[00:00:00] We've seen, like, kids with bedwetting, and we address sleep, and all of a sudden- Yeah ... [00:00:05] suddenly the bedwetting goes away. Um- Yes ... the disordered sleep [00:00:10] definitely affects, I feel like, bladder control muscles, um, the ability of the [00:00:15] diaphragm to move, which the pelvic floor coordinates a lot with the diaphragm.
So it's just an [00:00:20] interesting connection that it's like, if I have a kiddo that's bedwetting, I'm like, "We're ruling out [00:00:25] two things first. One, we're ruling out, um, constipation, and then second, we're [00:00:30] looking at, okay, is there a sleep issue?"
Speaker 2: Millions of women [00:00:35] are living with pain, discomfort, and silence, told that it is just a part of life.[00:00:40]
It doesn't have to be. This is Healing at Your Core, where pelvic floor [00:00:45] physical therapist Bree Allred brings more than 20 years of clinical expertise to the [00:00:50] conversations women deserve to have. Real answers. Real healing. No shame. [00:00:55] And now, your host, Bree Allred.
Speaker: Hi, everyone. I'm Bree [00:01:00] Allred with Healing at Your Core.
We're so excited for our guest today, Dr. Mike Bennett. [00:01:05] And, um, Dr. Bennett, go ahead and just tell us a little bit about yourself.
Speaker 3: Oh, thank [00:01:10] you. Well, I am a happily married, uh, father of [00:01:15] four, uh, children who are now adults, and they have [00:01:20] given us 10 beautiful grandchildren. So that's the happy, happy side [00:01:25] of my life.
But I've, uh, professionally, I've been practicing aspects of [00:01:30] dentistry for 27 years. I'm board certified in pain disorders, [00:01:35] jaw, TMJ, and also s- dental sleep medicine, like, [00:01:40] uh, snoring and sleep apnea, and I've been enjoying my career. [00:01:45] Uh, and, uh, also just been able to interact a lot with my [00:01:50] colleagues in helping people with chronic pain.
So I'm excited to, uh, to discuss this [00:01:55] with you today.
Speaker: Yeah. I'm super excited. So this episode, people may be [00:02:00] shocked to find out that there is a connection, um, between the jaw and the pelvic floor, [00:02:05] and I wanna explore a little bit more of this. Also, how it's affected through the nervous system and [00:02:10] through breathing, and these connections that we can find through, through our [00:02:15] core, and, and how they affect each other.
Um, so [00:02:20] tell me a little bit about your journey into more of the chronic pain, the [00:02:25] TMJ, the airway. What led you that direction in your dentistry practice? [00:02:30]
Speaker 3: That's a, that's a great question because early on I found that people would come [00:02:35] into the dental office and have these conditions of cracked teeth, worn down teeth.
Hmm. [00:02:40] We would fix those areas, and then they would come back, you know, 12 months later [00:02:45] and find that the dental work maybe ha- has broken, or they had additional teeth that were continuing to break [00:02:50] down. And that led me to ask the question, "Well, what causes this [00:02:55] excessive force in the mouth to break teeth?"
And the research indicated [00:03:00] that there's reflex activity that occurs while a person's sleeping- That if [00:03:05] their nervous system is activated into a sympathetic fight or flight drive, for whatever [00:03:10] reason, then you'll have this excessive movement disorder and teeth [00:03:15] mashing against teeth. And as a result, that, uh, that caused the breakdown of the [00:03:20] dental structures.
And I thought, "Well, why am I chasing symptoms? Why not try [00:03:25] to figure out what is it the root cause causing that movement disorder that's breaking [00:03:30] teeth?" And it turns out that a lot of it was breathing disorders. Uh, [00:03:35] when you don't breathe, your body goes into this reflex activity, and that results in that [00:03:40] breakdown.
But it's also many other things like PTSD and chronic pain throughout the [00:03:45] body or nutritional deficiencies can, can trigger that movement disorder. [00:03:50] So that led me to thinking, "Well, I could either chase the symptom, you know, I could [00:03:55] make plenty of money doing that, but that's not the best thing for the patient."
And so [00:04:00] I, I wanna get to the root cause, fix their symptoms, you know, protect them life... for a [00:04:05] lifetime, and, uh, so they don't have additional breakdown, and then work into this [00:04:10] interprofessional type, uh, arrangement with other providers so that we get [00:04:15] people breathing, get people sleeping, address their PTSD, their nutritional disorders, their [00:04:20] injuries throughout their body, like, you know, you and I can do together.
And then [00:04:25] they're not going to break their teeth down.
Speaker: Yeah.
Speaker 3: So that's sort of in a nutshell [00:04:30]
Speaker: So interesting because we're very much alike in that we like to get to the [00:04:35] root cause, and that's part of this healing at your core. It's like, yes, we're going deeper. We're getting to the root cause. We're [00:04:40] not just treating symptoms.
So I love that you brought that up. Um, [00:04:45] tell me, um, tell me a little bit more about why the [00:04:50] face and the jaw matter so much to the brain.
Speaker 3: Wow. Well, you just have to [00:04:55] study the neurology to get a good idea of what's going on because, uh, a [00:05:00] predominant amount of your sensory cortex of the brain is devoted to the face.
[00:05:05] When, when you stop to think about it, the face is where we survive. We [00:05:10] reproduce starting with the face. Uh, you, you, it's the beginning of the digestive [00:05:15] system and the respiratory system, and what's more important to the human body than breathing [00:05:20] and nutrition, right? So the, uh, the [00:05:25] sensory nerve- Staying alive Yeah, staying alive, survival.
And, uh, it's been said that the brain is all about [00:05:30] survival. It knows how to kick it in to, to protect the human being. Um, [00:05:35] but the, uh, the trigeminal nerve is the largest of all the sensory [00:05:40] nerves that, and that feeds the face, and it protects the face, jaw, tongue [00:05:45] areas. So if there's any injury or any functional [00:05:50] disturbances in that system that's, you know, this part that, where that big huge [00:05:55] sensory nerve is, then it's gonna activate the central nervous system easily [00:06:00] and put somebody into a fight or flight more quickly.
And anecdotally, uh, I, you know, I'm, [00:06:05] I'm, I'm thinking hypothetically, but I ... Clinically, I see it all the time. If I can get the [00:06:10] face right, the jaws right, the airway open, protected, it's amazing. People [00:06:15] start to heal fast.
Speaker: Yeah.
Speaker 3: They start sleeping better. Yeah. Yeah.
Speaker: It's... [00:06:20] And I would say arguing from a pelvic floor standpoint, so you're talking about all of the entrance for the [00:06:25] nutrition.
Speaker 3: Mm-hmm.
Speaker: Um, my end is talking about all the exit for the toxins that can kill [00:06:30] you too, and the other end of reproduction, right? So these very similar aspects where [00:06:35] it's like we have, um, muscles that are surrounding two ends of the very vital tube [00:06:40] to our body.
Speaker 3: Mm-hmm.
Speaker: Right? And very vital, um, bodily [00:06:45] functions and very, like, we are biologically wanting to reproduce.
So from- Mm-hmm ... all of [00:06:50] those aspects, I'm like, there's... It's so similar where we're just looking at two ends of the, two ends of [00:06:55] the body. Yeah. And very similar aspects there that are very highly connected to the nervous system. [00:07:00]
Speaker 3: Well, yeah, and that, that makes it a bidirectional thing. So for [00:07:05] example, I, I've had lots of patients with urinary tract infections [00:07:10] or other, other processes.
Let's say they've had a really tough delivery [00:07:15] and, and they've, you know, they've torn, that pubic symphysis is separated, never [00:07:20] came back together. And so they've got this chronic inflammatory issue in [00:07:25] this part of the body. Well- It, it's interesting how [00:07:30] that injury can trigger more bruxism, more movement disorder.
And so to fix the [00:07:35] jaw, I've gotta fix the pelvic floor, gotta fix the pelvis, gotta fix those injuries. [00:07:40] And so I can't be successful without somebody like you doing your job as [00:07:45] well. Do, you know, just to take away that trigger
Speaker: Yeah. It's a [00:07:50] whole body system
Speaker 3: Mm-hmm. Yeah Yeah Yeah
Speaker: Such a difference there
Speaker 3: So [00:07:55] that's it, and it's also interesting that, I don't know, I have about, uh, one out of, [00:08:00] one out of 10 patients are males, nine out of 10 are females in my [00:08:05] practice.
Do you, do you work with any males in your practice that strictly-
Speaker: I do as well. I [00:08:10] would say about, with our caseload, we're probably 10 to 15% male. Um, [00:08:15] so I mean, very similar. You're saying one in nine Mm-hmm I'd say about 10, 15% Mm-hmm ... of our [00:08:20] caseload is male. 'Cause then like males have a pelvic floor too.
Yeah It's just a little less [00:08:25] susceptible to injury based on childbearing, menopause, hormonal changes that are [00:08:30] different for females. Mm-hmm. But yes, we definitely see things with males as [00:08:35] well '
Speaker 3: Cause I'll, I'll often see, like somebody will come in and say, "My jaw hurts," [00:08:40] or, "I've got migraines," or, "I've got primary headaches types conditions."
And when [00:08:45] I go in and I help them with that, reduce their, their pain levels, [00:08:50] they tend to start sleeping better. And those who are in the childbearing years who are trying to [00:08:55] get pregnant, it's interesting. You get people sleeping better and [00:09:00] reduce their pain, it's amazing how fertile they, they can become, 'cause the body's [00:09:05] primed for it.
You know? It's like, okay, now you can sleep, now you're producing enough growth, [00:09:10] growth hormone during sleep that you can create another human being within your own [00:09:15] body. Whereas it is right now you can't because you're not sleeping well enough to, to [00:09:20] take care of your own needs of growth hormone and prolactin- Yeah
and so forth.
Speaker: Yeah.
Speaker 3: I see [00:09:25] that con-
Speaker: It's like when your body's in survival mode, it's not going to reproduce
Speaker 3: Yeah
Speaker: It's like it's, we're not [00:09:30] bringing something into that. Yeah. Absolutely I
Speaker 3: joke with my staff and they say, "Hey, this is the [00:09:35] TMJ fertility clinic," 'cause people didn't get pregnant after they get fixed.[00:09:40]
Speaker: Oh, neat. Just to see those connections though, that it's like the nervous system definitely affects- Mm-hmm ... [00:09:45] things both on the male and female side- Mm-hmm ... and things from fertility standpoints as well.
Speaker 3: Mm. [00:09:50] Mm-hmm. Yeah. Yeah. I love that
Speaker: So your focus when you're working with this to [00:09:55] get people breathing better, what...
How do you go about that? What does it look like when [00:10:00] you're like, "Okay, your airway stinks. You're not able to breathe well. You're not able to sleep [00:10:05] well." Do... What are you looking at in order to help correct that?
Speaker 3: Yeah, great quest- Because [00:10:10] it's basically, let's ask the question, where is the blockage? Where is the [00:10:15] obstruction in your airway?
So we image the whole upper airway, essentially from the tip of the [00:10:20] nose down to the hypopharynx vocal cord area. And if there's any, [00:10:25] um, constriction, pinched areas, then we'll make a plan for it [00:10:30] And so I've got a team of airway doctors who include pulmonologists, [00:10:35] sleep physician, allergy specialist, nutritionist, and all of us.
And I do [00:10:40] my part because frequently, probably most frequently, the, the pinched [00:10:45] or blocked area is in the retropalatal, retroglossal, behind the tongue [00:10:50] palate area. And so I'll do some procedures, oral devices, and some [00:10:55] other things to open up that airway. Also includes myofunctional therapy [00:11:00] to develop the musculature tone so it doesn't collapse so much.
And then I [00:11:05] kinda act as the advocate for the patient and refer them to other specialists [00:11:10] to get the rest of the work done and for the physician to overview, oversee, you know, the [00:11:15] whole process So that's kind of the next, the next step. There's so many [00:11:20] people are put on CPAP automatically, and it's a good thing.
Uh, it's just difficult to [00:11:25] tolerate a mask and straps on this already tender area of the body. [00:11:30] And so, uh, that f- that frequently is the question is, well, where's the [00:11:35] blockage? And let's make a plan for it. If we do, right now you're breathing just fine. They come into the office, they're [00:11:40] breathing great.
It's just when they sleep they don't breathe great. Yeah. So I've got a, I've
Speaker: got- When tissues [00:11:45] and structures relax, it can affect things.
Speaker 3: Yep.
Speaker: Yeah.
Speaker 2: Yeah. Absolutely. Yep.
Speaker 3: Yep, [00:11:50] that's what we do. So usually it's like a five to six-month period where we're working together. [00:11:55] I'll make the oral device, I'll do additional sleep tests to titrate or adjust the [00:12:00] device, and then recommend over-the-counter things, simple things to open up nose and [00:12:05] throat areas.
And then, um, and then retest to see if [00:12:10] it's working and, and then they, uh, they go on to the next, uh, specialist if, if things [00:12:15] aren't working out as well as I expect. It's, there's non-responders and then [00:12:20] prob- maybe 5%, 10% of the time people are like, "Oh, I just can't wear this thing in my mouth." But, [00:12:25] and usually it's because they can't breathe through their nose, and then I'm sticking a piece of plastic in there and [00:12:30] blocking their emergency breathing hole, you know?
And
Speaker: they're like, "I'm going more into fight or [00:12:35] flight."
Speaker 3: Yeah.
Speaker: With that.
Speaker 3: Exactly.
Speaker: Yeah.
Speaker 3: But it's interesting, in addition [00:12:40] to the nasal being a cause for not tolerating the device, so often it's an [00:12:45] injury in their body. And I would think especially in those nerve-rich [00:12:50] areas, the reproductive areas, that if things are agitated there, [00:12:55] that reflects to clench and then have a device in your mouth that you're gonna clench on, it's just, [00:13:00] it's, it's a lot of irritation.
And that's, I, and I think another [00:13:05] reason why people don't tolerate their oral devices because they are just irritated from other injuries [00:13:10] throughout the body. So another reason why I might send somebody to you to, to be [00:13:15] checked out is she can't wear her device. She's bruxing on it. She's complained of a history of pelvic [00:13:20] inflammatory issues.
Hey, can you help her with that?
Speaker: So it's really neat when you're [00:13:25] starting to look what different aspects of things.
Speaker 3: Mm-hmm.
Speaker: Um, I love this. We've seen [00:13:30] like kids with bedwetting, and we address sleep- Mm-hmm ... and all of a sudden- Yeah ... suddenly [00:13:35] the bedwetting goes away. Um- The disordered sleep definitely [00:13:40] affects, I feel like bladder control, muscles, um, the ability of the [00:13:45] diaphragm to move, which the pelvic floor coordinates a lot with the diaphragm.
So it's just an interesting [00:13:50] connection that it's like if I have a kiddo that's bedwetting, I'm like, we're ruling out two things [00:13:55] first. One, we're ruling out, um, constipation, and then second, we're looking [00:14:00] at, okay, is there a sleep issue that's underlying that? So-
Speaker 3: Oh, my- ...
Speaker: it's kind of interesting, and if we [00:14:05] get those addressed, oftentimes things will improve.
And if not, then that's where it's like, okay, now the [00:14:10] pelvic floor is the big driver for this, and we're gonna be looking a little bit more closely at, at rehabbing [00:14:15] and, and working with that.
Speaker 3: Oh, my gosh. I love that you're saying that, 'cause that's one of [00:14:20] my favorite things is to do expansion for kids, get them opened up, breathing, nervous [00:14:25] system starts to relax.
That, that, uh, peristalsis of the GI tract [00:14:30] starts to work again and yeah, yeah, for sure blood pressure drops. Yeah, it's, it's [00:14:35] an amazing- '
Speaker: Cause
Speaker 3: we
Speaker: start- ...
Speaker 3: concept ...
Speaker: when you look at the real basic d- we say the nervous [00:14:40] system responses, right? Sympathetic is where everything's fight, flight, freeze, fawn, [00:14:45] right? I think are the main ones where it's like those are what people will do in those situations.
Speaker 3: Mm-hmm.
Speaker: And when we're in [00:14:50] parasympathetic, we're looking at it's resting and it's digesting. And so [00:14:55] if we're not able to get the nervous system down, that can be a contributor to the [00:15:00] constipation that might- Mm-hmm ... be driving or underlying some of these issues as well.
Speaker 3: Mm-hmm. Yeah. Yeah. [00:15:05] Yeah. I love that, and I love that you're bring- bring up for breathing because breathing's [00:15:10] different in the fight or flight versus the parasympathetic Yeah.
Diaphragmatic [00:15:15] breathing and it, 'cause I'm all about trying to get people to breathe. And I'll use a technique [00:15:20] called Buteyko breathing to help people get into that diaphragmatic breathing. But I [00:15:25] can see how when they're in fight or flight, how it would be more upper quadrant ribcage [00:15:30] breathing, not diaphragmatic.
It's just emergency breathing. Get that air [00:15:35] in 'cause my brain is deprived of oxygen.
Speaker: Yeah. 'Cause we're seeing a lot of movement [00:15:40] here. Mm. Right? Versus down in the belly or deep into, [00:15:45] um ... 'Cause there is ribcage movement still with diaphragmatic breathing, but it's more downward and [00:15:50] opening rather than it being doing this really tight and upper chest.
Mm-hmm. [00:15:55] And we can even look just from a muscular standpoint, even from what you're talking about with the jaw, [00:16:00] right? Or looking at all of these neck muscles, these, this upper [00:16:05] ribcage. Do you know what I mean? These ac- we call them accessory or not primary breathing muscles, but [00:16:10] in certain situations they will, they will help, and that will promote more tension [00:16:15] through here.
And then it all of a sudden, doing effects into that jaw and [00:16:20] starts kind of changing how things are, are working there. Mm-hmm.
Speaker 3: Yeah. Yeah,
Speaker: from a [00:16:25] tension standpoint.
Speaker 3: Oh, yeah. Well, I find that the nose is a key player in that [00:16:30] because the nose heats, humidifies, filters the air, and it [00:16:35] mixes nitric oxide with the air as it it's inhaled, but the mouth does not do that.[00:16:40]
And so when you get into these emergency breathing situations, you get lower [00:16:45] oxygen levels and you get dirtier air going into your body when you mouth breathe, and then the [00:16:50] body has to cope with this pulmonary reaction to aspirating [00:16:55] stuff from your mouth into your lungs. And so one of the primary [00:17:00] drivers of this sympathetic state is, is gonna be mouth breathing and the [00:17:05] subsequent, you know, etiology of low oxygen because you are mouth breathing.
And so that's one of the [00:17:10] big keys is my ENT is like gold where they can get people [00:17:15] breathing, and the allergy specialists get people breathing through their nose to allow for those functions of heat, [00:17:20] humidify, filter, nitric oxide secretions, and then you get this good [00:17:25] gas exchange. The air coming in through the nose gets all the way into the alveoli, gas [00:17:30] exchange, better oxygenation.
There, there's a book from James Nestor called Breathe. [00:17:35] I thought it was excellent. He's a scientific journalist. Have you ever heard of that one?
Speaker: I haven't, [00:17:40] so I'm gonna have to read that one now.
Speaker 3: Yeah, you should check it out. I, I did a podcast with him, interviewed [00:17:45] him a while back, and he, he's, he's onto it.
I mean, he understands so much [00:17:50] that the body cannot go into the parasympathetic rest and digest state [00:17:55] and well enough if you can't nose breathe well. We're, we're supposed to be [00:18:00] nose breathers, not mouth breathers. Only emergencies we mouth breathe. When there are grizzly bears chasing us, go ahead and [00:18:05] open up.
But all night long, that, that has to be open. And so that's [00:18:10] one of the key principles is you kick in diaphragmatic breathing if you can [00:18:15] nose breathe well You know, and, and you can relax the nervous system if you know to [00:18:20] breathe well, too.
Speaker: Oh, great. And I love that you say that it's like it's taking a [00:18:25] team, it takes a village.
Just like we say to our mamas, it's like it takes a village to raise our kiddos. And I think as [00:18:30] practitioners, it takes a village to take care of our patients, right? From all of our different specialty [00:18:35] areas. And I love that you already have that team built, which is a really neat thing. It's [00:18:40] not a like, "Well, okay, now you need to find somebody to do this, and you need to find somebody..."
It's [00:18:45] no, it's like we have these teams in place, and we have these referral systems that we [00:18:50] know that we all speak the same language, per se, and that we're all have this [00:18:55] common goal in mind. So I love the fact that you're like, "Oh, we've got a pulmonologist," and it's like, okay, [00:19:00] um, people with asthma, people with d- I mean, lung conditions, that's gonna [00:19:05] affect what's gonna be happening in their airway as well, and how they're choosing to breathe.
So you need that [00:19:10] aspect of the team on board. And you're saying like, okay, you as the dentist, you're looking at the physical [00:19:15] structure of what's happening from a jaw alignment and from-
Speaker 3: Mm-hmm ...
Speaker: um, palate and all of those [00:19:20] aspects. And then you were saying, um, ENT, who's looking at the, the ears, nose, and [00:19:25] throat, and who's looking at
And it's just I love this, this comprehensive care, that it's like [00:19:30] we're all bringing our specialty areas to work together, and that you have that in place already. [00:19:35]
Speaker 3: Yeah. They, they don't really teach that in school, at least I don't remember hearing that. It's [00:19:40] maybe they did teach it, but it's so focused on passing the boards, you know, on those things.
But yeah, you're [00:19:45] absolutely right. The treatment outcomes are so much better in a team [00:19:50] environment versus somebody just trying to go at it o- at their own and then, uh, and then moving [00:19:55] forward if they don't get the outcome that they want. Yeah.
Speaker: So neat to be [00:20:00] able to have that aspect. And like I said, that a patient isn't left, um, doing that independently- Yeah
[00:20:05] all by themselves. 'Cause sometimes putting that team together that's like you go see somebody and it's like, "Well, I don't [00:20:10] really see what you're talking about." And it's like, okay. Versus You having that in [00:20:15] place where you have trusted providers that's there- Mm-hmm ... it's, it's really
Speaker 2: neat
Speaker: to, to hit that [00:20:20] multimodally.
And I do feel as people are getting more and more specialized in their fields, they're [00:20:25] getting better and better at what they do, but then oftentimes that allows the, the [00:20:30] patient themselves are kind of stuck with like, "Well, I only have one piece of the puzzle, and I need all of [00:20:35] these pieces of the puzzle," um, to, I don't really have a great general [00:20:40] provider that focuses on airway and breathing and, [00:20:45] and opening, opening that up.
So it's just such a huge, [00:20:50] I can't emphasize enough just the importance of that, and that you already have that trusted in place is really neat to [00:20:55] hit it from, from all the different specialties to where it's like, yes, you have the maximum [00:21:00] benefit because you have these amazing w- highly specialized individuals [00:21:05] working as a team together, so you're getting everybody's expert knowledge working into one whole.[00:21:10]
Speaker 3: Mm-hmm. Yeah, absolutely. Can't do it without your team.
Speaker: Yeah. [00:21:15]
Speaker 3: Where do you practice?
Speaker: So I'm in Logan, Utah, in northern Utah right now. [00:21:20] Yeah.
Speaker 3: Oh.
Speaker: Um, and we're looking to expand at some point, so if you know any [00:21:25] great pelvic floor PTs looking for a job, like we need somebody. Um, [00:21:30] and Yeah, just a really neat kind of overall arching thing.
So [00:21:35] when you have somebody with an elevated nervous system, what would you say are your go-to things [00:21:40] that you're looking at? Obviously one is, like, can they breathe well? But when you're looking at that from [00:21:45] can you breathe well, what is, what are you ruling out? What is your process to go through [00:21:50] that's like, "Oh, this is how I can get somebody to breathe well"?
Mm-hmm. And then here's how I'm addressing their [00:21:55] nervous system in other ways.
Speaker 3: Well, I've gotta take a really good history. I gotta find out what [00:22:00] symptoms they're dealing with, and oftentimes you had alluded to a few things, like [00:22:05] bedwetting, but there's also irritability, underperforming in school, [00:22:10] um, just, uh, unable to f- you know, pay attention, attention [00:22:15] deficit disorder or hyperactivity issues.
And so I'll, when it comes to [00:22:20] children, I'll have the parents fill out a little questionnaire that is, "Hey, observe your child for two [00:22:25] weeks and see what they're dealing with, what they're doing." And then we bring them [00:22:30] in, review that, and determine if there's enough grounds. Af- after looking in their mouth, [00:22:35] their throat, if there's not r- enough, enough room for their tongue, there's a [00:22:40] small mouth means small airways, so I'll, I'll do a sleep test if there's [00:22:45] enough.
And I partner with a board-certified sleep doctor who reads the sleep testing data, [00:22:50] and then they'll render a diagnosis on what's going on. And so we'll know [00:22:55] officially if there's a breathing disorder. And with children, it only requires one and a [00:23:00] half events per hour, meaning if you stop breathing or pause breathing more than 10 [00:23:05] seconds, 10 or more seconds, and your oxygen drops 3%, that's considered [00:23:10] one sleep apnea event.
And it's so bad for children to have sleep apnea [00:23:15] that they've defined sleep apnea in children at 1.5 events per hour. [00:23:20] And so we'll get that data- And then if they, and most [00:23:25] often they do have a breathing disorder, then we'll look at the X-ray to find [00:23:30] out where the issue is. It's typically under development of the jaws, [00:23:35] which, uh, which then begs the question, why are so many people underdeveloped?
Why [00:23:40] don't people have their wisdom teeth? Did you have your wisdom teeth taken out?
Speaker: I did.
Speaker 3: Yep, [00:23:45] me too. It's like 90-plus percent of the population in America have [00:23:50] their wisdom teeth taken out, or it's probably close to that. And, um, why are [00:23:55] faces shrinking? Why are they small? 400 years ago, the, the, uh, skeletal records [00:24:00] showed that people had their wisdom teeth.
They may have died of a tooth infection, you know, at [00:24:05] age 40 or whatever, but they had their, all their 32 teeth and spaces between [00:24:10] them, and these days our mouths are small. And when you look at the anatomy location [00:24:15] of the mouth, it sits under the nose and in front of the throat, airway, [00:24:20] and when it's small, those structures are also small.
And so we're already [00:24:25] susceptible to these small jaws and faces because of, there's [00:24:30] lots of reasons: lack of breastfeeding, nutritional issues, durability of [00:24:35] foods. We're eating soft foods, Cheetos. And so the, the musculature doesn't [00:24:40] stimulate the bone. The bones don't grow. We have small mouths, jaws. And that [00:24:45] consequently results in a small airway.
So that's a long way of saying, yeah, this [00:24:50] child is developing in a way that's prohibiting good breathing. [00:24:55] Um, and so we need to try to reverse the underdevelopment of [00:25:00] those structures. And so they're di- let's, for example, they're diagnosed with sleep [00:25:05] apnea. They, there's options. They can go in and have body parts removed, like tonsils [00:25:10] and adenoids, which in some situations you wanna remove those because the, the child is [00:25:15] in such distress, you wanna take those out.
But But I find more [00:25:20] often than not, expanding the airway, talking about eating whole foods, [00:25:25] getting the pre- the patient, um, sleeping, drinking enough water, [00:25:30] sleeping enough hours, those basic things, uh, that'll result in a lot of the, uh, [00:25:35] you know, the shrinking of those lymphoid tissues, and then they start breathing better.[00:25:40]
And so that's sort of the start and the finish. You got a ADHD child, [00:25:45] treat their airway. At the end of it, they're sleeping better. They wake up, [00:25:50] their brain is... Versus before, their just brain is overly tired, and now they're very [00:25:55] rested, and they can be themselves. You know, the real child comes out finally when that [00:26:00] child starts to sleep, and it's a beautiful, beautiful thing.
Speaker: So if you address the airway and [00:26:05] you still feel like somebody's nervous system is ramped up, what would you, what would you say is kind of your next [00:26:10] steps that you would look at? Yeah,
Speaker 3: so you... I mean, it's not as simplistic to just say only [00:26:15] airway focused, obviously. So, so I'm gonna stand them up, and I'm gonna look at their [00:26:20] posture, and frequently you see this forward posturing, those, uh, scapulae [00:26:25] turned out, uh, you know, you s- loss of kyphotic curvature in the [00:26:30] spine.
Yes. Yes. That's exactly it And so that creates [00:26:35] injury in the body, and that malalignment needs to be addressed along [00:26:40] the way. And what I've found is once you get the airway opened, posture during sleep [00:26:45] improves, therefore posture during the day actually improves, but sometimes you still [00:26:50] need therapy to get those structures into alignment and get the muscles [00:26:55] stronger, the core, you know, helped out and, and, and then you, uh, and, [00:27:00] you know, you gotta get the, uh, the injuries out of the body a- and addressing [00:27:05] each of those restrictions and range of motion and so forth.
Speaker: Yeah.
Speaker 3: So [00:27:10] yeah, that's- And
Speaker: that's where physical therapy comes in beautifully- Mm-hmm ... to help and assist with that.
Speaker 3: Yeah. [00:27:15] Yep.
Speaker: Um, we will also, um, like just from my experience, I can't say every [00:27:20] physical therapist is trained, but, um, we can do some stimulation techniques of the vagus nerve, [00:27:25] which the vagus nerve is a really great on-ramp to a healthy nervous [00:27:30] system, to bringing things back into a parasympathetic, um, space.
But then it's [00:27:35] like, just like you said, therapies from more of an emotional and mental standpoint. Is the body [00:27:40] holding onto trauma from certain things from a mental health standpoint or an emotional standpoint [00:27:45] that we may need to address? Um- Right ... I've seen chiropractic come in as well from a [00:27:50] nervous system standpoint to help things from a whole, whole body nervous system standpoint [00:27:55] as well, so it can be really neat.
And then there's yoga practice and meditation and all [00:28:00] these- Yeah ... other things that I think can be hugely beneficial. And I love having a toolbox so that [00:28:05] it's, you know, that one's not gonna work for me. I'm not gonna meditate. I'm like, "Okay, let's find something [00:28:10] else that will work for you that you can access, that you can do on a regular basis."
Speaker 3: Oh, that's so [00:28:15] good. And so you got exercises, you got at home activities they can do to kind [00:28:20] of maintain and sustain. Yeah. I think that's beautiful when you can give a person the [00:28:25] gift of independence so that they don't have to rely on you or me, [00:28:30] that long-term they can do stuff at home, the good healthy practices.
You know, [00:28:35] interestingly, I find that a lot of kids are dehydrated too. Like, next [00:28:40] to air, what's more important to the body than water? You know, so it's, [00:28:45] "Hey, let's start, uh, focusing on getting a little more hydration, especially during these hot days." [00:28:50]
Speaker: I really do think that it, there's some simple, simple things.
Like you said, like, let's eat [00:28:55] more whole foods, right? Let's get more water intake. And- [00:29:00] Oftentimes it doesn't even have to be, 'cause we hear that and then we're like, "Oh, okay. We have [00:29:05] to do like a really good healthy diet, and we have to do lots and lots of water," to where I'm [00:29:10] offering it to my kid every hour.
And it's like, no- Agreed ... it doesn't have to be this big [00:29:15] grandiose thing. I can alwa- I usually tell my patients, I'm like, "From a constipation standpoint, they've shown [00:29:20] differences with 16 ounces a day."
Speaker 3: Mm-hmm.
Speaker: Which I'm like, "Okay, can you offer your [00:29:25] child a glass of water two additional times a day?"
Speaker 3: Mm-hmm.
Speaker: Like, is [00:29:30] that, is that doable? Maybe it's like right as they're getting up in the morning, and maybe it's you're making a m- little [00:29:35] bit more emphasis to have a drink with your meals. Maybe it's, right, getting them a [00:29:40] cool water bottle that they like so they'll carry it around with them. Um, these all work for [00:29:45] adults by the way too, we're just big kids.
And, um, with whole foods it's like, okay, [00:29:50] can I add a fruit or vegetable to a meal? And it's kind of finding things [00:29:55] that you like where it's like, oh, okay, for breakfast could you add some strawberries to it? Mm-hmm. For [00:30:00] lunch could you offer d- I'm like, I tend to go more towards fruits, but could you [00:30:05] offer, do you know what I mean, some ranch and carrot sticks?
Mm-hmm. Can you... 'Cause the more it's offered, the more we're [00:30:10] exposed, the more we're wanting to usually- eat those foods or the more [00:30:15] willing from a kid's standpoint that we are to try. Mm-hmm. So I just think it's interesting that it's like it doesn't have to be big and [00:30:20] grandiose oftentimes that we think.
That it's like, no, these small little changes and just making [00:30:25] an effort one different time of day can really make a difference there.
Speaker 3: No, I love those [00:30:30] little ideas that mean everything. Yeah, like my wife is a nutritional, um, expert, [00:30:35] and she has- she went to the dollar store, got one of those little veggie tray things with the [00:30:40] covers on it, and so she'll, she'll cut up veggies, cauliflower, broccoli, [00:30:45] celery, carrots, put them in that.
And so we have grandkids that come over and, and [00:30:50] even with us, she'll pull that out. That's the first menu item for lunch, [00:30:55] breakfast, dinner, even breakfast. And she's always saying, "Well, if we can get the fiber [00:31:00] in, that becomes the vehicle for all that glucose, and then you're not gonna have [00:31:05] such a spike in insulin, you know, from the foods you're eating if you start and end with a veggie [00:31:10] and get that fiber in."
And that, that's been really good. And not only that, from a jaw [00:31:15] standpoint, if the child's biting on durable foods, they're activating muscle and [00:31:20] bone grows. They'll have better development in their face just from eating [00:31:25] more vegetables and taking time to chew those vegetables too.
Speaker: Yeah. Slowing down.[00:31:30]
Actually paying attention to the foods we're eating- Yep ... instead of eating on a device. Yeah.
Speaker 3: Oh, yeah. We can [00:31:35] save lots of parents orthodontic bills if they do a lot of this stuff we're talking about. [00:31:40]
Speaker: Tell me kind of the nine to one females to males, do you have any theories behind that [00:31:45] for within your practice that you're sh- d- you're seeing that?
Is it more just we tend to have a [00:31:50] smaller jaw structure? Is there stressors in the female life that might be a [00:31:55] contributing factor to that? Tell me, do, do you have any theories behind that, or is there any [00:32:00] research? Yeah.
Speaker 3: I, I definitely have thought about that a lot over the years and, um, [00:32:05] a couple things.
One is they have different neurology. There are a lot more [00:32:10] nerve receptors in the trigeminal area, especially in the joint [00:32:15] capsule. I mean, they just feel it more. Uh, estrogen tends to elevate [00:32:20] pain response, whereas testosterone tends to mitigate it. And so, [00:32:25] um, men, men are just as messed up from a TMJ standpoint.
They just don't feel it. [00:32:30] And so when a man comes in, it typically is very advanced, like [00:32:35] bone-on-bone, arthritic changes, loss of articular disc space and all [00:32:40] kinds of things. And so the ladies just feel it, uh, more quickly. So that, [00:32:45] that's one item. The other item is, is- Unfortunately, there [00:32:50] is PTSD in the world.
You know, life happens, and that, [00:32:55] that stress response, and often those things are happening [00:33:00] toward women and girls that you, you have to keep that in mind [00:33:05] because that can trigger the movement disorder, the reflex response. And [00:33:10] so un- it's not uncommon for me to ask a few brief [00:33:15] questions. Is there anything in your life that you're just holding onto that, you know, and just kind of...
And [00:33:20] as a, as a way to screen out for any PTSD. And then if there is, like [00:33:25] part of our therapy needs to be you go to talk to somebody you trust and you love and who [00:33:30] loves you and/or, or a professional therapist, anybody like that, and work that through, 'cause that's part [00:33:35] of the solution, is we've gotta make sure that you're, you're dealing with those things that can [00:33:40] trigger the movement disorder that causes the jaw injury.
So [00:33:45] PTSD and definitely airway-related things are, [00:33:50] are often related to that, and the neurology. Those are three main, uh, [00:33:55] hitters when it comes to causing females to be a predominant patient in the [00:34:00] practice But interestingly, being parents, like it's not [00:34:05] uncommon for a mom to come in and say, "Okay, I was leaning over my two-year-old," and they stood up all of a [00:34:10] sudden and just bam, hit my chin.
Shoves those condyles [00:34:15] back and they're like, "I can't open my mouth anymore." And, and so actual trauma, [00:34:20] macro trauma, you know, it's, it's uncom- it is actually very common.
Speaker: [00:34:25] So children, again, we love them.
Speaker 3: F- children, [00:34:30] start to finish, they're traumatic on all of us, right?
Speaker: Yes. Yes. That's how- how we roll But we grow because of [00:34:35] them so much.
Right. We love them. Yes. Yes. Um, okay, if you [00:34:40] had just kind of a general message that you wanted to tell [00:34:45] all of our viewers, um, what would it be in relation to, [00:34:50] uh, y- you could say airway or health or jaws or, or things [00:34:55] there. If you had, whether it be some advice or just something that you'd want them to know, [00:35:00] what is your, what would, how would you answer that?
Speaker 3: Bre, great question. The message I would [00:35:05] have them hear is that the human body is designed to heal itself, and [00:35:10] there are healing properties within the human body that if, [00:35:15] if we unlock those, then any therapies that you or I do, [00:35:20] they'll tend to be magnified. They'll be much better. And so how do you unlock healing [00:35:25] properties in the human body?
Well, the body heals during sleep. Everybody [00:35:30] knows that. Like 10 out of 10 people, if you ask, "When does the body heal? Is it while you're [00:35:35] awake or while you're asleep?" They'll say, "While you're asleep." And [00:35:40] so the, one of the keys, if you're dealing with chronic issues, if you're suffering [00:35:45] in any way, emotionally, spiritually, physically Then you ought to [00:35:50] look at your sleep.
Is that working for you? Is it, is it, uh, is it [00:35:55] optimal? And if it's, if it's not, what can we do about it? So how do you test? Well, [00:36:00] do sleep tests. Do a sleep test, and it can be a simple thing. There's a [00:36:05] app called Snore Lab where you can record your own breathing. You get five free [00:36:10] recordings, Snore Lab, uh, on iPhone, and you can find out if you're gasping or [00:36:15] choking or tossing and turning or snoring a lot.
And it gives you an [00:36:20] idea if you're waking up continually un- refreshed, then you should talk to somebody like [00:36:25] myself who has a background in sleep, uh, because then we can evaluate that. One of the first [00:36:30] lab tests a person should do b- in addition to blood work is a sleep [00:36:35] test, because that's where we identify how well does my body heal or [00:36:40] what kind of potential for healing do I possess.
So look at, look at [00:36:45] those issues and then create a plan with your provider to optimize your sleep [00:36:50] quality because as you do that, now your... the little sleep physician, the [00:36:55] physician within your body can wake up and start to do its job when your [00:37:00] sleep quality has improved. For example, there should be...
there's three stages [00:37:05] of non-REM sleep and one stage of REM sleep and each has important healing properties [00:37:10] and we need to have a certain amount of REM sleep which is about 20% of our night. That's where our [00:37:15] muscles are fully relaxed and how would that be, Bre, if, if you could get those muscles in the [00:37:20] pelvic floor to fully relax so that they, they can be perfused with blood [00:37:25] and nutrients and restored and just all that wonderful work that you do [00:37:30] all night long the body is, is doing therapy on your patient and then, [00:37:35] uh, you know, hopefully enough non-REM stage three sleep which is where a growth hormone and [00:37:40] prolactin's secreted most of the night.
But they don't get that if they're having pauses in [00:37:45] sleeping all night because their airway doesn't work or they have injuries they're dealing with or PTSD [00:37:50] and so their sleep quality then is diminished. So that would be the message is [00:37:55] there is hope for you. There's not a s- there's no person in this world that's [00:38:00] smart as, that is as smart as your body is in healing itself.
We [00:38:05] try our best. We do our very best, don't we? Do our best, but if we can partner [00:38:10] with the body then we have a real shot of [00:38:15] healing any condition that, that is, uh, capable of, of healing in the [00:38:20] body. Yeah. So there-
Speaker: I often tell my patients my job is just to help your body get out of its own way [00:38:25] 'cause I feel like it gets stuck in some sort of process.
Yeah. And it's my [00:38:30] job just to help it get out of its own way so that it can heal.
Speaker 3: Yeah. Yeah. No, I love [00:38:35] that. Your, your patients are very fortunate to have you.
Speaker: Yeah. I agree and you as [00:38:40] well. It's such a neat thing. Thank- The, like there's been the whole movement for mouth taping. [00:38:45] What are your thoughts on that?
Speaker 3: Excuse me. I think you need to be [00:38:50] careful with it. I personally do mouth taping maybe [00:38:55] 30% of the time. And, um, if you nose breathe well, [00:39:00] if you, if you're confident that you do, then you can go ahead and do it. And the technique of [00:39:05] mouth taping is really important. You never use duct tape and cover your whole mouth, at [00:39:10] least in my opinion.
Um, you, uh, you do things to [00:39:15] clear, clean and clear your nose before you mouth tape And you [00:39:20] should really do a sleep test before you do any of the mouth taping because y- you might, you might be [00:39:25] plugging the emergency breathing hole that your body's trying to use, and you [00:39:30] might have an emergency event.
But I think overall it can be safe. [00:39:35] With children, you have to be more careful, uh, of course, and, and, uh, y- if [00:39:40] you're going to do it with your child, do it during the day. When I tape, I put it in the 11 [00:39:45] spot, you know, on the sides, so it's not covering the entire mouth [00:39:50] versus all the way across, just one strip here, one strip here.
And [00:39:55] it's interesting, the, the musculature around the lips tends to go, "Okay, I guess I need to calm [00:40:00] down," so it relaxes. But if you put it over the cupid's bow, that's a highly [00:40:05] nerve-rich area that you wanna avoid 'cause you'll be irritated a lot throughout the night if you [00:40:10] do that. And you'll wanna tape with, uh, 3M [00:40:15] Micropore-type tape that you wrap a wrist with or some K tape.
And [00:40:20] I actually prescribe mouth taping to my patients on a fairly regular [00:40:25] basis, but only after we've established patency through the nose and we've got oral [00:40:30] patency behind the tongue, and that, that's a way to get, keep the mouth closed and the tongue [00:40:35] up on the roof of the mouth suctioned there. You like, you make a suction cup [00:40:40] up there.
And then the tongue doesn't collapse the airway quite as much. You have a better chance of [00:40:45] breathing better. So it has a place if you do it right in the right kind of plan, [00:40:50] uh, in there.
Speaker: But I think often people just go in and like, "Let's try this," [00:40:55] can be- Mm-hmm ... a little bit scary as well. Yeah. Just like, yes, you need to make sure you can breathe well first other ways.[00:41:00]
Speaker 3: That's right. Absolutely. Yeah. Yeah, that book by James Nester actually is a [00:41:05] really good one where he talks about the, the research behind mouth taping and so [00:41:10] that would be a good reference.
Speaker: So if we have someone that these symptoms that we're talking about are ringing [00:41:15] true, um, where would you suggest they start?
Do they start with a sleep [00:41:20] evaluation? Do they start with an expert like yourself? Where do, where [00:41:25] is their entryway or their, their on-ramp into care for these issues?
Speaker 3: [00:41:30] Well, they could start with their primary care doctor. Um, the issue is that [00:41:35] they're, they're not, they only, uh, teach about two hours of sleep medicine in medical [00:41:40] school, and in dental school I don't remember them talking about it at all.[00:41:45]
And so everybody has varying levels of knowledge and expertise, so [00:41:50] y- I would, I wish I could say everybody's well-versed in the healing powers of [00:41:55] sleep, but they're not, and, and everybody's so busy and everybody's doing the best [00:42:00] they can. Um, but find somebody who has a background in [00:42:05] sleep disorder. Um, when, when you come to a person like myself, [00:42:10] let's say, I'm going to give you the perspective of let's [00:42:15] identify the actual blockage of the airway.
And let's, [00:42:20] but let's go to the physician first to get the diagnosis. And if you [00:42:25] heard somebody with my background that, that can help direct kind of where to [00:42:30] go next, then that's helpful because then you're not pigeonholed into you're on [00:42:35] CPAP, and I can't tell you how many people just get thrown on CPAP.
You got it. They don't... And I'll [00:42:40] ask them, "Did they tell you where your airway's blocked?" "No, they just said wear my CPAP." And that's a [00:42:45] good thing because you're not breathing, so wear that damn CPAP. But, but really the next question [00:42:50] is, if you don't want to be on that your whole life, then let's find out where you're blocked.
So come [00:42:55] to somebody who has a background in sleep like myself, and let's identify [00:43:00] that, and let's work in a team environment. And it takes a while to develop a team. [00:43:05] I, I'm sure you know that well enough, where you, you have a group of people who are like-minded, [00:43:10] who genuinely care, and I've got a great team that, that does, and then [00:43:15] I can activate it.
It's like, okay, you're here. Let's get this figured out and who needs to help [00:43:20] you. And at the end of all of this, you're going to be breathing, sleeping, body healing faster. [00:43:25] So that's the key. You could go directly to a pulmonologist and get a sleep [00:43:30] test done. Uh, but sometimes your insurance requires a referral from your primary [00:43:35] care to that sleep doctor, though they can, they can go.
But if they find, [00:43:40] "Hey, I'm just being told to wear CPAP," there are plenty of alternative to [00:43:45] CPAP, and there's plenty of research to support those things. But there are some [00:43:50] conditions like central sleep apnea, where the brain doesn't even trigger breathing, that, that [00:43:55] has to be identified. And that's a serious thing because you need to be on a thing called like a, it's like a [00:44:00] ventilator at cer- at certain times of the night too.
So nothing to trivialize because there's a lot [00:44:05] of serious medical problems like Alzheimer's, stroke, heart attack, [00:44:10] diabetes, hypertension that are associated with unmanaged sleep disorders. [00:44:15] So it's good when people get screened and take it seriously.
Speaker: Now just [00:44:20] some fun questions to close things out. What would you say is your favorite guilty [00:44:25] pleasure for food?
Speaker 3: Guilty pleasure for food. [00:44:30] I like to buy chocolates They're, they're [00:44:35] pretty amazing. They're expensive, but they're, they're a fun little treat to have every- So
Speaker: like the high [00:44:40] quality stuff, huh? Yeah.
Speaker 3: Right.
Speaker: And then how about, um, your [00:44:45] favorite way to spend your time outside of work?
Speaker 3: Oh, man. It's, it's playing with the [00:44:50] grandkids.
It's, uh, traveling with my, with my wife Kathy all over the world. We [00:44:55] love to go places. Tokyo, Taiwan recently, New Zealand, so love, [00:45:00] love, love all that. Love learning about the world. It's, it's amazing. Tasting good food
Speaker: too. [00:45:05] Cultures take on a whole different ... Culture takes on a whole different meaning when you're able to experience it in real [00:45:10] time.
Yeah.
Speaker 3: Oh, yeah. It's, it's a big world out there, for sure, and it's a lot of fun to see [00:45:15] cultures and things and learn about people, history. Love it.
Speaker: Well, thanks so much for your time this morning [00:45:20] and for talking with me. I think it was fun to explore this kind of pelvic floor and jaw and [00:45:25] sleep, um, and breathing kind of connection that we have between the two, and [00:45:30] I really- Yeah
appreciate you joining us today and teaching us all about your specialty and your passion, [00:45:35] and, um, it was really fun.
Speaker 3: Thank you, Bre. Wonderful to be [00:45:40] with you.
Speaker: Thanks for joining us today. I hope you guys learned a lot about the connection between the jaw [00:45:45] and the pelvic floor, your breath and your nervous system.
It was a fun discussion between dental and [00:45:50] pelvic floor physical therapist, and just assessing where it's like we have to look at the [00:45:55] whole person. We need a team involved. We need to be looking at the root causes and really getting to the [00:46:00] core of deep issues here so that we can really correct things and not just Band-Aid them.[00:46:05]
So we appreciate you tuning in today and hope you have a wonderful rest of your day.
Speaker 2: Millions of women are [00:46:10] still waiting for someone to take their symptoms seriously. You found this show. [00:46:15] Share it. New episodes of Healing at Your Core release every week. [00:46:20] Evidence-based, non-surgical, and built around one belief: You do not have to live [00:46:25] with
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