Hi everyone and welcome back to Airway First, the podcast from the Children's Airway First
Foundation.
I'm your host, Rebecca Downing.
Our podcast today is a little different than our usual interview.
Today we have two guests in studio, Dr. Gerald Simmons and Dr. Kevin Boy.
Both are renowned doctors focused on sleep and airway health for children.
Today I'm going to open the mic for them to talk a little bit about why it's so important
that the medical side works with the dental side and about possible continuing education
opportunities for both.
So please welcome Dr. Gerald Simmons and Dr. Kevin Boyd.
I want to thank you Dr. Simmons and Dr. Boyd or Dr. Kevin as it is for being on the podcast
today.
And our topic today, obviously this is a little more widespread than children, but we want
to focus a little on pediatric sleep issues and how it relates to airway and the lack
of education that we're finding in the medical profession at large.
So Dr. Simmons.
Well thank you for the opportunity to be here today.
We have an annual conference, the Sleep Education Consortium, which is trying to address the
deficit in the health care education.
Most physicians and dentists have almost no education on sleep.
On the four years of medical school, only two to four hours are spent teaching medical
students anything on sleep physiology or sleep pathology.
And yet we spent a third of our life sleeping.
So there's a big deficit and we now know that sleep disorders have a significant impact
on other health care issues.
Diabetes, hypertension, stroke, Alzheimer's, just so many things.
And so the consortium functions as a way of bringing all this information in and packaging
it so that a health care provider that never really received any education can get up to
speed and learn pretty quickly how important sleep is and give them an approach to where
they can then implement it into their practice.
So today Dr. Kevin Boyd is joining us from his vacation with his family skiing.
We're fortunate to have him so we want to be respectful of his time.
But I'm a neurologist, I deal with kids and adults, but a lot of these issues with adults,
it doesn't start in their adulthood.
It's not like someone has sleep apnea that's diagnosed when the person's 30 or 40, it didn't
start when they were 30 or 40.
We can trace it back to it started actually when they were born.
A lot of the individuals just have deficiencies of the cranial facial anatomy and we're now
becoming more sensitive to what those cranial facial deficiencies are.
And there are things that can be done to intervene at an early, early age to open up the airway.
And a lot of what's been done within orthodontics and dentistry has really, up till now, has
been really wrong because we didn't understand what was going on.
But there's a trend to try to now improve things.
So I included Dr. Boyd into our Sleep Education Consortium back to a couple of years ago because
of what he's really recognized and where his role comes in in terms of teaching dentists
and other health care professionals, myofunctional therapists, how to identify early on the deficiencies
and what can be done and teaches things that can be done to open up the airway.
So Kevin, thanks for joining us on your vacation.
I'm going to pass it over to you to talk for me.
Thank you.
Thank you, Jerry.
And thanks for being patient with me.
Yeah, I think you said it all is assessing risk.
Risk for what?
Well, comorbidities with malocclusion.
Well, what is malocclusion?
You know, that's the term that our dental profession uses to describe jaws and teeth.
They don't line up correctly.
And at some point, you'll need braces.
Well, that's like an ophthalmologist saying, boy, if you recognize the early signs of nearsightedness
in a four-year-old, boy, you can say, hey, let's be prepared to fix it when they're
driving a car, which is ridiculous.
When you see the signs of malocclusion in a three-year-old that jaws and teeth don't
line up correctly, it never self-corrects.
Hear that again, please.
It never self-corrects.
And it will always worsen.
And it will usually be or become comorbidities with sleep and breathing disorders.
You can take that to the bank.
It's true.
And it's been known for 100 years.
So that's it.
It doesn't mean we need to treat every three-year-old with a narrow jaw, with a protruded mandibles
or protruded upper jaw.
It means we need to recognize it and bring it to the attention.
First, are you ready for this?
Not the pediatricians, not the dentists, to the mother if the child is so lucky to have
a mother.
There are a lot of kids who have these problems that don't have a mom, that don't have a
dad.
But let's just say adult caregivers.
And if you're lucky to have the female adult caregiver who has an instinct that's different
from what we with a Y chromosome have, we care, we love, but nobody knows a kid like
a mom.
And so many times, when mothers bring their kids to me with sleep and breathing disorders,
malocclusion, comorbidity.
And I say these things are related.
The most common response is, I thought so.
I thought so.
And I tell you, if that's one thing that everybody can take away from the SEC conference, we
must get to adult caregivers, especially the moms, about the fact that it's their child's
jaw isn't right for feeding, isn't right for swallowing, isn't right for breathing through
the nose while they're awake in a sleep.
habitually, from birth, we got a problem, Houston, where we will be.
We have a problem.
I just made that up.
It's pretty good.
Okay.
Well, that's all I got.
That's all I got.
I can't wait until April.
Well, great.
So so you sort of look at this conference as being a way to fill some of the void that
exists in our healthcare education.
Yep.
And if moms get it, believe me, you get a pissed off mom, sorry, we use the vernacular,
but angry moms get sucked on.
And the rest of our healthcare provider colleagues, they'll get it.
Even if for fear of losing market share, they're going to get it if moms demand it.
So talk a little bit about the hands-on portion.
I know last time we did the conference, you were part of the faculty that also was in
the breakout sessions where we're teaching people how to do the exams.
Real quickly, you look at a face.
A face is the front of the airway.
And there are certain components that I will discuss.
This isn't a tech meet scores, but there's going to be a lot of healthcare providers
there that don't treat kids, but they treat former kids, they're called adults.
And there could be genetic predisposition to the problems that you're trying to solve
on the adults, so you might be the first healthcare provider to make them aware that
their grand kid, great grand kid, niece or nephew, son or daughter might be being set
up for future problems.
So what do you do?
Well, just look at the kid.
Is their mouth open all the time?
How often should you breathe through your mouth?
As often as you eat with your nose.
Just tell them that.
If they're mouth breathing, looks apart, you got a problem.
But more specifically, I think during the conference, I think you go over certain measurements
that should be taken and how to make some of those measurements.
Yes.
Well, one of them was called the Bogue in Dentist.
TA Bogue was a physician dentist in the late 19th, early 20th century who limited his dental
practice.
He didn't even practice medicine.
His dental practice to kids under six years old who had malaclusion and sleep and breathing
problems.
He said, we need to spread the visciduous arch, that's the language they use back then,
for the purpose not of correcting irregularities of fatigue, but to give them nasal respiratory
advantage.
And there's all kinds of articles like in the New England Journal of Medicine before
it was called that, in 1910, in the Boston Journal of Surgery and Medicine, TA Bogue talked
about nasal respiratory advantage from dental facial orthopedic or, you know, they didn't
call it that either.
They just called it, the Siduous Maxillary Expansion.
So I'm bringing this back.
It fell out of favor in World War II.
We don't know why.
It's coming back with a vengeance.
You don't have to treat these kids.
You need to know how to assess the risk.
You don't have to be a dentist to measure the width of their upper second baby molars
prior to age six.
It should be 24 millimeters per age.
Okay.
But now, so what?
We go when we identify these problems on three or four years old, four year olds.
Can we do anything?
Can you do anything about those?
You can make the parents aware.
And you can decide that.
No, but besides that, are there any interventions?
I basically want to talk about what you do professionally in terms of your population that you're treating.
Yes.
There are all kinds of things out there.
There are, well, first of all, myofunctional therapy, nursing and weaning.
Even before a kid's born, there's things you can do.
It's called pregnancy wellness, not just pregnancy vitamins and not just yoga, but better sleep
for moms, better breathing for moms.
Right.
But also-
Wouldn't you typically intervene orthodontically?
I want 20 teeth.
That's about two and a half to three years old.
That's in JAMA 1922, that 30 months of age is the ideal time to begin spreading the deciduous
arcs.
But there are obstacles to that.
And one of the greatest obstacles is that most orthodontists do not want to treat.
They don't even want to look at kids until seven years old and much less treat them
until after 10.
It doesn't mean they're all not doing that, but that's the majority because their curriculum
says, we don't really teach behavior guidance of little kids being fearful in a dental setting
because we don't treat them at that age.
That's what the implication is.
We have to demonstrate a huge competence in managing anxiety in children and parents
that are associated with receiving treatments in a novel healthcare setting like a dental
office.
We know how to do that.
Listen, kids are hardwired to want to please their parents and their adult care gives,
especially the moms.
If the parents get it, the kids will do it.
Best kept secret north of us.
So there's a lot you can do.
Why is it 30 months?
Is it because it's been long enough that it's solid enough?
No, why not early?
Two and a half, no, there's things you can do earlier.
But that's when 20 teeth are in.
Okay?
So you can do that really by two and a half or three years old.
Kids have 20 teeth and you can fit an expander in them.
But before that, you can do things like shawty mouth, mild munchy, infant trainers, healthy
start, just mild functional, just by talking to your child and preparing them for something
that's going to be fun.
That is a form of treatment.
You help the parents understand.
This is in the best one and short term health interest of their child.
There's evidence now that, yes, that children who have good self control, which was associated
with good sleep and breathing before 11 years old will live longer than kids who don't.
Before 11 years old, validated metrics were taken on 1,037 babies born in 1973 in Dunedin,
New Zealand and have been followed since for over 15 years.
I know that because my 1973 high school union's coming up.
50 years and a thousand of these kids now adults are being followed.
And those that demonstrated good self control before the age of 11, they managed wealth
better.
There's less criminal and addictive behaviors.
They're more resistant to chronic disease and they've looked 10 years younger.
If you just Google Dunedin study self control, you will find a myriad of information concerning
this expanding a kid and getting them to breathe out some of them meaning to their nose
habitually during sleep and wakefulness.
This portends that they will live longer.
They'll probably live to be 100.
Can't promise that, but minimize risk if you get them sleeping, breathing well.
And they're just going to have a better quality of life.
And there's loads of research already in the public domain in the scientific body that
says just maxillary expansion alone will improve the kids quality of life was much better systemic
health.
And it now from the group from Stanford, Audrey Yoon and company have shown that when you do
transfer expansion that are sadly the transfer sufficient child with or without a cross fight,
you can increase the nasal pharyngeal corridor.
You can help shrink the ad noise, normalize the lymph tissue.
It's published in the journal sleep 2021.
So anyway, so much to be optimistic about.
And that's what I tell parents.
I'm not promising you.
I'm the dental, I'm going to solve the malocclusion to the best of my ability.
And I am going to give you optimism that your child will benefit from this, not just from
a better looking smile.
Oh, they'll get that.
You know, they'll need an invisible line someday.
But they're adult P. This is something we do in early childhood, just like correcting
your side of this.
You don't let it go till they're driving a car.
You don't let a non self-correcting malocclusion go until they have more permanent teeth.
So you're saying it's not really about the teeth, but it's about the cranial facial
structure.
And so just because the adult teeth aren't in, it doesn't mean you shouldn't do orthodontics
because you could change the skull, the skeletal anatomy, even when the baby teeth are there.
Yes, it's the field where the teeth grow.
You know, the field being the alveolar bone and the apical base of the alveolar bone.
That needs to be shaped early.
That needs to be optimized early.
Mother Nature used to do it for us 300,000 years of anatomically modern human existence
without malocclusion.
Go figure.
Then three or 400 years ago, here we go.
That is not genetic.
The genome takes thousands of generations to incorporate a mutation.
This is something that every child born has potential for optimal occlusion of the cranial
facial and interconnected respiratory complexes.
This is really becoming common knowledge, but not enough.
Not enough stuff.
So looking forward to seeing everyone in Houston got lots of information, lots of case studies
to show evidence of what I'm talking about here.
Great.
Well, listen, I want to be respectful of your time.
I know you're with your family skiing, and so I want you to get out, back out on the
slopes.
I really appreciate that you were able to connect with us so we can get the word out there.
I'm honored to be part of your faculty, you guys.
Thanks.
All good.
All right.
See you around like a donut.
Take care.
Bye.
Well, that's great.
Yeah.
So, you know, I think having Dr. Boyd is part of the faculty, clearly you can see as a lot
of energy and a lot of passion for what he does.
But he's leading the pack.
I mean, he's really helping to expand the awareness of what can be done in the pediatric
population.
And so it's really a great thing, but there's other faculty members who cover so many things
in the conference.
We talk about surgical interventions, different things that can be done from an ENT standpoint
to open up the airway.
We're talking about inspired news, the newer methods of treating obstructive sleep apnea.
And also talk about frenulum release, the tongue tie, and things can be done surgically
along those lines.
And maxillofacial surgery, you know, having mandibular, maxillomindibular osteotomies,
bringing the face forward.
And there's some new techniques.
Dr. Alfie's going to be presenting about some new methods where the time it takes to do
the surgery has been drastically reduced and outcomes have really improved with some of
the newer methods to do these more extensive surgical interventions, which as time goes
on, these are going to be done more commonly, but that's to change the structure.
So for the individual where you don't catch it in their infancy, and then now they're
an adult, there are certain things that can be done surgically to try to open up the airway.
And another important thing is we're not just talking about the airway.
We're going to be talking about other types of sleep disorders, narcolepsy, insomnia,
restless leg syndrome.
You know, if someone is a dentist and then they're going to start talking about sleep
disorders to their patients, they're opening up a can of worms, and there's all different
kinds of things that are going to become apparent.
And the dentist needs to know something about these conditions.
Not because they're going to treat it, but they're sensitive enough that they're going
to get the patient locked in or linked into a physician that can handle these other kinds
of medical problems.
But it also strengthens the credibility that the patient has, that the dentist has with
the patient, when the dentist seems to be aware and have some understanding of these
other sleep-related conditions.
And you can't go into dealing with sleep with just a tunnel of vision saying, this is the
only thing.
Every sleep problem is an airway problem, and the way to treat it is with an oral appliance.
I mean, that's not correct.
So the dentist coming to this conference is going to learn, along with physicians, in
the same group.
I would say it's not just dentists because this is one of the things the conference is
doing.
It is a holistic approach because that's one of the things you're rallying for, especially
with pediatrics.
You've got my own functional therapists that are going to be their speech pathologist,
dentist, physicians.
I mean, it's not just dentists that should be attending and learning.
Right?
Right.
It's about collaboration.
And we're working with the AAPMD, American Academy of Physiologic Medicine and Dentistry.
They're integrally involved with this conference.
And their main theme and mission is collaboration cures.
And that's really when I started the Sleep Education Consortium 19 years ago, that was
really the idea that we want to collaborate.
And I was getting chastised by a lot of my physician colleagues and said, why are you
trying to enable the dentist to go out there to do all these things that on their own and
do inappropriate things?
They go, no, that's not the concept here.
The concept here is to, these dentists want to get involved and I'm trying to give them
proper knowledge so they do it correctly.
And what does a dentist do?
They look at the mouth.
Right?
That's the beginning of the airway.
And so one of their patients, so imagine if they start screening for sleep apnea.
I mean, I realized years ago that the dentist can be a great group to collaborate with to
help screen for sleep apnea because they're looking in the mouth of it.
It's the first line of defense, yeah.
Yeah.
And if they knew what they were looking at and they could understand how certain features
are going to increase the likelihood of obstructive breathing during sleep, then they're going
to start referring these patients on to get proper treatment or they'll implement it on
their own.
But really, if they're going to do that, my position is that they should do it in conjunction
with a physician because of all the comorbidities involved.
And it should be really a physician identifying the efficacy of treatment because it's not
just wearing an appliance and it's not just about wearing a CPAP mask.
It's not just about keeping the oxygen level from dropping.
It's about improving overall quality of sleep.
But years ago, when I was on faculty at UCLA, I submitted a grant to the NIH, one of the
sleep education grants submitted it from UCLA.
And about a third to a half of the grant was focused on educating dentists on sleep disorders.
And half the reviewers thought it was a great idea.
They thought I was a genius.
The other half of the reviewers thought I was a misguided physician.
And I really needed to spend more time focusing just on teaching physicians.
Well, here we are now.
This was like in 1996.
Right?
So here we are years later, almost, you know, so where are we with all this?
Right now, sleep dentistry is in vogue.
And to the point where the ADA has now taken on as a statement saying that all dentists
should be screening for sleep apnea.
So music to my ears because I've been saying this for my entire professional career really.
We need to work collaboratively.
Yeah, absolutely.
And you have available for people a free sleep questionnaire, correct?
Yes.
So if you go to the webpage for the Sleep Education Consortium, my practice, which is
Comprehensive Sleep Medicine Associates, we've been using a one-page sleep questionnaire
for 20 years.
And so, and it's really a good overview for taking a sleep history.
Well, basically, we gave this to the Sleep Education Consortium so they could put it
out there and someone could download that questionnaire and start incorporating it to
the practice.
And then coming to the consortium is going to help them understand how to deal with those
responses that a patient is going to fill out on there because there are questions about
unusual behaviors during sleep, parasomnias.
So if someone starts kicking and yelling and screaming in their sleep, what is that?
Could it be REM behavior disorder?
Is it part of a post-traumatic stress disorder?
Is it part of nocturnal seizures?
So again, it's not all breathing.
Someone has uncomfortable sensations in their legs when they're lying in bed still.
I mean, that's a question there.
It pertains to restless leg syndrome.
So the questionnaire, it's available for people to go to the webpage, download, look at it,
incorporate it into your practice, come to the consortium and learn more about it.
Yep.
And we'll put a link to both because there are, there's two sides.
So for the dental track, I'll include the link for that.
And then there's one for the physicians and their staff.
So listeners can take either, either one.
And just, you know, real fast, in your opinion, I mean, how have we missed this?
How has the education so far off on this?
Well, a lot of it's based on the technology and the development of, you know, like when
did we really start understanding more about sleep?
And it says our technology developed.
So when we had like an EEG, when we started measuring brain waves, we started realizing
that when you're asleep, your brain waves have certain characteristics that are different
than when you're awake.
And then looking at other physiologic aspects and REM sleep was recognized, you know.
And so basically in the 1960s is really when a lot of the basic physiology was being identified
and realizing that sleep is divided up into different stages.
But then it's a matter of tying that in with respiration and the identification of obstructive
sleep apnea.
And then so once it was being identified, then what can you do about it?
Well, then CPAP was developed, continuous positive airway pressure, which could make
a drastic improvement in treating patients with obstructive sleep apnea.
So but we basically we've been unable to really assess the sleeping process until relatively
speaking more recently.
Okay.
And as our technology has developed, our understanding is developed.
And now it's a matter of getting the education out there.
And in a medical school environment, there's so much competition for educational real estate,
if you will, you know, there's only a certain amount of time.
And there's everyone, all the faculty, they want to get their topic into the curriculum.
And so, you know, you've got Nobel Prize winners or people that are really passionate
about their very narrow area and they want a lecture on it.
And it's hard to get things incorporated into the into the curriculum.
And if you look at epidemiology and say, well, what are the most common problems?
I mean, insomnia or excessive daytime sleepiness.
I mean, those conditions affect about a third of our society will have some degree of excessive
sleepiness or difficulties with their sleep.
Right.
Third of society, why isn't this taking up more time?
Why isn't this giving more time in our medical education?
And that's because we don't necessarily develop the education curriculum based on the epidemiology.
And so, but it needs to take more of that even nutrition.
We talk about how there's such a lack of education and nutrition in medical schools, but yet
everyone needs.
And so, it's hard to change the curriculum.
And until we change the educational curriculum, physicians aren't going to know.
So if you have a patient that's all excited, they think they have a condition, they're
learning about something, they watch a podcast, they go right to their physician and they
try to get validation of this concept.
And the physician, they don't know.
I'm going to say, oh, no, you know, yeah, don't worry.
Or that happens with dentists a lot of times.
The dentist is going to take a course, be all excited about all the sleep stuff that they've
learned.
And they probably know more than at that point than a lot of physicians.
So they're going to tell their patient, I think you have X, Y and Z.
Right.
They're going to go into your physician and then they don't know.
Right.
And the physician is going to totally discredit what the dentist had just said to that patient.
So then, so it's a problem.
And that's why I think for my, you know, what can I do to contribute part of the solution?
And that's by enhancing the education of the healthcare system, because now I was fortunate
enough to do a fellowship.
After I did my neurology training, I did a fellowship at sleep at Stanford University,
top rated place.
And I was back in 1991 where sleep was when I was the first neurology resident that finished
the program at Washington University that went on to do a fellowship in sleep medicine.
And I remember telling most of my colleagues, you know, that I was going to go and this
was actually 1990 when I finished my residency, when I told them I was going to do a fellowship
in sleep.
A lot of them looked at me like sleep.
What do you mean?
I don't know.
And I mean, I had sort of vision, recognize, you know, I realized this is an upcoming area
because I saw the physiology, the way it all interrelated.
And it was fascinating to me.
But when I was doing my fellowship, I learned certain things.
I said, like, why didn't I learn these things earlier?
They're not that conceptually difficult to understand.
And yet I see the impact that it's having on patients lives.
This should be part of the regular curriculum.
And it's not.
So I'm no longer on a teaching faculty in a teaching institution.
I used to be on faculty at UCLA, but then moved on into private practice, but still
like to teach and help spread the education.
And I'm really happy to what's evolved with the sleep education consortium.
And I have a great panel of other clinicians working with me to educate and hope people
can attend and gain more knowledge and will definitely impact your practice.
Absolutely.
And so again, the dates are April 27th, 28th, 29th.
For the dentist.
Yeah.
And for the physicians, it's the 28th and 29th of April.
And the reason for the differences, the first day is focused specifically for the dentist,
who we talked about appliances.
They're going to, the dentist is going to get a chance to work with appliances.
We go over the oral exam, some of the things that Kevin was talking about.
They learn about how to do digital scanning.
That's a big area now to take a scan of the, instead of doing the impressions, the way
they used to in the molds now, they're done digitally.
So these are parts of the breakout session and learning the importance of making a morning
reposition or any patients going to be on a mandibular advancing dental appliance in
the morning should be in a morning reposition or to bring the job back to help prevent some
of the side effects that can occur from mandibular advancement.
But we even present an appliance.
Dr. Yssefian is going to talk about an appliance that brings a job forward, the mandible forward
without pulling it.
It stimulates the job forward by how it functions the apno dentist.
Interesting.
So, you know, there's a lot covered.
And even the overlap of other conditions, Dr. Andrew Maxwell, he's a pediatric cardiologist
in California that is really a thought leader in the relationship between POTS disorder,
you know, which is autonomic dysfunction, connective tissue disorder, Ehlers-Daniels,
mast cell disorder, and how this relates with obstructive breathing and even narcolepsy.
And there's these patients that are the chronic debilitating conditions and they're so hard
to treat.
And he's really come up with ways of identifying and looking at the progression of this pathology.
And I reached out to him a couple of years ago about participating in this conference
because I was seeing these patients.
And I was, you know, recognizing there's something to relationship between these different conditions
because I'm seeing it over and over again.
And I came across his lecture and it's like, oh, you've got to participate.
And some of these patients I was getting from a Dr. Cheng Rang, who is also going to be
giving a talk in a conference.
And he sees a lot of patients with chronic illness that are being missed elsewhere.
And he's going to be talking about actually using EEG, quantitative EEG as a way of assessing
for hypersonal and markers of sleep deficiencies that are not necessarily been put into standard
practice today, but are good methods of identifying cerebral dysfunction that can occur from sleep
disturbances.
And we're also going to talk about a little bit of overlap about sleep problems and leading
to Alzheimer's and also COVID-19 and the impact it's had on sleep.
So these are some of the other topics that will be covered at the conference.
And I know this conference is specific for clinicians, right, from both sides.
But for parents, just as a takeaway that we could leave for them, how can a parent identify
a potential sleep issue in their child so that they know to go seeing airway physician
or dentist?
Well, you know, does the child have difficulty falling asleep at the beginning of the night?
And then once they're asleep, are they sleeping comfortably or are they tossing and turning
all night long?
Are they mouth breathing?
Are they frequently drooling on the pillow?
Can they hear them grinding or clenching their teeth?
Do they seem congested?
Are they waking up repetitively during the night?
Are they kicking the sheets off the bed?
Are they hard to sleep within the bed because of how much they're moving around?
Are they difficult to wake up in the morning?
And then once awake, are they calm and relaxed?
Or are they bouncing off the wall all day long?
Is the child hyperactive?
Or the child in a car, you strip them in the seatbelt, in the car seat, then you drive
and boom, they're out.
They're asleep.
Hyper, hyper, hyper, or they're out.
One extreme or the other.
And that hyperactivity could be a way of overcoming the excessive sleepiness that they're carrying
around.
And there's a number of things.
So from a parent, you just want to basically see, if your child goes to bed easily, if
it's easy to sort of standardize their schedule and they sleep through the night and they wake
up easily and they seem to be sitting quietly during the day and they're not mouth breathing,
there's not a problem.
But otherwise, it's worth checking out.
Yeah.
Awesome.
All right.
So for all of our dental listeners, it's dentalsleepconference.com.
And for everyone else, it is medicalsleepconference.com.
And we'll put a link in the show notes.
So I appreciate you and Dr. Boyd being on.
Thank you.
Great.
Well, thank you for the opportunity.
So CAF is a great organization in its infancy and really focusing in on children's airways
and children's airway first foundation.
But also some of the aspects of identifying right at birth and what kind of, I know that
one of the missions is to try to implement some maybe future mandate where all neonates
are going to be screened probably for having deficiencies of their airway, which may be
most apparent by difficulties with feeding and issues with breastfeeding go hand in hand
with these airway issues.
It's now starting to be recognized and they'll be covered more at the conference as well.
Awesome.
All right.
Well, thank you very much.
Thank you.
Have a nice day and talk to you soon.
Thanks again to today's guests, Dr. Gerald Simmons and Dr. Kevin Boyd for sharing their
medical insight and information on the upcoming SEC Dental and Medical Sleep Conference.
And thanks to each of you for listening to today's episode.
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And finally, thanks to all the parents and medical professionals out there that are working
hard to help make the lives of kids around the globe just a little bit better.
Take care, stay safe and happy breathing everyone.