help prevent some 502 00:31:59,620 --> 00:32:03,160 of the side effects that can occur from mandibular advancement. 503 00:32:03,160 --> 00:32:05,160 But we even present an appliance. 504 00:32:05,160 --> 00:32:10,040 Dr. Yssefian is going to talk about an appliance that brings a job forward, the mandible forward 505 00:32:10,040 --> 00:32:11,440 without pulling it. 506 00:32:11,440 --> 00:32:16,680 It stimulates the job forward by how it functions the apno dentist. 507 00:32:16,680 --> 00:32:17,680 Interesting. 508 00:32:17,680 --> 00:32:21,800 So, you know, there's a lot covered. 509 00:32:21,800 --> 00:32:27,360 And even the overlap of other conditions, Dr. Andrew Maxwell, he's a pediatric cardiologist 510 00:32:27,360 --> 00:32:35,920 in California that is really a thought leader in the relationship between POTS disorder, 511 00:32:35,920 --> 00:32:42,120 you know, which is autonomic dysfunction, connective tissue disorder, Ehlers-Daniels, 512 00:32:42,120 --> 00:32:48,400 mast cell disorder, and how this relates with obstructive breathing and even narcolepsy. 513 00:32:48,400 --> 00:32:54,400 And there's these patients that are the chronic debilitating conditions and they're so hard 514 00:32:54,400 --> 00:32:55,400 to treat. 515 00:32:55,400 --> 00:33:01,640 And he's really come up with ways of identifying and looking at the progression of this pathology. 516 00:33:01,640 --> 00:33:06,160 And I reached out to him a couple of years ago about participating in this conference 517 00:33:06,160 --> 00:33:08,560 because I was seeing these patients. 518 00:33:08,560 --> 00:33:13,080 And I was, you know, recognizing there's something to relationship between these different conditions 519 00:33:13,080 --> 00:33:15,160 because I'm seeing it over and over again. 520 00:33:15,160 --> 00:33:21,640 And I came across his lecture and it's like, oh, you've got to participate. 521 00:33:21,640 --> 00:33:26,240 And some of these patients I was getting from a Dr. Cheng Rang, who is also going to be 522 00:33:26,240 --> 00:33:28,440 giving a talk in a conference. 523 00:33:28,440 --> 00:33:34,680 And he sees a lot of patients with chronic illness that are being missed elsewhere. 524 00:33:34,680 --> 00:33:39,040 And he's going to be talking about actually using EEG, quantitative EEG as a way of assessing 525 00:33:39,040 --> 00:33:48,040 for hypersonal and markers of sleep deficiencies that are not necessarily been put into standard 526 00:33:48,040 --> 00:33:56,360 practice today, but are good methods of identifying cerebral dysfunction that can occur from sleep 527 00:33:56,360 --> 00:33:57,360 disturbances. 528 00:33:57,360 --> 00:34:00,880 And we're also going to talk about a little bit of overlap about sleep problems and leading 529 00:34:00,880 --> 00:34:05,920 to Alzheimer's and also COVID-19 and the impact it's had on sleep. 530 00:34:05,920 --> 00:34:09,200 So these are some of the other topics that will be covered at the conference. 531 00:34:09,200 --> 00:34:15,520 And I know this conference is specific for clinicians, right, from both sides. 532 00:34:15,520 --> 00:34:23,520 But for parents, just as a takeaway that we could leave for them, how can a parent identify 533 00:34:23,520 --> 00:34:29,440 a potential sleep issue in their child so that they know to go seeing airway physician 534 00:34:29,440 --> 00:34:30,440 or dentist? 535 00:34:30,440 --> 00:34:36,440 Well, you know, does the child have difficulty falling asleep at the beginning of the night? 536 00:34:36,440 --> 00:34:40,680 And then once they're asleep, are they sleeping comfortably or are they tossing and turning 537 00:34:40,680 --> 00:34:41,680 all night long? 538 00:34:41,680 --> 00:34:42,680 Are they mouth breathing? 539 00:34:42,680 --> 00:34:44,320 Are they frequently drooling on the pillow? 540 00:34:44,320 --> 00:34:46,560 Can they hear them grinding or clenching their teeth? 541 00:34:46,560 --> 00:34:48,080 Do they seem congested? 542 00:34:48,080 --> 00:34:50,960 Are they waking up repetitively during the night? 543 00:34:50,960 --> 00:34:52,760 Are they kicking the sheets off the bed? 544 00:34:52,760 --> 00:34:56,560 Are they hard to sleep within the bed because of how much they're moving around? 545 00:34:56,560 --> 00:34:58,960 Are they difficult to wake up in the morning? 546 00:34:58,960 --> 00:35:02,400 And then once awake, are they calm and relaxed? 547 00:35:02,400 --> 00:35:05,600 Or are they bouncing off the wall all day long? 548 00:35:05,600 --> 00:35:07,600 Is the child hyperactive? 549 00:35:07,600 --> 00:35:12,360 Or the child in a car, you strip them in the seatbelt, in the car seat, then you drive 550 00:35:12,360 --> 00:35:13,360 and boom, they're out. 551 00:35:13,360 --> 00:35:14,360 They're asleep. 552 00:35:14,360 --> 00:35:16,200 Hyper, hyper, hyper, or they're out. 553 00:35:16,200 --> 00:35:18,320 One extreme or the other. 554 00:35:18,320 --> 00:35:22,840 And that hyperactivity could be a way of overcoming the excessive sleepiness that they're carrying 555 00:35:22,840 --> 00:35:23,840 around. 556 00:35:23,840 --> 00:35:30,720 And there's a number of things. 557 00:35:30,720 --> 00:35:36,080 So from a parent, you just want to basically see, if your child goes to bed easily, if 558 00:35:36,080 --> 00:35:42,280 it's easy to sort of standardize their schedule and they sleep through the night and they wake 559 00:35:42,280 --> 00:35:49,880 up easily and they seem to be sitting quietly during the day and they're not mouth breathing, 560 00:35:49,880 --> 00:35:52,640 there's not a problem. 561 00:35:52,640 --> 00:35:55,280 But otherwise, it's worth checking out. 562 00:35:55,280 --> 00:35:56,280 Yeah. 563 00:35:56,280 --> 00:35:57,280 Awesome. 564 00:35:57,280 --> 00:35:58,280 All right. 565 00:35:58,280 --> 00:36:04,080 So for all of our dental listeners, it's dentalsleepconference.com. 566 00:36:04,080 --> 00:36:07,240 And for everyone else, it is medicalsleepconference.com. 567 00:36:07,240 --> 00:36:09,680 And we'll put a link in the show notes. 568 00:36:09,680 --> 00:36:12,720 So I appreciate you and Dr. Boyd being on. 569 00:36:12,720 --> 00:36:13,720 Thank you. 570 00:36:13,720 --> 00:36:14,720 Great. 571 00:36:14,720 --> 00:36:15,720 Well, thank you for the opportunity. 572 00:36:15,720 --> 00:36:26,400 So CAF is a great organization in its infancy and really focusing in on children's airways 573 00:36:26,400 --> 00:36:29,880 and children's airway first foundation. 574 00:36:29,880 --> 00:36:36,160 But also some of the aspects of identifying right at birth and what kind of, I know that 575 00:36:36,160 --> 00:36:47,120 one of the missions is to try to implement some maybe future mandate where all neonates 576 00:36:47,120 --> 00:36:51,840 are going to be screened probably for having deficiencies of their airway, which may be 577 00:36:51,840 --> 00:36:59,520 most apparent by difficulties with feeding and issues with breastfeeding go hand in hand 578 00:36:59,520 --> 00:37:02,800 with these airway issues. 579 00:37:02,800 --> 00:37:07,000 It's now starting to be recognized and they'll be covered more at the conference as well. 580 00:37:07,000 --> 00:37:08,000 Awesome. 581 00:37:08,000 --> 00:37:09,000 All right. 582 00:37:09,000 --> 00:37:10,000 Well, thank you very much. 583 00:37:10,000 --> 00:37:11,000 Thank you. 584 00:37:11,000 --> 00:37:15,720 Have a nice day and talk to you soon. 585 00:37:15,720 --> 00:37:20,440 Thanks again to today's guests, Dr. Gerald Simmons and Dr. Kevin Boyd for sharing their 586 00:37:20,440 --> 00:37:28,000 medical insight and information on the upcoming SEC Dental and Medical Sleep Conference. 587 00:37:28,000 --> 00:37:31,560 And thanks to each of you for listening to today's episode. 588 00:37:31,560 --> 00:37:34,800 If you're new to our podcast, please don't forget to subscribe. 589 00:37:34,800 --> 00:37:38,800 And if you enjoyed today's episode, leave us a review or comment telling us about what 590 00:37:38,800 --> 00:37:40,760 you enjoyed most. 591 00:37:40,760 --> 00:37:44,840 You can stay connected with the Children's Airway First Foundation by following us on 592 00:37:44,840 --> 00:37:48,880 Instagram, Facebook, Twitter, LinkedIn and YouTube. 593 00:37:48,880 --> 00:37:56,400 Parents can also join us via our Facebook support group, The Airway Heddle, at facebook.com, 594 00:37:56,400 --> 00:38:00,600 backslash groups, backslash airway huddle. 595 00:38:00,600 --> 00:38:06,720 The CAF YouTube channel has a variety of original video content as well as video recordings 596 00:38:06,720 --> 00:38:11,760 and excerpts from selected Airway First podcast episodes. 597 00:38:11,760 --> 00:38:16,080 If you'd like to be a guest or have an idea for an upcoming episode, choose a note via 598 00:38:16,080 --> 00:38:24,360 the contacts page on our website or send us an email directly at info at childrensairwayfirst.org. 599 00:38:24,360 --> 00:38:28,200 And finally, thanks to all the parents and medical professionals out there that are working 600 00:38:28,200 --> 00:38:32,680 hard to help make the lives of kids around the globe just a little bit better. 601 00:38:32,680 --> 00:38:59,520 Take care, stay safe and happy breathing everyone.