Sleep Apnea and Dentistry: Unlocking the Airway Connection with Dr. Casey Jones

Dr. Casey Jones joins me to uncover the fascinating interplay between dentistry and sleep apnea. Her journey from a professional dancer to a devoted dentist is deeply influenced by personal experiences with obstructive sleep apnea, including witnessing her grandfather’s struggles. We promise that you’ll understand how snoring might be more than just nighttime noise and why dentists are crucial allies in identifying and managing sleep apnea. From advancements in treatments like the Inspire device to the intricacies of breathing techniques, Dr. Jones's insights illuminate the path toward better healthcare outcomes.

Our conversation doesn’t stop at sleep apnea. Dr. Jones delves into the importance of comprehensive screenings for oral cancer and airway health in dental practice, challenging the norms of addressing jaw issues and teeth grinding. She shares compelling cases where early intervention made a significant difference, especially in children, advocating for a proactive approach to prevent future health complications. We explore the connections between breathing patterns, dental health, and overall wellness, examining how improper dental appliances might exacerbate sleep problems.

We wrap up with an exploration of breathing techniques that can transform health. From box breathing to myofunctional therapy exercises, Dr. Jones offers practical strategies that enhance not only sleep but also mental and physical well-being. The discussion emphasizes the necessity of collaboration between dental professionals and sleep specialists to ensure holistic patient care. This episode is a treasure trove of knowledge, bridging the gap between dental practice and sleep health to foster better living through understanding and innovation in breathing and wellness.

Ready to connect with Dr. Jones? 

https://inspireddentalwellness.com/

Follow her on Instagram: https://www.instagram.com/drcaseyjones/

Follow her on YouTube: https://www.youtube.com/@dr.caseyjones7564

To learn more about holistic dentistry, check out Dr. Carver's website:

http://carverfamilydentistry.com

To contact Dr. Carver directly, email her at [e-mail]

Want to talk with someone at Dr. Carver's office?  Call her practice: 413-663-7372

Reverse Gum Disease In 6 Weeks! With Dr. Rachaele Carver Online Course!

Learn more about here: https://reversegumdiseaseinsixweeks.info/optinpage

Disclaimer: This podcast is for educational purposes only. Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner. Before using any products mentioned or attempting methods discussed, please speak with a licensed healthcare provider. This podcast disclaims responsibility from any possible adverse reactions associated with products or methods discussed. Opinions from guests are their own, and this podcast does not condone or endorse opinions made by guests. We do not provide guarantees about the guests' qualifications or credibility. This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Episode Transcript

Dr. Carver (00:00):
Welcome back to another episode of the Root of
the Matter.
I am your host, dr RachelCarver, and I am thrilled to
have my friend and colleague ontoday, dr Casey Jones, who's
recently come back to ourwonderful area in Berkshire
County and she has a realexpertise in kind of sleep apnea
, snoring and we've talked alittle bit about this before on

(00:21):
the podcast.
But this is becoming a realissue and I think in dentistry
we have really neglected thisfor a very long time because we
didn't understand and also asdentists, technically we cannot
diagnose sleep apnea, whichseems bizarre since it's all in
the head and neck, which is ourrealm, and so there's a lot of
dentists who have seen this andthere's some amazing foundations

(00:44):
and organizations that reallyteach us a lot about sleep.
But I think you know forpatients to understand that
snoring, although it's common,isn't necessarily normal and
that we shouldn't maybe ignorethat.
So, Dr Jones, thank you so muchfor coming on, and why don't
you tell us a little bit aboutyour story and why you found
this interest?

Dr. Jones (01:05):
in.
First of all, dr Carver, thankyou so much for having me.
I'm super excited to be here.
I think you're amazing andeverything you're doing to raise
awareness is fantastic.
I was thinking about this lastnight for what drove me to be
interested in obstructive sleepapnea and how it connects to
dentistry, and I feel like thatcould be an hour long talk in
and of itself.

(01:25):
I'll try to give some snapshots.
And it wasn't just one thing,it's been lots of things in a
journey along the way.
First of all, in college Ifirst got interested to do
research in obstructive sleepapnea because I would see my
grandpa fall asleep in the chair, stop breathing and then to
wake up, and it has been thatlong that we've really known

(01:46):
about obstructive sleep apnea,so that was my first exposure to
it.
And at first we were doingresearch to try to develop like
a pacemaker for the tongue tostiffen and get out of the
airway, which it's fascinatingthat now exists in Inspire,
which is not something that I do, but it is actually like a
pacemaker for the tongue.
And then later fast forward andI, at the end of my dance

(02:10):
career in New York City, decidedthat I wanted to go back into
research.
So I did research again inobstructive sleep apnea.
They were trying to figure outhow to train the positive airway
pressure machines to calibratethemselves in real time instead
of them having to go back to asleep position.
And amazingly that now existsas well an automatic positive

(02:31):
airway pressure therapy.
So that's fascinating as well.
But I hated it because it wasthe first time that I would go
into work.
I had no people interaction.
I was sitting in front ofcomputers scoring these breaths
and it's great to have thatknowledge of how they're looking
at the things.
That it wasn't for me.
So I went back into dance andthen figured out that I wanted

(02:53):
to be a dentist and I still havecarried this interest and I
guess I gave a talk while I wasin dental school on it, which I
don't even remember doing.
And then later my child wasstruggling because he was still
wetting the bed not wetting thebed but in pull-ups, and no
interest or caring.
That was the case.
His younger sister was out andthere was nothing wrong with him

(03:15):
, but he was restless, sleeping,and it was an airway issue.
And once we put him in themyobrace, within a few nights he
was able to sleep through thenight, dry pull-up, and all of
that can be related.
So that was another touch point.
And then for myself, I've alwaysbeen a dysfunctional breather
and just not known it.
So if I am sleeping on my back,I have moderate sleep apnea and

(03:39):
it can be positional, but Idon't sleep on my back, so I'm
not considered bad enough.
Positional, but I don't sleepon my back, so I'm not
considered bad enough.
And yet I was waking up 3, 4,10 tonight without feeling
rested.
I had asthma as a child,allergies as a child, just so
many different things thatpointed to dysfunctional
breathing, which I believe isthe precursor to obstructive

(03:59):
sleep apnea.
So I, during the pandemic,picked up the books by Patrick
McEwen again Close your Mouth,and then the Oxygen Advantage,
and I was on a jog and I cameback and wrote in my journal
that I wanted to teach the worldto breathe and I thought that
makes no sense, because I'm adentist, there's no codes for
that.

(04:19):
How do you do that that?
And yet I trained with him inthe Oxfamage method and then in
the Buteyko Clinic breathingmethods, and so that's been
several years now and Iincorporate that all the time
because I see so much more decay, more gum disease.
I see so many more systemicissues in these people that are

(04:39):
maybe mouth breathing or maybehave undiagnosed obstructive
sleep apnea, and the way thatyou put it was that we've
ignored this for so long indentistry.
And I don't know if that'sexactly true, because I think
it's such a huge conversationand such a huge area to open up
that if I had anything to fallback on that had been secure in

(05:00):
the last several years, Idefinitely would have jumped
back to the dentistry that I'veknown because it's easier.
But at the time in my journey Iwas in North Carolina and I
moved there right before thepandemic hit, and six months in
I was let go due to a lack ofwork related to the pandemic and
I just ended up filling invarious offices.

(05:21):
I've been in 40 differentoffices working as a dentist.
I've gotten to see and learn alot, but I've also had the time
to get my American Academy ofDental Sleep Medicine.
I've become a diplomat and justreally dove into this and tried
to figure out okay, what isthis?
How do we open theseconversations with patients?
And then how do you get thisinto an already busy disc where

(05:44):
we're looking at so many things.
And now here we have to get toI shouldn't say have to, but we
get to look at another possibleroot cause of everything that's
going on and at least empowerthe patients to make the
decision on if they want toexplore it.

Dr. Carver (06:00):
It's so true and, like the new patient, exam has
gone from half an hour to 45minutes to an hour and a half
because, you're right, there'sso much when you start thinking
about root cause of problems.
We cannot ignore the airway,right, it's right there.
And I was getting frustratedrecently I have had so many
patients come in with jointissues and I was like I, just

(06:22):
like you, I did that DawsonAcademy about eight, nine years
ago and I was like I think Ineed a refresher and I remember,
after finishing that in like2015, I'll never forget the one
story and maybe they told itwhile you were two about how
each of them Dr Dawson first,and then Glenn and then Whit
they all had this one patientand he kept destroying all of
the crowns that they kept andeach dentist was like I can do

(06:44):
it better and I can do it better, yeah, and they would all break
.
And I remember that stuck withme because I was like afterwards
I was like you know what?
That patient had an airwayissue and they didn't realize it
.
That's why he kept breaking it.
It wasn't that their dentistrywas poor, right, it was that

(07:07):
they weren't addressing theairway issue.
So he was really rexing anddestroying all that porcelain
because of an airway issue.
And now so I recently was therea couple of weeks ago, went
down for the TMD and airwaycourse and they know now they
said, yeah, we were missing thishuge piece.
So people who have a lot ofjoint issues, we've got to
screen them for the sleep issues.
And then we've got to thinkabout, okay, if there is an

(07:28):
issue with sleep, we need toaddress that before we can fix
the joint issue.
And then it's interesting andwe'll probably get into it right
.
I like the way they divided it.
So do we manage the airwayproblem or do we resolve the
airway problem?
And those are two differentthings.
And again, that really dependson that conversation with the
patient and what they're willingto do.

(07:49):
We've talked about this on thepodcast with other doctors our
other colleague Ballinger whenwe catch them when they're
little, right, she's apedodontist and that's where she
loves to live and she wants tosee them before age six, right,
because if we get them at theearliest stage, we can prevent
all of this sleep apnea and allthese joint issues, which is

(08:09):
amazing.
But once we get to adulthood,the thought of wearing all these
expanders and all these crazythings.
Some patients are like I just Idon't want to go through that.
So then those are.
The patients were like okay,then we're going to go
management, but, like you said,it's, how do you start talking
about this?
So one of the goals of thepodcast is to create awareness,

(08:30):
because I want patients to betheir own best doctor or dentist
, whatever it may be, so that ifyou are a snorer or you've been
diagnosed with sleep apnea,maybe you hate your CPAP right,
that's still the gold standard.
Many people cannot toleratethat, so they just live with the
sleep apnea.
People cannot tolerate that, sothey just live with the sleep
apnea right, which we know leadsto so many chronic issues.
So we've got to start creatingmore awareness among dentists.

(08:51):
And again, it's hard to doeverything in dentistry.
As a general dentist, you gotto be able to pick and choose.
You can't be the expert ineverything, and so it's nice to
have colleagues like you and theendodontist and Dr Brown, like
all these people who I say I doknow a lot, but I can't be the
expert in everything.
I'm so happy that you're backin the area and you're taking

(09:12):
this on.
So tell me a little bit.
If a patient comes to you, howare you screening them for any
sleep issues?

Dr. Jones (09:18):
Yes, yes.
So essentially I've developedwhat I call an oral cancer and
airway screening, because I wasalways looking at the airway
when I was doing the oral cancerscreening anyway.
So I start with them sitting upand I basically just have them
open their mouth and I look andwe have what we call a Malampati
or Freeman score.
They're both very similar.
But I'm essentially looking atis there much space between

(09:39):
their tongue and the roof of themouth when they're awake?
And if there isn't, then theyhave a small airway to begin
with, and that airway cancollapse even more when they
fall asleep.
So that's one thing where theycan just be high risk.
Simply from how they're built,that airway can collapse.
There's no bony structure tohold the airway open.
Aside from that, I may see abig tongue when they open.

(10:00):
If their tongue goes all theway over their teeth, then
they've got a big car in a verysmall garage and you'll often
see the scalloping.
It almost looks like thepinking shears went around the
tongue and that's the tonguepushing out to try to get out of
the airway, but there isn'troom.
I often see acid erosion on theteeth because there's reflux.

(10:21):
They're trying to breathe andthat acid will get pushed up.
I see a lot of wear becauseoftentimes they're trying to
open up the airway, or thebody's super smart and its goal
is to keep you alive, and inorder to do that it will either
wake you up to breathe or it maytry to even just do CPR at
night and bring that job forward.
But if it's constantly comingforward and the teeth get in the

(10:41):
way, we'll see lots of wear.
And so people may not be awareof the grinding, they may not be
aware of waking up, becausesometimes the body just wakes
that person up enough to be ableto breathe and then they fall
back asleep, and so it nevergets into that restful sleep,
into the REM that we need.
And it's such a huge puzzlebecause it's not always just

(11:02):
here.
It might be here.
They may have difficultybreathing through their nose,
they may not breathe throughtheir nose, and so their mouth
may be open while they'resleeping.
If their mouth is open whilethey're sleeping, it's going to
close off the airway even more,because the jaw goes back, and
so if you're breathing that way,you're also breathing more air
in.
So if you imagine drinkingthrough a straw and you suck

(11:25):
really hard, it's going tocollapse, whereas if you're more
gentle in how you're suckingthrough that straw, it's going
to stay open.
Same thing happens when we'rebreathing through our mouth.
If we're breathing a lot of airin an airway that is prone to
collapsing is going to be morelikely to collapse than someone
who's maybe breathing gentlythrough their nose, and that
airway can stay open.
Not to mention that breathingthrough our nose helps to use

(11:50):
our diaphragm, which helpedairway open.
There's so many pieces to it andthat's what's so fascinating to
me.
When you brought up the jawjoint issues you're bringing up
so many good things.
Yes, we see a lot of jointissues in people who are also
suffering from obstructive sleepapnea.
Some of that's the grinding,some of it can be other things,
and sometimes it's a chickenbefore the egg.
Which one happened first.

(12:11):
But if we put oftentimes if weput a traditional appliance in
the mouth in order to treat justthe grinding of the teeth and
protect the teeth, usually thegoal of that is to relax the jaw
, which then causes the jaw tofall back more and that's going
to close off the airway evenmore.
So when someone who does haveundiagnosed obstructive sleep

(12:33):
apnea, trying to help to protecttheir teeth can actually make
it worse for their breathing,and so it's really.
I think one of the questionsthat you asked me when I was
looking to prepare for this isshould everyone have a sleep
study?
And I don't know if everyoneshould, but I do think it should
be a lot more common than it is.
I had a patient the other daywhere I just saw her for one of

(12:56):
her well visits.
I came in to do the exam and Istarted doing my oral cancer and
airway screening.
I'm also doing all this stuff.
And I start saying has anyoneever told you that you snore?
And she said we've already hadthis conversation.
You did this last time.
And I said I know I do it everytime.
And she said no, but I had thesleep study done and I had
moderate to severe obstructivesleep apnea and she had no idea

(13:17):
it's this fit female.
She, her physician, didn't know.
And you bring up that if we canget to these children when
they're six or younger, then wecan make changes in how they
grow.
But because I was one that wasstruggling, I believe there's

(13:40):
hope and I think there's alwayssomething that you can do, and
so we both did the DawsonAcademy training, and one of the
biggest things I took out ofthat is the Wydium rule.
Would I do it on myself?
And so I always will try it onmyself.
So, whether that is, I'vetrained in the homeoblock.
I've trained in the Somaappliance.
I am currently in some clearaligners right here I'm my own

(14:05):
puzzle, trying to figure it out,trying to figure out what is
the best way to do this.
I've gone through the trainingto have functional breathing.
I then realized that if I'mteaching breathing, I can't not
teach myofunctional therapy.
So then I trained inmyofunctional therapy and I will
often see a patient and justgive them, you know, maybe three
exercises in order to start toraise the awareness on their

(14:28):
tongue.
I've put videos on our websiteunder patient resources to try
to give some resources so thatpeople can go away and educate
themselves and then come back tome with questions and figure
out do they want to continuethis conversation?
Because it takes a lot of timeand it takes a lot to figure out
and no one's the same.

Dr. Carver (14:49):
Yeah, what you bring up is such an important point
for any dentist who may belistening to this.
You know we were taught weweren't taught much about joint
issues or nothing really aboutairway at all in dental school
and but we were taught to makeguards Right.
If there's grinding, just throwa guard.
So you make a really importantpoint that I think needs

(15:09):
reiterating that when we seewhere we really need to
understand, why is there wherethat's my biggest thing always
why?
Because if we really don'tunderstand where it's coming
from, not only could we not behelping, we could be making
matters worse.
So I think this was fascinatingwhen I learned this years ago
that, oh my gosh, these guardscould actually be increasing

(15:31):
sleep problems Because, again,if they're really slippery and
the teeth are able to slidearound, yes, we could be causing
that airway to fall back.
So that's why it was great inthe course I just took that when
we see somebody with a jointissue or were that, we need to
screen for the airway first,because, again, we don't want to
just make.
There are lots of differentkinds of splints that you can

(15:51):
make.
So it's really again importantIs this a TMD patient with
airway or a TMD without Becauseyou're going to treat them
differently.
And so, again, having thatawareness of what exactly is the
issue, right?
So do we need a device thatholds the jaw forward, versus
just something that is, ifthey're not an airway case, then
we can make something like a Bsplint, which is a typical guard

(16:14):
that just has even contacts allaround and the idea of that is
to stop take the pressure offall those muscles.
Again, it's really important todo this thorough evaluation,
because worn teeth is one thing,but not being able to breathe
is a whole other issue.
You talked a lot about themouth breathing, right, and if
we are mouth breathing and we'rein that sympathetic nervous

(16:36):
system all the time, it shutsdown our digestion, which
impacts our immunity.
It's a really big deal.
I thought it was interestingMaybe you can elaborate a little
bit when you said like asthma,so some things in childhood
might be a precursor to sleepapnea.
We certainly know thatteenagers who got their teeth
extracted to have straight teeth, all of those people end up

(16:58):
with sleep apnea, right?
Because when it used to be, wecalled it four on the floor oh
there's crowding, let's justtake the teeth out.
And then what happened?
They shoved everything back, soeverybody with that.
Unfortunately, their teeth maybe straight.
A lot of them not, though,right, because we didn't really
address the whole issue.
Tell me a little bit about that, the precursor.
I'm interested to learn moreabout that.

Dr. Jones (17:20):
Yeah, so, like I said , dysfunctional breathing can
look like a lot of things, so itcould be for me.
I did have asthma, I did haveallergies, so for me that meant
that I was.
I didn't realize that I was bad, but I would be breathing
through my mouth and you canbreathe through your nose, you
can retrain it, you can do that.
I guess a lot of times I'msaying that we can fix the
structure.
But just because we fixsomething and it may not be we,

(17:43):
it might be an ENT that doesnasal fixes, the structure of
the nose, for example but if youdon't address what's causing
that problem to begin with, thennothing's going to change.
So I guess with asthma, what Iwould say is that I was on
medications and I had sometimesexercise induced a lot of
allergies as a child.
I did have allergy shots as achild and stuff.

(18:04):
So it helped to address mybreathing, but I didn't realize
that I was still.
You can be breathing up in yourchest a lot, so I wasn't
necessarily breathing down deepenough to be able to be using my
diaphragm, and that can berelated to anxiety as well and
going off on a tangent.
But when we don't breathethrough our nose, we don't get

(18:27):
to use the nitric oxide that weproduce naturally in our sinuses
, which does so many cool things, including disinfecting the air
.
It's been shown to fight thevirus that causes COVID.
But if we're not breathingthrough our nose, we don't get
the benefit of all the wonderfulthings that our nose does.
Nitric oxide being produced inour sinuses is just one of those

(18:48):
things.
But if I was so stuffy that Iwasn't able to use my nose, then
I was sick more often and I wassick a lot and that affected my
breathing.
I was the child that was messysheets everywhere and I would
wake up in the middle of night.
I would go into my parents'room.
I couldn't sleep.
I would sleep on the groundjust so that I could fall asleep
again.
There's a picture of me on mybed with one leg down even

(19:17):
because that's how much I hadmoved around in my bed.
So I think that it washappening all throughout my life
and again, I'm not that bad, soyou wouldn't think of it and
I've always been fit.
I've been a dancer.
But sometimes even in the peoplethat exercise, it could be as
simple as you're not breathing.
When you breathe in, you wantto expand like a jellyfish and
then, when you breathe out,everything collapses.
And if you're constantlyholding your core, you're not

(19:38):
ever going to be able to beusing the diaphragm in the way
that you want to.
So again, so many pieces of thepuzzle, but yawning can be a
sign of over-breathing Sighingfrequently.
There's ways that the body willtrick us into breathing more air
than we need to, and it's sointeresting.
Just like anything or a lot ofthings, right now we are

(20:00):
overdoing it.
So, whether we're overeating,whether we're over breathing,
you actually can learn tobreathe less.
And if you breathe less, youcan breathe more efficiently.
And as you breathe moreefficiently, you will start to
breathe better at night as well,because if you're breathing
badly during the day, absolutelygoing to be breathing badly.

(20:20):
And so if we can address thebreathing along with the other
stuff, sure, I'm going torecommend the positive airway
pressure therapy, I'm going torecommend the appliance, we're
going to do the things to helpyou be able to breathe, but
we're also going to need to fixthat root cause.
If you're willing Not everyoneis but if you're willing to do
the myofluxial therapy and thebreath-free training along with
all of that.

(20:41):
I try to incorporate that intoevery appliance that I do.
I give them morning exerciseswhen they do their AM aligner to
try to prevent jaw changes,teeth changes, bite changes, all
of that.
We are trying to minimize anyside effects but ultimately we
want you to be able to breathe.

Dr. Carver (20:59):
That's really important and I've recently
really discovered that too.
Before I was thinking sleepapnea, we'd look in the mouth
and looking at the structures.
Oh yeah, we're doing a CBCT, a3D x-ray.
You could see whoa, that airwayis so narrow.
But I started to realize themore I would do these 3D x-ray.
You could see whoa that airwayis so narrow.
But I started to realize themore I would do these 3D x-rays.
I was like, wow, some patientshave a huge airway yet they have
sleep apnea or vice versa, thenarrow airway.

(21:22):
And then I was doing a lot of mylaser training.
One of the reasons you can havethe airway obstruction rise,
the soft palate collapses.
Sometimes you see the uvulareally stretchy.
So the laser is a greatnon-invasive way to go in there
and help stimulate the collagento pull that up.
But it made me think, okay,this is good, but there's more
to it than just the structure.

(21:43):
Because then I would see apatient who's yes, I want to do
the laser, and I'd look at theirthroat, their soft palate
looked beautiful.
There was no stretching of theuvula and I would think is this
really a structural issue?
And then I was like I thinkthis is more breathing issue,
and so I started doing moreresearch too, and it was like
started having all of mypatients who if they get the
laser, then they also get allthe breath training Right, and

(22:04):
like there's great YouTubevideos.
You have amazing resourceswhich we'll link to at the end
here and in the show notes.
But so, right, and I was reallyinterested in my breathing
because I was like, oh man, Ifeel when, at the end of the day
, I'll be driving home and I'myawning like crazy or sighing,
and so I was like I think I'mnot breathing properly,
especially when we're at work,we're concentrating so hard and

(22:24):
I hold my breath my husbandwould say I'd hold my breath at
night sometimes too and so I wasable to find this little device
called OXA, which now they'vesold company, so I don't know if
you can get this anymore, butit was like a little breathing
belt and I started wearing itduring the day and ideally right
, according to the experts,right, we want to breathe about
six to 10 breaths a minute.
I was breathing 17.

(22:45):
I was like, no wonder I'mexhausted when I'm, when, maybe
why I snore more often, and soit's fascinating.
And so now during the day, likeyou said you have to do it
during the day.
Right, the more that we canlearn how to breathe properly
during the day, the better we'llsleep at night.
Because I was looking at myselfin the middle of my workday but
then, even at night, I was like,oh, I'm still breathing a lot
and I notice when I track it,when I start breathing better

(23:08):
during the day and I practice,I'm getting better and better at
night, which is so important.
Right, because we need to getinto those deeper parts of sleep
, like REM and deep sleep, if wewant our body to be able to
repair and heal from all thenonsense that is in our life all
day long.
I think this is a reallyimportant part to the sleep

(23:28):
picture.
We've got to make sure we'rebreathing properly, training the
tongue properly, because againwe've got to, these devices are
great and they're helping, butagain they're managing and
ideally, we want more resolution.
So when we can stack, whenbiohacking they always talk
about stacking things.
So this is what I think we'restacking the deck, we're doing

(23:49):
anything.
The physical stuff, thebreathing stuff, all of these
combined are going to give usthe biggest bang for our buck.

Dr. Jones (23:57):
Yeah, and I think it's so many good things.
You're saying.
Atomic Habits, I think, is abook that I love that talks
about putting habits with otherthings.
You're already doing so asdentists.
I think there's so many thingsthat put us at risk for
dysfunctional breathing or maybeeven obstructive sleep apnea
Because we're talking all day.
That's part of our profession,right, and that is a form of
over-breathing.

(24:18):
You can't avoid it.
But it does affect how we'rebreathing, how much air we're
giving out, taking in all ofthat, and so it's resetting that
throughout the day, doingthings at night to help with
that.
Some of it you can't avoid.
In addition, our posture isconstantly looking down.
There's cool loops now you canuse.
I haven't dove into those yetbut with with having that

(24:39):
posture, I would notice thatduring certain things I would
start to really concentrate andI would open my mouth and push
my tongue towards a certaintooth for some reason, and every
time I did that I would end theday with a headache and I
realized that I was switching tomouth breathing.
I was was changing my pattern,and as soon as I recognized that
and switched that, it helpedtremendously, because posture is

(25:01):
also related to breathing, andI've started training with the
Postural Restoration Institute.
That's amazing.
I didn't even know that therewas pelvic floor therapy.
I did some of that because thatalso helped me to be able to
breathe with my diaphragm.
There's so many practitioners,so many pieces that can help put
this together, and that's whatI love to do is collaborate and

(25:24):
figure out what are those pieces.
So when I do my intake fordoing a sleep appliance, for
example, I'm also looking at thenose.
So I will ask people to inhaleand see do their nostrils close
when they do that?
Because if this is closing offevery time you breathe in, then
that's going to be your limitingduring, and you could try
something like a mute nasaldilator.

(25:44):
Or some patients love this newproduct called Hale.
I think there's a few differenttypes of it, but you could try
something reversible, even abreathe right strip, to see if
opening up your nose is going tohelp to.
You know, open up the airwayand be able to breathe.
It could be a piece.
I'm not going to fix your noseas far as the structure, but if
that's something that needs tobe addressed, let's try

(26:04):
something that's reversiblefirst.
Same thing with the appliancelet's try something.
I'm always of the stand of.
Let's try something that weknow that we can just take out
and reverse and then figure outif that's going to work for you
before we jump into surgery andother things.
So let's get you as well as wecan with myofunctional therapy,
with breath retraining, all ofthose things that, if you want
to take that into your hands andempower yourself to become

(26:27):
healthier, I'd love to partnerwith you.
There's just so many pieces toit and we'll even like test.
Do you have trouble breathingthrough your nose and then I'll
treat, I'll teach the naturalnose clearing exercise that
Patrick McEwen does, where youtake a normal breath in and a
normal breath out of your nose.
You pinch your nose and yougently nod your head up and down
as many times as you can,holding your breath after you

(26:48):
breathe out, and then, as soonas you have to take a breath,
like you've been swimming aslong as you can, then you're
going to let go and breathethrough your nose and if that
makes you feel less stuffy whenyou do it, then you can do that
as many times as you want,because that will help train you
to have that airway open, beable to breathe through your
nose.
And the more you can breathethrough your nose, the easier it
becomes to breathe through yournose.

(27:10):
There's rebound stuffiness.
If you don't use it you lose it.
And if you can breathe throughyour nose, it depends on who you
ask.
But if you can breathe throughyour nose for a minute, you can
breathe through your nose forlife.
Other people say three minutesfor life.
But either way, we want to makesure that nose isn't obstructed
, because there are ways to takethe mouth closed at night.

(27:30):
We haven't even talked aboutthat and sometimes that will
help people to stop snoring,because if you snore through
your nose then if you breathemore lightly you can't make that
same noise, but if you'rebreathing through your mouth and
you close your mouth, you can'tmake that noise, and so for
some people, just closing themouth will actually make more

(27:54):
room in that airway, because nowit's not closing it off, and so
there are so many differentways to do it and I'm always
cautious about telling anyone todo it.
You can always try it duringthe day.
But Patrick McKeon developedMyoTape, which does go around
the lips, so there's nothing toactually keep you from opening.
Great way to start.
You can take a little bit ofMicropore tape and put it this
way so you could still breatheout of the sides if you needed

(28:16):
to.
I do it every single night.
I'm not saying that people needto do this, because it's very
important that you be able tobreathe through your nose.
You don't want to be nauseous.
Obviously you don't drinkbefore.
There's so many things that aspractitioners, we need to be
careful, just recommending thatto everyone.
So you want to make sure thatyou can breathe through your
nose, but it's been as simple asthat for some patients I had

(28:37):
yesterday and she was like, ohmy gosh taping.

Dr. Carver (28:39):
What a difference she's.
I can't believe it is so simple, it's great.
But I also warn them.
I'm like don't do this at night, like I did when I first
started.
I would start ripping it off inthe middle of the night because
I was not used to and I wasusing the micropore.
It wasn't like it was duct tape, but my brain was not used to
breathing through my nose at alland I felt suffocating.
So now I always tell peoplealways do it during the day

(29:00):
first.
Okay, just let your brainunderstand that you're safe and
that you can breathe throughyour nose before you start just
putting it on before bed.
That's you know people whoaren't used to it.
It feels different, but it is.
That's an amazing, just likeyou said, we try these babies,
that we're going to try thesethings first, right Before we go
to the bigger surgery.
We want to see does this makeyou better?

(29:22):
And now the sleep studies.
They're not what I just learnedin the course a couple of weeks
ago.
The one drawback with a sleepstudy is it can be expensive and
it's only one night.
So if for one reason, the nightyou did it, you did something
out of the ordinary, it mightskew the results right.
So when I'm giving them now, Isay, okay, do it in midweek,
when you're in your routine,don't do it on a Friday or

(29:43):
Saturday or on vacation.
But now there's something calledthe sleep sat pulse oximeter,
which is a little bit fancierthan the ones they can buy in
the store.
Which is a little bit fancierthan the ones they can buy in
the store, but it gives an ideaof what the AHI, or the apnea
hypoxia index, is.
That's what we usually look forat a sleep site to determine if
you're mild, moderate or severe.

(30:04):
But it shows, like, how oftenyour oxygen levels are dropping
and how severe the drop is, andthat with that because it's much
less expensive you can do thatmaybe over three nights or
something like that and that maybe more repeatable versus
always doing a $200 test.
It's amazing, all of thewearables and everything we have
nowadays.
We're really coming into an agewhere we can be our best.

(30:26):
We have so much data that we'reable to.
There's so many.
All the Apple watches and thewhoop and the all the different
things are so great.
Can you maybe tell us aboutsleep a little bit?
What would be ideal sleep?
Maybe talking about like thedifferent phases and why we need
to have those phases?

Dr. Jones (30:46):
Yeah, so I guess in layman terms there's different
parts of sleep that do differentthings.
And in people who do sufferfrom sleep disorder breathing
I've had it explained to me asalmost like junk sleep, so just
like you eat junk food.
Some people are sleeping eightto 10 hours a night, but if
they're constantly in this lightsort of sleep then they're
never going to get that restfulsleep that they need.

(31:08):
Rem is the rapid eye movementsleep.
That's not a lot of your nightof sleep, but that is the time
when things start to clearthemselves out.
That's when you're dreaming,everything is really relaxed and
that's on purpose, becausethere is a disorder where you
will act out your dreams andthat can be dangerous.
But because everything is sorelaxed and you're almost

(31:31):
paralyzed, that's going to bewhen it's more likely that
people's airway will collapse,if it's going to collapse.
And so those who are strugglingwith untreated obstructive
sleep apnea, a lot of times whatwill happen is they'll start to
enter into that REM sleep wherea lot of things clear out.
It helps with Alzheimer's, allthat sort of stuff.
Memory gets integrated and ifwe don't get into that then we

(31:55):
will wake up and so you're notgetting that restorative sleep
that you need.
So I unfortunately I can'tremember off the top of my head
I should have studied this foryou exactly how much time we
should have in all of theseparts of sleep, but I will say
that a lot of people don'tunderstand what it is that we're
looking for.
So you mentioned the AHI, solet's talk about that.

(32:17):
What we're looking at in sleepstudies, ahi stands for apnea
hypopnea index.
Apnea means that you literallystop breathing for 10 seconds or
more.
Hypopnea means that you'reessentially breathing badly for
10 seconds or more.
It is the benchmark, I believeis about 30% less of a breath,
and it's a measure of how manytimes you're either stopping

(32:40):
breathing or breathing badly perhour, though, and so for people
who have mild or stage oneobstructive sleep apnea, that
means that you're stoppingbreathing 5 to 15 times per hour
.
Breathing five to 15 times perhour, so that's every four to 12
minutes that you're strugglingto breathe in some way.

(33:00):
And then if you go up to higherso moderate would be 15 to 30,
which is like stage two, andthen severe would be 30 plus.
So if you're struggling 30times an hour, that's every
couple minutes that you'rereally having difficulty
breathing, so you can imaginehow hard that would be to get
that restful sleep, andsometimes people who are

(33:23):
struggling to sleep haveinsomnia, maybe have trouble
falling back to sleep Again.
Your body is super smart andthe goal is to keep you alive,
and so if it knows that when youfall asleep you're going to
essentially be suffocated,strangled, or at least that's
how it's interpreting it, andwhy would it let you fall asleep
?
It's going to keep you awake inone way or another, and so that

(33:45):
can be waking up to go to thebathroom, waking up frequently.
Your body is never getting intothat rest and digest, and so
people will say I don't sleepbecause I'm getting up to go to
the bathroom.
Are you getting up to go to thebathroom?

Dr. Carver (33:57):
Like which one is coming first.
When we are not, we're moremouth breathing and not sleeping
properly.
We don't activate thatanti-diuretic hormone, right?
So men will say I'm at that age, it's my prostate, it's airway.
My hygienist, her husband,never gets up in the middle Once
he started mouth taping, nevergets up to go to the bathroom in
the middle of the night.
So we've got to get away fromthis myth that it's all about

(34:17):
the prostate, that really it'smore about airway, right?
Because again, there is anactual hormone that's secreted
when we're sleeping that says,hey, bladder, kidneys, we're
good, we don't need to pee rightnow, wait till we wake up,
right?
So we should not be getting upin the middle of the night.
And to circle back to the REMand the deep, ideally we should
get about an hour and a half ofboth REM and the deep sleep, or

(34:38):
about 30% of our total sleep ofthose kind of things, and that's
again necessary, right?
The REM is when, like you said,that memory integration, that's
when we're dreaming.
So people who don't ever dream,you're probably not getting
into that REM.
And then the deep sleep that iswhen we everything's getting
repaired, we're not dreaming,we're just, we're completely out
.
And again, very important forclearing all this stuff.

(35:00):
Like you mentioned the brain,like we've discovered this whole
lymphatic system in the brainand if you're not getting into
deep sleep you're not draining.
So then all the toxins orwhatever that may be in the
brain, could they be causingsome of the plaques forming and
all that kind of stuff?
Again, those stages of sleepare important and if you've got
that severe apnea you're nevergetting into those and of course

(35:22):
you wake up feeling exhaustedand sluggish and you're having
cardiac issues.
Right, if you're not breathing,you're not getting that oxygen
right throughout the system,you're not oxidating anywhere in
your body.
We know how vital oxygen is.
So if we're not having thatproper and the other thing
that's interesting about oxygen,it's that balance with the

(35:42):
carbon dioxide- yes that's whatI was just going to say.

Dr. Jones (35:46):
Yeah, so people think of carbon dioxide as a waste
gas.
But in order to use the oxygenthat we have, most of us are
breathing plenty of it, but itgets stored in the hemoglobin
and if we don't have carbondioxide to replace that and
release the oxygen to then go tothe places that it needs, then
we're not going to get to usethe oxygen that we have.

(36:06):
Same thing, if we're breathingreally up in our chest and it's
rapid and it's here, we don'thave anything to do.
Gas exchange Everything in ourlungs is located further down.
So if we breathe more deeplyand more slowly, we're going to
be much more efficient at usingthe air that we have, because we
can be working so, so hard tobreathe, but we're not getting

(36:28):
the benefits of it.
And if we're breathing up inour chest you were talking about
blood pressure, things likethat, even digestion that can be
related to dysfunctionalbreathing, because the diaphragm
does so many more things thanjust breathing.
It is this really cool muscle.
That is somewhat automatic, butyou can control how you breathe
as well.
You can retrain yourself in themechanics of breathing and when

(36:51):
you do use it it actuallymassages all of those organs.
We need that movement of it.
It helps with digestion.
There's so many cool things.
It helps with posture.
So a lot of people who arestruggling with back pain it can
be related to the breathing aswell, and I am one who also,
along with my dysfunctionalbreathing as a former dancer, I

(37:13):
have some chronic injuries orthings.
Being a dentist, posture, allthose sorts of things.
I've had back pain in the pastand one of the times that
triggered I still had to work afull day Like what do I do with
this?
And I just got down andsquatted and started breathing
with my diaphragm and thatbreathing alone was able to

(37:34):
start to release, not that itessentially just triggered,
which that's a whole otherconversation too, because
emotions and all of that canalso trigger some of those
things.

Dr. Carver (37:45):
But that's important , like we've had people on
talking about.
We had Alina Canron who talkedabout the postural restoration,
talks about the fascia right,people with hiatal hernia and
reflux.
Well, what's your breathinglike?
What is your diaphragm doing?
Because usually it's like whenthat pushes up through the
diaphragms, how do we get thatdiaphragm in better shape and
breathing properly?
So important.
And it's talking about thatcarbon too, right?

(38:07):
That's why a lot of breathtraining is having a longer
exhalation, right, because thatallows that carbon dioxide to
build up a little bit so that werelease the oxygen.
So that's a really importantthing to understand.
It's not just about breathingair, it's like you have to.
And breathing is the fastestway to get in the proper acid
alkaline balance in the body,right.

(38:28):
It's the fastest way to getinto a balanced nervous system
and the cool thing is like yourbreath is totally free.

Dr. Jones (38:37):
And you can control it.
Thankfully it's automatic.
You don't have to think okay,today I'm going to breathe, but
at the same time you can bringawareness to it and you can
control it.
And oftentimes, when there'sthese simple breathing exercises
that you can do to resetyourself, like small breath
holds or whatever you choose todo, whether it's cadence
breathing, there's so manydifferent ways that you can

(38:57):
breathe and lots of them havegreat benefits, but most people
don't know you're doing them, soyou can do them in the middle
of a workday.
There's so many.
Every profession Dentistry maybeit's a difficult procedure,
maybe it is a patient that'supset, for whatever reason.
There's a lot of fear indentistry and that can affect
their perception of things goingon.

(39:18):
So I've been known to, when I'mgiving anesthetic, so many
things to try to make themcomfortable in that process.
But I've also learned I don'ttell them to take a deep breath,
I just tell them to exhaleslowly as I'm doing it, because
if they go, that's going tomimic that anxiety feeling and
they're going to be really as Ido it, whereas if they're just

(39:39):
breathing normally and slowlybreathing out if I sense that
they're anxious about it, thenthat's really helpful and
something that you can use as atool anytime.

Dr. Carver (39:50):
Speaking of things, a lot of that in the fast, rapid
breath rate contributesdirectly to the anxiety.
So is there a particulartechnique for if you're anxious,
whether it's right before adental procedure or before a
test or something, any kind ofenvironment that gives you a
little anxiety what do you findis the best technique for
reducing anxiety.

Dr. Jones (40:10):
Yeah, my favorite and simplest one, because you don't
have to think about how you'rebreathing or anything is just
small breath holds, and so howyou do it is you usually want to
ask people to hold their breath.
It's after the exhale, which isdifferent than most things, but
you just take a normal breathin and a normal breath out of
your nose and then you hold yourbreath to pinch your nose, but

(40:30):
you can if you want but you holdyour breath for three to five
seconds and then you just let gobreathe normally.
You don't have to do anythingabout and alter any way that
you're breathing.
You don't have to slow itwhatever.
Just breathe through your nose,if you can, and then breathe
normally for 10 to 15 secondsand then repeat.
So, normal breath in, normalbreath out, hold it for three,
two, one, and then you justbreathe normally for 10 to 15

(40:54):
seconds, and then you just woulddo it again, where you take a
normal breath in, normal breathout, and if you do that for
about a minute, usually it'llhelp you reset and what you're
doing is you're actually it'ssimilar to where you're
prolonging that exhale right,because you're stopping the
breathing, you're slowing itdown, you're putting a pause

(41:14):
button on that rapid breathingthat you're having, and that
will often just relax people.
You can also use box breathing.
That's super, super simple.
It balances both thesympathetic and the
parasympathetic nervous systems.
It's been used for ages.
It's supposed to make you calmand alert at the same time, and
the way that you do it is youjust breathe in for four counts.

(41:35):
So you breathe in two, three,four, hold your breath two,
three, four.
Exhale two, three, four.
Hold your breath two, breathtwo, three, four, and then you
just keep repeating that andthat will help to balance things
.
But I also learned there is I'mthrowing a lot at you, but

(41:58):
sunrise and sunset breathing, soif you want to be more alert,
you can stay in that sunrise ortop part of it more.
So you would breathe in forfour, you would hold it for four
, exhale for four and then justgo.
You don't hold it, you just in.
And if you are trying to calmyourself down at the end of the
night, you could basicallybreathe in for four, exhale for

(42:21):
four, hold it for four, inhalefor four, exhale for four, hold
it for four, and that puts youin that part where you're in
exhale mode for longer.

Dr. Carver (42:31):
Yeah, so many ways prolonging the exhale but it's a
journey, what you're doing, sothat's not embarrassing for any
reason, and so those areabsolutely great techniques.
And again, your body is reallyagile, right, it wants to heal
and help you with practice, andfive to 10 minutes a day, it
doesn't take a whole lot.
And how about some other teachus a little bit?

(42:53):
We've had myofunctional therapyon, but it's always good to
refresh our memory.
Maybe give us like three goodexercises that you think are the
most helpful to retrain thattongue, maybe?

Dr. Jones (43:04):
Yeah, yeah, my favorite three to start with,
and you mentioned fascia.
So sometimes there literally isa tongue tie that's preventing
that tongue from going up to theroof of the mouth where we want
it and there are somerestrictions that sometimes
people have just never had it.
And having an open mouthposture with that tongue low can
be as bad as breathing throughyour mouth, because some people

(43:25):
are breathing through their nosebut their mouth constantly like
this, and that's going toaffect things as well,
especially if it's a child.
So the three go-to that I willteach are to take your tip of
your tongue, start right behindyour teeth, a thing called the
incisive papilla.
It's a little bump and you'regoing to trace your tongue from
right behind your teeth as farback as you can, and I usually

(43:45):
say to do that 20 times.
So for people who haven't had itup there, I often will hear
them say it tickles.
That's how the body interpretsthat sensation if it's never had
that before.
So you just would go like thisand you can see how this is
going down and it doesn't reallymatter how far open you are,
but it is good to try not tomove the jaw.

(44:08):
At the same time we're tryingto separate the tongues from the
jaw.
So doing that 20 times.
One of my favorites supersimple, I would say it's like a
typewriter and younger kids maynot know what that is, but
people always ask do I trace itforward and back?
No, you reset, trace it, reset,trace it.
So that's one.
The next one I love is doingtongue circles, and so you would

(44:29):
basically put your tonguebetween your lips and your teeth
and make a circle, and I do 10times each direction to start.
So it would look like this soher lips are closed.

Dr. Carver (44:40):
Anybody who's listening.
Her lips are closed and she'sjust rotating that tongue around
the whole side.
So it's like a face yoga thingtoo.

Dr. Jones (44:46):
It is.
And so you're just drawing thatcircle, trying to be
intentional with all the corners.
You go the other direction, andthat's the one where usually
people are like, oh, my tongue'stired, or they may feel it in
their jaw, or I actually feel itall the way in the back of my
neck, and so you can then startto bring the awareness that,
okay, this is a really bigmuscle, it's really strong and
can do a lot of things.

(45:07):
So that's the second one.
The last one that I love to dois start people off with tongue
clicks.
Just get them.
Can they get their tongue upthere at all?
And then cluck.
To me is more like getting theback of the tongue up there and
so trying to suction the wholetongue up in the roof of the
mouth, including the back partof it.
So if you were to look atsomeone doing it, it would look

(45:30):
like a line and caves, almostlike you can put those two
fingers on each side of the line, which is your attachment to
the tongue, or what we call thefrenum, and so you're going to
suction up there and I usuallysay count to three and then make
the loudest you can.
So it would be like and if youcan see, you would see how
there's the line and then thespace that's there.

(45:50):
So I usually just start peoplegoing to take less than five
minutes at a time.
I have one video that does justthose three so it's easy for
people to remember.
Yeah, and that gives them agood start, because I'm always
saying tongue up, lips together,teeth apart, breathe through
the nose.
The more we can have that habitbe happening all the time, say
that one more time.

Dr. Carver (46:09):
What are the four things we're looking for?

Dr. Jones (46:12):
So, tongue up, lips together, teeth apart, breathe
through the nose, and by teethapart I really just mean we
don't need to be clenching.
You're going to have your teethtogether when you're swallowing
, when you're chewing, oftenwhen you're talking, but they
should just be really lightlytouching the rest of the time.
And if your tongue is up in theroof of your mouth.
I don't have science to supportthis, this is just my

(46:34):
experience is that if yourtongue is actually suctioned up
there, it does tend to releasefor those clenchers, so that I
personally can't keep my tongueup where I want it and clench at
the same time.
So it can help to retrain.

Dr. Carver (46:47):
Right, those of us who are clenchers or have those
sore muscles.
Every time, especially thoseback teeth touch you instantly
activate your muscles At rest.
We don't need our teethtouching.
So that's important and itdoesn't mean your mouth is wide
open.
It just means that because we do, we want the lips closed, but
the teeth don't need to touch.
Those are important tips.
And, again, taking five minutes, I tell my patients you're

(47:12):
going to brush in your floss andyou're going to do your
exercises or other things that Ilike too because, as you said,
like we don't have bonystructure in the throat, right.
So how can we help thatcollagen stay strong?
So in the shower, I'll tellpeople, last 30 seconds of your
shower, try to gargle some ofthe water right To create good
strength in the airway.
Humming is a fantastic way tovibrate because not only do we

(47:37):
build the collagen but we'realso stimulating that vagus
nerve which is important forthat rest and digest.
So those are some great ways.
And then again you can humwhile you're in the shower or
hum in the car.
Like you talked about stackinghabits, we don't want to add
something.
We're busy enough and tryingjust the thought of having to do
something else.
But if we're already showering,hopefully, or if we're already
brushing and flossing, we justadd one little thing and it's

(47:57):
baby steps.
But both of us have found thesethings to be remarkably helpful
.
Both of us are really inspiredto steal your lovely name of
your practice.
I love it Inspired Wellness.
We really want to give ourpatients the tools to be their
best selves and, as you said, Ilove that you use the word
partner, because that's been aword for mine always we're not

(48:19):
here to tell you what to do.
We're here to educate you andpartner with you and facilitate
what you want to do to gain thebest health you can get,
absolutely.

Dr. Jones (48:31):
My goal is really to empower the patients, because if
they they're the ones that are,we see them occasionally and we
can't control, and that goesfor the dental stuff too.
So that's why it's inspireddental wellness.
There's the breath part of it.
There's inspiring the people.
There's getting thatinformation out there and just
letting it go, cause that's allI can do.
Not everyone is going to wantto hear about obstructive sleep
apnea.
Not everyone is going to wantto open that conversation.

(48:53):
Someone once told me a storyabout how there was someone on a
beach and there were all thesestarfish that were out on the
beach and that person startedthrowing the starfish back.
And someone said why are youdoing that?
You're not going to make adifference.
Look at all these that are outthere.
And they said what made adifference to that?
And so all we can do is try tokeep throwing one starfish back

(49:14):
at a time.
Give people the opportunity tomake the decision for what's
best for them and let go of whatthat outcome is, because I
don't know what's going on intheir lives and what might be
prioritized above what I'mtelling them that day or when
they might be ready.
What might be prioritized abovewhat I'm telling them that day,
or when they might be ready tohear it, or who wants to hear it
.
I've often been wrong as togoing.
I probably shouldn't talk aboutthat, because I don't think

(49:36):
they want to hear this, and thenthey're the one that is so
interested.

Dr. Carver (49:40):
So you get the blank stare and then they start
asking questions.
You're like, oh, okay, I ammaking it like, okay, this is
good.
That's often sometimes when youand I we okay, I am making it
like, okay, this is good.
That's often sometimes when youand I, we both know so many
things beyond conventionaldentistry that we're talking and
sometimes like is this personand are they absorbing this?
Like you said, every time theycome in you talk about, unless
the patient says I don't want tohear about any of that, okay,
great.

Dr. Jones (49:59):
But those that are.

Dr. Carver (50:01):
You know they come in and you know over the 15
years people now will come to meand ask stuff, because people
will talk hey, well, ask DrCarver because she helped me
with my reflux or my arthritisor whatever it is.
But I think you know one thingthat I want to leave patients
and Dr Everybody with is tothink about that airway.
Right, because, let's say, youhave the gum disease or you have

(50:22):
so many carries that maybe inkids too.
Right that you're tryingeverything.
Right, you're doing all themechanical stuff and the
brushing and the flossing andyou're using all the mouth rinse
or whatever and you're notgetting better.
What is the puzzle piece?
We're missing.
And airway is really big right.
Not to mention we didn't eventalk about how, when you're
mouth breathing, you're dryingout the mouth severely.

Dr. Jones (50:44):
You're changing the oral microflora, all that stuff,
and so you are going to.
Absolutely that is definitelymy wheelhouse and one of the
things that's driving them thisso much is that you do see those
patients where you're like,okay, they're brushy, there
isn't that much plaque.
Why is it so much gingivalbleeding, so much gum bleeding

(51:04):
and putting that knowledge thereso that they can learn to close
their mouth or is there anairway issue?
So many of these pieces, and Ithink that one of my huge
long-term goals is really to getthis out into more dentist's
hands, because this is huge andnot every dentist is going to
want to pursue knowing as muchabout this area.

(51:26):
But every dentist has theopportunity to screen as they're
doing their oral cancerscreening, because hopefully
everyone is doing that and Ibelieve that they are.
So you can just add inscreening for airway issues and
just open that conversation andhave somewhere to send them to
get more information, whetherit's books On my website there

(51:46):
also are all the books that Ilove.
Just trying to put someresources that you can get to
why I love them.
Products like what is the name?
The Rem Plenish water bottle,for example, with that little
myofunctional straw.
That's great in some people'shands.
You're going to be drinking.
So anything that we can thinkof to help give the patient at
least the opportunity to startto explore on their own, I think

(52:11):
is helpful.
And so if I'm using you have somuch knowledge, dr Carver, that
I don't have so if I can useyour resources to send patients
to you or refer patients to you,I think that's the key.
We don't have to know it all,but if we can work together and
if we can start to at leastrecognize and say okay, this
tooth is breaking and I'm notgoing to do any better to fix it

(52:33):
, let's see.
Maybe you need a sleep study.

Dr. Carver (52:35):
Let's just try to start to open those
conversations.
Well, I think it was 2017 whenit came out the ADA said that we
are obligated to screen forsleep, which is still
frustrating, why we can'tdiagnose or be, but regardless
another conversation but stillthat's seven, almost eight years
ago that we we need to bescreening for this and there is

(52:56):
education out there for thoseand, like you said, we don't
have to know everything.
I certainly do not have theknowledge you have.
I haven't done as much training, but at least I'm I'm looking
for and I know, and so then Ican say, okay, here's, I can
scream, we can do the test andbe like, okay, and now you're
going to see Dr Jones and she'sgoing to help you manage the
airway and do all these otherthings we didn't even actually
talk about too.
We talked about managementright, these advancement devices

(53:18):
, but we didn't really talkabout resolving it right, which
we've talked about on thepodcast before, like with
expansion, and there aremultiple ways to do it.
Do you have any thoughts?
Are you doing any of theexpansion?
It's a tougher treatment to notnecessarily sell, but a lot of
patients don't, especially ifthey're older.
They don't want to go throughthe expansion.
I think it works amazing in mypatients who are compliant.

(53:40):
It works amazing and it'srelatively quick.
In a matter of six months wecan, and I've, treated patients
well into their 60s.

Dr. Jones (53:48):
Right, you can get expansion but you've got to have
good compliance.
Yeah, and I think it alwayscomes down to the priority is
that they breathe right, and soif, depending on what the
diagnosis is if they aremoderate, severe, whatever the
case is I would definitely Iwant them to be treated in some
way.
So I always want to know whatis the diagnosis?
What are we trying to do?
Because expansion is fantasticand it can fix the structure so

(54:11):
it can create more space for thetongue, and then the roof of
the mouth is the floor of thenose, so sometimes you actually
even get a larger noseessentially to breathe in and
all the things.
So you're fixing the structureand then we still need to
retrain the people on how tobreathe and breathing through
that nose, getting that tongueup into the correct position so
that once we create thiswonderful thing for them to use,

(54:35):
they're able to use it, becauseit's not.
What I keep saying is it's notmagic.
And that is a harder areabecause we don't we don't know
for sure.
With a CPAP you can thatpositive pressure is like a
vacuum in reverse.
At some pressure we can popthat airway open.
We know we can have that personbreathe, Whether or not they
can tolerate it.
That's a different story.

(54:56):
Same thing with the appliancewe can bring the jaw forward.
It doesn't work for everyone,but it works for a lot of people
to help keep that airway open.
But when we are expanding, to meit's always a piece of the
puzzle, because we may expandand they still may need to wear
an appliance or they still mayneed to have CPAP.

(55:16):
So it can tremendously improveand I think it is a wonderful
thing that it's such a greatarea that we've opened, and I am
looking at it in that way.
So when I do any sort ofrepositioning of the teeth, I'm
considering like, okay, as aside effect, we might get a
nicer smile, but how do weprotect these teeth and their
function?

(55:36):
How do we create more space forthe tongue?
What's the whole picture ofwhat we're trying to fix as
we're doing the rest of thestuff?
So, yeah, it's a great fieldand there's so much to learn
there as well.
So exciting in kids, but yes,there's still hope for adults.
So many different ways to do it.
Absolutely.
I'm so glad that you're doingit no-transcript.

Dr. Carver (56:13):
Obviously, please tell us your website and all
those great resources youmentioned too.

Dr. Jones (56:18):
Yeah, absolutely.
I don't know that there'sanything else that I would like
to share other than thank you somuch for this opportunity.
This has been really fun tochat with you.
I always love getting to chatwith you.
Just felt like we were having aconversation and the website is
sleep wellness or, excuse me, itis two one back, so it is
Inspired Dental Wellness, sothere's two D's in a row.

(56:42):
It's Inspired Dental Wellnessand you can go to patient
resources and there's videos.
There's links to differentbooks, different products,
things that I love and oftenrecommend and why I recommend
them, so you absolutely can goto that.
The videos that are on thereare actually on YouTube.
It's not easy to find me onYouTube, so that's probably the
quickest way is to go that way.

(57:03):
I just didn't know what I wasdoing when I was setting it all
up, so it's a little convoluted,but that's okay, we get it done
.
And other than that, I wouldjust say, dr Carver, have a
fantastic day, don't forget tosmile and dance, look for the
blessings, and I promise you'llsee them.
Thank you so much for being ablessing in my day and getting
it started in this way.
I really appreciate it.

Dr. Carver (57:24):
I know how busy you are starting your practice here
and I am so grateful that youtook the time to come and chat
with us.
And, for those of you local, drJones is in Lee, massachusetts.
If you are having a questionabout airway sleep and all that,
please reach out via thatwebsite.
You'll find her number and allthat good stuff.
Thank you, I love you dearlyand I'm so happy to be your

(57:48):
colleague and friend, and thankyou for inspiring all of us to
smile and dance.
Thank you so much.
As always, please reach out tome if you have any questions or
comments or topics that youwould love to learn more about.
And otherwise, have a wonderfulrest of your day and we'll see
you on the next episode.

(58:08):
Hello, I'm Dr Rachel Carver, aboard-certified naturopathic,
biologic dentist and a certifiedhealth coach.
Did you know that over 80% ofthe US population has some form
of gum disease?
Many of us don't even know thatwe have this source of chronic
infection and inflammation inour mouth that's been linked to
serious consequences like heartdisease, diabetes.
Linked to serious consequenceslike heart disease, diabetes,

(58:32):
stroke, dementia, colon cancer,kidney disease, even pregnancy
complications.
Would you like to learn how toreverse and prevent these
chronic debilitating conditionswithout spending a lot of time
and money at the dentist.
Join me for my six-week coursewhere I will teach you the root
cause of disease.
You'll learn how to be your ownbest doctor.
Are you ready to get started?
Let's go.