The DOC Podcast

The Evolution of Airway Dysfunction, Malocclusion, & Chronic Disease (w/Dr. Mark Cruz)

In this episode, I sit down with Dr. Mark Cruz - general dentist, former assistant director of the UCLA Center for Aesthetic Dentistry, and a pioneer in airway-focused dentistry - for one of the deepest conversations we've had on the show. We get into the medical and dental comorbidities of pediatric sleep-disordered breathing, the ongoing debate over whether malocclusion is driven by genetics or environment, and why I believe orthodontists are uniquely positioned, yet often reluctant, to lead in airway health. Mark walks me through his personal journey, including the terrifying night his six-year-old son stopped breathing, and how that experience reshaped his entire clinical philosophy. We dig into the evidence (and lack thereof) behind long-held orthodontic dogma, the anthropological data showing just how dramatically our facial skeletons have changed in only 500 years, and the evolutionary story of why our jaws and airways are in crisis today. We close out by tackling the "no evidence" myth head-on, most notably the claim that tooth extraction and tongue space have nothing to do with airway, and Mark breaks down exactly where that argument falls apart. If you care about early intervention, craniofacial growth and development, or evidence-based practice, get ready to take notes. **Timestamps:** - 0:00 — Open - 0:51 — Meet Dr. Mark Cruz - 2:15 — Mark's Path to Airway-Focused Dentistry - 16:57 — Which Dental Specialty Has the Strongest Evidence? - 17:26 — Why Orthodontics Is Positioned to Lead on Airway - 18:25 — The Airway as the Keystone of the Face - 25:24 — The History of Upper Airway Resistance Syndrome - 27:34 — How Our Facial Skeleton Has Changed in 500 Years - 35:22 — Rethinking Medical and Dental Education - 43:46 — The Airway as the Nexus of Health - 56:07 — Why Is This So Common? The Anthropology of Malocclusion - 61:32 — The Evolutionary Story: From Hunter-Gatherers to Modern Jaws - 70:15 — Debunking the "No Evidence" Myth on Extractions and Tongue Space - 79:03 — Closing Thoughts - 81:53 — Outro and How to Reach Dr. Cruz Know someone who'd make a great guest, or want to be one yourself? Email me at drmike@theorthocoach.com, and don't forget to join The Doc Community on Facebook. Thanks for listening, and remember, you've been blessed with the ability to do amazing things. LINKS Contact Mark - markcruz@markacruzdds.com Orthotown Article Part I: https://www.orthotown.com/magazine/digital/649/march-2025 Orthotown Article Part II: https://www.orthotown.com/magazine/digital/652/may-2025 Phase I Early Treatment Course: https://theorthocoach.com/courses/phase-i-arch-development/?portfolioCats=99 Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Instagram: @theorthocoach Email: drmike@theorthocoach.com

• Chapters

The Truth About Mouth Breathing, Sleep, & Sleep Medicine (w/Dr. Funke Brown) [Ep.170]

In this episode, I sit down with Dr. Funke Afolabi Brown, a triple board-certified sleep physician, founder of Restful Sleep MD, and best-selling author. We go way beyond the basics of sleep, exploring what "good sleep" actually means, why sleep medicine gets so little attention in physician and dental training, and why that has to change. Dr. Brown and I dig into the full spectrum of sleep-disordered breathing (it's so much more than just obstructive sleep apnea), the strengths and serious limitations of polysomnography versus home sleep testing, and why relying only on the AHI can cause us to miss patients who are genuinely struggling. We also spend a lot of time on the far-reaching effects of poor sleep in kids - behavior, learning, emotional regulation, and how sleep issues so often masquerade as ADHD. We talk candidly about why snoring and chronic mouth breathing should never be treated as "no big deal," why interdisciplinary collaboration between sleep physicians, pediatricians, ENTs, dentists, orthodontists, and myofunctional therapists is essential, and why I'm genuinely optimistic about where sleep medicine is headed. TIMESTAMPS 0:00 — Cold open: sleep's impact on children isn't benign 0:38 — Podcast welcome 1:02 — Guest introduction: Dr. Funke Afolabi Brown 4:20 — Interview begins 5:39 — Dr. Brown's background and path into sleep medicine 7:13 — Sleep education gaps in medical/dental training 10:19 — Defining good sleep: quantity, quality, timing 14:42 — Wearables, sleep tracking, and orthosomnia 20:24 — Acute vs. chronic sleep problems and recovery 26:52 — In-lab polysomnography: strengths and limitations 37:28 — The sleep-disordered breathing spectrum 41:10 — Primary snoring: why it's never normal 46:14 — Allergies, nasal airway, and root causes 48:12 — Chronic mouth breathing debate 54:23 — Why physicians and dentists avoid the topic 1:00:10 — ADHD and sleep-disordered breathing overlap 1:08:57 — Home sleep testing and treatment options 1:09:48 — The future of sleep medicine 1:16:00 — Closing thoughts and where to find Dr. Brown If you found this conversation valuable, please share this episode with someone who needs to hear it, follow DOC Podcast on Instagram, and subscribe to the channel on YouTube so you never miss an episode. LINKS Connect w/Dr. Brown: Website: https://www.restfulsleepmd.com/ Beyond Tired Book: https://a.co/d/2aSRSQt Instagram: https://www.instagram.com/restfulsleepmd/ LinkedIn: https://www.linkedin.com/in/drfunkebrown/ Facebook: https://www.facebook.com/funke.afolabibrown/ Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ The Generational Wealth Code: https://a.co/d/05TlkLJX Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Instagram: @theorthocoach Email: drmike@theorthocoach.com

How to Use the Tax Advantages of Real Estate to Build Wealth (w/Christine Vento-Conway, CPA)[Ep.169]

In this episode, I sit down again with Christine Vento Conway, Senior Vice President at Inland Securities, to dig into the real estate side of building generational wealth. We pick up where we left off with her family, this time focusing specifically on how real estate's tax advantages (1031 exchanges, DSTs, depreciation, and Qualified Opportunity Zones) can help investors defer, reduce, and even eliminate capital gains taxes. Christine breaks down the numbers, walks through real timelines and rules, and we compare these strategies to REITs so you know exactly which tool fits your situation. Whether you're a seasoned real estate investor or just getting started, this conversation will give you a clear framework for thinking about real estate as a tax strategy, not just an asset class. TIMESTAMPS 0:00 – Introduction and catching up with Christine 3:59 – Christine's role at Inland Securities and her CPA background 10:59 – The four key benefits of real estate as an investment vehicle 14:02 – Duplex vs. institutional real estate: diversification and risk 18:57 – Breaking down the tax consequences of selling a property 36:36 – The 1031 exchange timeline: the 45-day and 180-day rules 37:28 – What a qualified intermediary does (and why you need one) 49:20 – The three phases of a DST investment 56:32 – How DST income and distributions are taxed 1:12:13 – DSTs vs. REITs: what's the difference? 1:15:24 – Qualified Opportunity Zones and the One Big Beautiful Bill Act 1:27:41 – Who qualifies: accredited investor requirements and minimums 1:29:17 – How to get in touch with Christine If this conversation gave you a new way of thinking about real estate, please don't keep it to yourself. Send this episode to your financial advisor or CPA, since many of them aren't familiar with DSTs. Pick up a copy of *The Generational Wealth Code* to go even deeper, and if you want to explore these strategies for your own portfolio, reach out to Christine directly at conway@inland-securities.com. And if you enjoyed this episode, please subscribe, leave a review, and share it with someone who could benefit from a smarter approach to real estate and taxes. LINKS Purchase The Generational Wealth Code: https://a.co/d/0cye2Lqu Email Christine: conway@inland-securities.com Call Christine: 917-410-7725 First Episode w/Vento Family: Second Episode w/John Vento Sr: Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

The Role of the Nasal Passageways in Airway Disease (w/Dr. Peter Catalano)

Overview In this episode, I sit down with Dr. Peter Catalano - an otolaryngologist, rhinology fellowship director, and pioneer of minimally invasive nasal surgery. Dr. Catalano has held appointments at Mount Sinai School of Medicine, the Lahey Clinic, and Tufts University, and has spent over three decades developing and publishing on targeted nasal airway surgery. I've had the privilege of working with Dr. Catalano on a major article addressing mouth breathing, and our conversation here is one of the most important I've had on this platform. We go deep into the science of nasal airflow, the structural and institutional barriers preventing children from getting the care they need, and the very real consequences (neurological, behavioral, cardiovascular, and craniofacial) of untreated mouth breathing and sleep-disordered breathing. We also address the myths and dogmas that continue to persist in both the ENT and orthodontic worlds, and what it's going to take to break them down. If you've ever wondered why the two worlds of dentistry and medicine remain so siloed on this issue, or what it means for patients when they fall through the crack, this episode is for you. Timestamps 0:00 – Introduction and Dr. Catalano's background: ENT, skull base surgery, academic appointments at Mount Sinai, Lahey Clinic, and Tufts University 4:10 – How Dr. Catalano's career trajectory led him from engineering to medicine to rhinology — and the philosophy of fate and the "hidden angel" guiding his path 9:12 – The MicroShaver revolution: meeting Dr. Setliff in South Dakota and the aha moment that changed everything about minimally invasive sinus surgery 11:13 – The unexpected discovery: patients reporting they stopped snoring after sinus surgery, and how that led to a focus on nasal airway and sleep-disordered breathing 13:18 – [Ad] Early Orthodontic Treatment Comprehensive — a two-day hands-on immersive course with Dr. Daniel Camacho, Fort Lauderdale, FL, November 13–14. Click the link in the show notes to register. 14:27 – The 2009 Singapore breakthrough: Dr. Deyun Wang and computational flow dynamics — why no one actually knew how air moved through the nose until then 19:32 – Why previous nasal surgeries failed for OSA, and what "follow the airflow" means for surgical targets between the eyes 20:30 – Why making big holes in sinuses made things worse — and why the sinuses don't actually ventilate during breathing 23:58 – How the superior airway and structures like the uncinate process and concha bullosa became key surgical targets, producing a 15–20% improvement in airflow 26:08 – The insurance dilemma and medical-legal risks that prevent ENTs from performing airway surgery — even when the data is clear 30:03 – The ferret studies and the "never operate under 16" dogma: how flawed 1980s animal models became entrenched standard of care for pediatric ENT surgery 35:48 – Parallels to hormone replacement therapy and the rampant hypocrisy in academic medicine — how good studies get buried and bad ones persist 40:55 – How Dr. Catalano fought back against an insurance company, changed their pediatric sinus surgery policy, and survived multiple attempts to have his medical license revoked 47:12 – The Harvold monkey studies: why the obligate nasal breather argument is wrong, why the studies are foundational, and what it means that no one could repeat them today 58:07 – Children don't just "outgrow" airway obstruction: why the lymphoid involution argument is true but dangerously misleading when 90% of craniofacial growth is complete by age 8 1:13:57 – CBCT in ENT and orthodontic practice: why orthodontists need to learn to read the full image, how Dr. Catalano and Dr. John Walker found hidden tumors, and why rhinology-focused ENTs already use equivalent imaging 1:17:33 – Nocturnal enuresis and airway: the pituitary/ADH connection, why these children ask about bedwetting the moment they wake from surgery, and the anecdotal but compelling clinical evidence 1:27:15 – Swell body reduction: how a novel procedure Dr. Catalano pioneered in 2015 went from being met with rotten tomatoes at conferences to becoming standard of care Closing If this conversation resonated with you, I want to encourage you to share it with your colleagues, your dental and medical partners, and anyone who works with young patients who struggle to breathe. This is exactly the kind of interdisciplinary dialogue that can change outcomes for kids who are being told to wait it out. LINKS Dr. Peter Catalano: Email: catalanop9@gmail.com AJODO Article on Mouth Breathing: https://pubmed.ncbi.nlm.nih.gov/40057896/ Join The DOC Community on Facebook for more great content and discussions (https://www.facebook.com/share/g/1Cb9rkQVde/) Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

One Family's Airway Revolution (w/Sydney & Dr. Victor Avis) [Ep.167]

In this episode, I sit down with a truly inspiring father-daughter team - Dr. Victor Avis, a recently retired general dentist and orthodontist of 38 years, and his daughter Sydney Avis, co-founders of the Airway Revolution Foundation. What begins as a deeply personal story about Sydney's lifelong, undiagnosed struggle with airway and sleep disorders quickly evolves into a powerful conversation about the systemic gaps in how medicine and dentistry recognize and treat airway-related health issues. From Sydney's childhood as a chronic mouth breather to her life-changing double jaw surgery in 2020, and from Dr. Avis' discovery of the Mews and orthotropics to the launch of a nonprofit digital learning platform, this episode is packed with insight, honesty, and a whole lot of heart. Timestamps 0:00 — Introduction & welcome 0:23 — About today's guests: Dr. Victor Avis & Sydney Avis, co-founders of the Airway Revolution Foundation 3:16 — Dr. Avis frames the conversation: what it's like to see patients transform through airway treatment, and why he didn't see it in his own daughter 7:19 — Sydney begins her story: growing up without knowing something was wrong 8:21 — Dr. Avis reflects: he didn't know mouth breathing wasn't normal, even watching home videos; the missed opportunity at age 6 10:43 — School struggles begin: from A student to C student despite extraordinary effort; asthma, inhalers, and cavities nobody connected to airway 15:25 — Sydney's growing anxiety: first panic attack at prom; daily panic attacks escalating through her gap year 15:57 — The breaking point: a 3 AM call from Thailand - Sydney in the hospital getting a brain scan 20:29 — Dr. Avis discovers John Mew on YouTube; two weeks later he's in England studying orthotropics 22:19 — Presenting Sydney's case to Bill Hang's study group: the recommendation for double jaw surgery, and Sydney's immediate answer: "Okay, let's do it" 24:13 — The pre-surgery journey: sleep studies, DICE with Dr. Soroush Zaghi, MADs, CPAP, nothing helps; surgery delayed by COVID 31:11 — Sydney shares life after surgery: REM rebound, finally feeling rested, and the lifting of the "fog" 52:37 — Why they founded the Airway Revolution Foundation and built a free digital learning platform for parents, educators, and adults 1:12:28 — Lessons from trying to change doctoral education and lobbying Capitol Hill and why they ultimately decided to go directly to the public 1:22:51 — The danger of anti-airway commentary; 50–60% of kids on ADHD medications may have an undiagnosed sleep disorder; how to connect with the Foundation Closing Dr. Victor and Sydney Avis are doing something rare - turning personal pain into a movement that has the potential to change millions of lives. If their story resonates with you, visit airwayrevolution.org and follow @theairwayrevolution on social media to stay connected as their digital learning platform launches this fall. LINKS Airwayrevolution.org Connect w/the Avis' on Social Media: @theairwayrevolution Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

More Than the Tongue: Rethinking Oral Ties, Latch, & Facial Development (w/Dr. Shereen Lim) [Ep.166]

In this episode, I'm joined for the second time by Dr. Shereen Lim, an internationally recognized dentist whose work is reshaping how we think about oral tethered tissues and their role in craniofacial growth, airway health, and orthodontic outcomes. Since her first appearance on the show (Episode 34 - link below), Dr. Lim has pushed even further beyond tongue ties, focusing her clinical lens on lip ties, buccal frenum ties, and their profound influence on facial development, maxillary arch constriction, dental crowding, and orthodontic relapse. This conversation is a masterclass in staying intellectually curious, remaining open to what the evidence in your own practice is telling you, and constantly reassessing your diagnosis and treatment approach as new information emerges. Timestamps 0:00 – Introduction & episode overview 3:12 – Welcome back: Dr. Lim returns to The DOC Podcast 4:43 – Beyond tongue ties: Dr. Lim's evolving focus on lip and cheek (buccal) ties and their impact on latch, facial tension, and development 8:46 – The lower lip tie discovery: how chin strain and mentalis tension led to a clinical breakthrough 9:55 – Buccal ties, orthodontic relapse, and how cheek tension shapes the dental arch 14:45 – Interdisciplinary collaboration: working with osteopaths, chiropractors, and lactation consultants 15:59 – The emotional weight of realizing what we've missed — and why blinders happen 19:01 – Case study: the patient with severe malocclusion and the tightest cheek ties Dr. Lim has ever seen 22:03 – My talk on why orthodontists resist airway-focused care — and granting colleagues grace 25:44 – Tongue ties without transverse deficiency: how cheek ties may explain the variation 27:36 – V-shaped arches, orthodontic relapse, and the role of perioral restrictions 29:39 – Historical perspective: the Frenkel appliance, lip bumpers, and treating the etiology 33:03 – How to assess what's normal vs. abnormal: signs to look for across infancy, childhood, and adulthood 36:41 – The procedure: CO2 laser technique, team-based approach, and what to expect after releases 39:10 – When outcomes fall short — and why proper pre/post care changes everything 41:34 – A remarkable case: releasing ties in an infant with Down syndrome against specialist advice 44:19 – Challenging the 2020 AAO-HNS consensus statement and the misuse of evidence-based medicine 46:53 – The real value of clinical observation and patient-reported outcomes 50:19 – Pushback on social media vs. trust within the clinical community 52:10 – Functional trainer appliances (Myobrace, Vivos, 2Pill): where they help and where they fall short 56:18 – Post-release comfort: why oral releases may make functional appliances easier to tolerate 57:54 – The journey approach: doing one thing at a time and building confidence incrementally 1:00:46 – Vestibuloplasty technique: releasing multiple sites together for better outcomes 1:03:46 – A message to overwhelmed clinicians: you don't have to do it all at once 1:06:32 – Evidence-based practice in action: what Dr. Lim is actually doing in her clinic 1:07:09 – Where to find Dr. Lim & closing thoughts This conversation reminded me of why I do this work. Dr. Lim's willingness to look critically at her own outcomes, stay open to what her patients are showing her, and continuously evolve her clinical approach is a model for all of us. Whether you're brand new to airway-focused dentistry or have been in this space for years, I hope this episode leaves you a little more curious, a little more humble, and motivated to ask whether there's a better way to serve the children and families we care for. LINKS Episode 34 w/Dr. Lim: LINK Dr Lim’s Book: Breathe, Sleep, Thrive Dr. Lim’s Website: https://www.drshereenlim.com.au/ Dr. Lim’s IG: @dr.shereenlim Dr. Lim on FB: LINK Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Instagram: @theorthocoach Email: drmike@theorthocoach.com

A Holistic Approach to the Management of Sleep Apnea (w/Dr. Dave McCarty) [Ep.165]

In this episode, I sit down with Dr. Dave McCarty - board-certified in internal medicine and sleep medicine, Chief Medical Officer of Rebis, and the visionary behind the Empowered Sleep Apnea Project - for one of the richest conversations I've had on this show. We go deep on why the AHI is far more limited than most providers and patients realize, trace the history of sleep apnea from Dickens' "Fat Joe" to the invention of CPAP, and unpack a landmark trial now questioning whether high-pressure CPAP may cause harm. Dave draws a compelling parallel between today's resistance to airway-focused thinking in dentistry and the tragic story of Ignaz Semmelweis, the physician who discovered handwashing saves lives and was institutionalized for it. We also make the case for nasal breathing, tackle the real limits of evidence-based medicine, and Dave shares his vision for Rebis: an integrated sleep medicine ecosystem that puts the patient, not the algorithm, at the center. Timestamps 0:00 – Introduction & Dr. Dave McCarty bio 2:40 – Dave's origin story: from primary care to sleep medicine ("I'm a recovering primary care doc") 12:32 – Cold-calling Tom Colquitt & the dental-airway connection 15:59 – Enthusiasm as a guiding force: Ralph Waldo Emerson, cold calls, and following fear 18:20 – Why insurance-driven medicine creates silos — and what the dental community can teach physicians about patient-centered care 21:37 – Unpacking the complexity of sleep apnea: obstructive vs. central, the "vanilla chocolate swirl," and why the AHI is a code that needs decoding 26:12 – The history of sleep apnea: from Osler and Dickens' "Fat Joe" to Pickwickian syndrome 29:21 – 1966: Henri Gastaut studies a Pickwickian patient and discovers sleep apnea as we know it 30:38 – Colin Sullivan and the invention of CPAP in 1981 40:40 – The five reasons to treat sleep apnea: risk, snoring, sleep experience, wake experience, and comorbidities 50:00 – Why nasal breathing matters: autonomic nervous system, nitric oxide, craniofacial development, and immune defense 56:07 – The Semmelweis parallel: dangerous truths, resistance to change, and the human cost of orthodontic practices we may need to revisit 1:12:43 – No randomized controlled trial proves CPAP prevents mortality — and new data suggests over-pressurization may cause harm 1:18:22 – Rebis: building an integrated, multidisciplinary sleep medicine ecosystem that democratizes complexity 1:27:40 – Closing thoughts & how to connect with Dr. McCarty LINKS: Rebis: https://www.rebishealth.org/ Contact Dr. McCarty: https://www.empoweredsleepapnea.com/ Beyond OSA: https://www.nxtbook.com/farran/orthotown/orthotown-march-2025/index.php?startpage=36#/p/34; Articles Referenced by Dr. McCarty: email Dr. DeLuke (drmike@theorthocoach.com) Phase I CE Courses: https://theorthocoach.com/courses/phase-i-arch-development/?portfolioCats=99 Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach If this episode opened your eyes to how much more there is to sleep-disordered breathing than a number on a sleep study report, I encourage you to share it with a colleague in medicine, dentistry, or orthodontics who needs to hear this conversation. The siloes between our disciplines are costing patients, and it's going to take all of us working together to tear them down.

The Oral-Systemic Connection: Why Dentists Need to Look Beyond the Mouth (w/Dr. Witt Wilkerson) [Ep.164]

Summary: In this episode, I sat down with one of the most respected voices in dentistry, Dr. Witt Wilkerson - Director of Dental Medicine at the Dawson Academy and a true pioneer in the intersection of occlusion, TMD, airway, and integrative dental medicine. We had an incredibly rich conversation about the paradigm shift that I believe is transforming our profession: moving away from reactive, tooth-focused treatment and toward a whole-health, root-cause approach. Dr. Wilkerson shares his 44-year journey from treating bruxism purely as a bite problem to recognizing airway and sleep-disordered breathing as primary drivers of dysfunction. We challenged the siloing of dental specialties, made the case for dentistry as oral medicine, and explored the enormous opportunity we all have, dentists and hygienists alike, to screen for and address systemic health issues, including inflammation, blood sugar dysregulation, and sleep disorders. This is a conversation you do not want to miss. Timestamps: 0:00 - Welcome 0:23 — I introduce Dr. Witt Wilkerson and what we'll cover in today's episode 4:46 — Dr. Wilkerson shares his background: joining Dr. Pete Dawson's practice in 1982 and a career built on the question, "Is there a better way?" 6:07 — We discuss the segmentalized state of dentistry and medicine, and why the younger generation is finally starting to change that 8:33 — The 2009 Baylor article that changed everything for Dr. Wilkerson: the link between sleep apnea, bruxism, and airway 12:51 — I ask Dr. Wilkerson about the courage and humility it takes to admit you were wrong, and to update what you've been teaching for decades 28:23 — Dr. Wilkerson walks us through the three pillars of Integrative Dental Medicine: inflammation/infection, airway/sleep, and TMD/occlusion 29:26 — Why salivary testing should be part of every new patient exam, and what it can tell us about systemic health 30:06 — The diabetes-periodontal link we've known about since dental school, and why almost none of us are acting on it 30:52 — How continuous glucose monitoring is being used as both a periodontal and whole-health tool in Dr. Wilkerson's practice 45:41 — We get into orthodontics and TMD, including the defensive reaction from the ortho community that held the profession back, and what I think the specialty should do instead 50:05 — A critical clinical protocol: why you should always study sleep before placing any occlusal appliance on a bruxer 54:43 — The adult complex restorative patient: how I believe we should be approaching these cases from a truly interdisciplinary standpoint 1:14:16 — The future of treatment sequencing: why airway therapy may need to come first, before any restorative or orthodontic work 1:18:15 — How to connect with Dr. Wilkerson, the IDM Scholar Society, and the S3 Workshops Call to Action: If this conversation lit a fire in you the way it did for me, here's what I'd encourage you to do next: Connect with Dr. Witt Wilkerson and learn more about the IDM Scholar Society and his S3 (Sleep, Saliva & Sugar) Workshops at IDMScholarSociety.com, or reach out to him directly at WittWilkersonDMD@gmail.com Join me and Dr. Daniel Camacho at the Early Orthodontic Treatment Comprehensive Course - a two-day hands-on event, November 13–14 in Fort Lauderdale, FL. We'll cover early airway-focused interceptive treatment, CBCT reading, live patient observation, and so much more. Includes 41 CE hours. Space is limited, so grab your spot at https://www.earlyorthotreatment.com/ Share this episode - If this conversation shifted your perspective on dentistry's role in whole-body health, please pass it along to a colleague. The more dental professionals hear this message, the more patients we can help and the stronger our profession becomes. Join The DOC Community on Facebook for ongoing discussions, resources, and more content like this. https://www.facebook.com/share/g/1Cb9rkQVde/ Work with me directly - Head to theorthocoach.com to access my CE courses or schedule a private one-on-one coaching session. LINKS AAO White Paper Review: https://youtu.be/pKSD_PVO4G0 YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

The Fundamentals of Generational Wealth: Planning, Fiscal Discipline, & Real Estate (w/John Vento Sr.) [Ep.163]

OVERVIEW Most high-income professionals work incredibly hard, yet wonder why wealth and financial freedom seem just out of reach. The answer, more often than not, isn't about earning more. It's about understanding the fundamentals that turn a good income into lasting wealth. In this episode, Dr. Mike sits down with John Vento Sr., a CPA, financial advisor, and co-author of The Generational Wealth Code, for a conversation that could genuinely change the financial trajectory of your life. John has spent 40 years helping dentists and other professionals build real, lasting wealth, and in this episode, he lays out the exact framework he uses with every client: start with fiscal discipline and margin, know your numbers cold, minimize your tax burden legally, and then deploy your capital strategically through real estate. Whether you're just starting out and trying to dig out from under student loan debt, or you're well into your career and ready to accelerate your wealth-building, this episode gives you a practical roadmap — one built not on hype or shortcuts, but on proven principles that compound over a lifetime and beyond. TIMESTAMPS 3:42 — Episode begins; Introduction to the series and The Generational Wealth Code 4:25 — Why "Living Within Your Means" is the most important chapter in the book 6:45 — Taxes as your #1 lifetime expense; the importance of tax literacy 9:22 — Good debt vs. bad debt; how to approach student loan debt as a young professional 13:44 — The 20 questions in the book's introduction and using it as a lifelong financial guide 15:00 — Knowing your numbers: the statement of net worth and cash flow analysis 18:07 — The cost of waiting; why starting early is critical 22:47 — Balancing competing goals: student loans, retirement, college savings, and investing 25:56 — Retirement planning; the 12-variable financial calculator and setting realistic goals 30:21 — Estate planning: wills, trusts, LLCs, and when to start 39:20 — The "live for today" mindset; balancing enjoyment and financial responsibility 43:22 — Cash flow statements; where your money is really going 47:45 — Transitioning to real estate: creating margin to invest 50:01 — Why dentists should own their office space; the phantom deduction of depreciation 52:47 — LLCs, liability protection, and entity structure for real estate 56:55 — Tax benefits of owning real estate through an LLC; SALT workarounds 1:00:49 — The One Big Beautiful Bill Act and accelerated depreciation for capital improvements 1:03:45 — Cost segregation studies and maximizing depreciation deductions 1:09:46 — The value of a financial coach; the importance of an ongoing, intimate client relationship 1:14:14 — Leverage in real estate: using other people's money to multiply returns 1:17:10 — Equity recycling: pulling out equity to buy more properties and build wealth 1:19:28 — Depreciation, step-up in basis, and passing real estate wealth to the next generation 1:24:47 — Passive vs. active real estate investors; IRS classifications and what they mean for your taxes 1:28:27 — Passive Income Generators (PIGs) and Delaware Statutory Trusts 1:30:25 — Preview of the next episode with Christine Vento: 1031 exchanges, Qualified Opportunity Funds, and advanced real estate strategies 1:31:17 — Types of 1031 exchanges: simultaneous, delayed, reverse, and construction/improvement 1:37:26 — Closing thoughts: tax planning as a year-round chess match against the IRS If this episode got you thinking differently about your financial future, please don't keep it to yourself. Share it with a colleague, a friend, or anyone in your life who could benefit from hearing this information. The principles John shares here don't just help people save money; they help people build the kind of financial freedom that lasts for generations. The information discussed in this podcast is intended for informational and educational purposes only and should not be considered individualized financial, investment, legal, or tax advice. Please consult your own professional for advice specific to your individual situation. LINKS: Purchase John’s New Book: https://a.co/d/0cye2Lqu Vento Tax & Wealth Mgmt. Website: https://www.vtwmg.com/ Joint Episode w/The Vento Family: https://youtu.be/9sEzEto2mAM Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Link to Balance Sheet on DOC Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

The Great Airway Debate: All That's Old is New Again (w/Dr. Duane Grummons) [Ep.162]

Overview: In this landmark episode, Dr. Mike sits down with Dr. Duane Grummons - a board-certified orthodontist, educator, and internationally recognized lecturer with over 50 years of clinical experience. Dr. Grummons traces the origins of airway-focused orthodontics from his early training under Ricketts, Bench, and Gugino in the 1970s, through the political and clinical headwinds of the 1990s, to the evidence-based framework he champions today. The conversation covers early facial orthopedics, slow maxillary expansion, mandibular arch development, face mask therapy, cone beam imaging, and the critical importance of treating the whole patient, not just the teeth. Timestamps: 0:00 — Welcome 0:23 — Introduction of Dr. Duane Grummons and his 50+ year career in orthodontics 3:16 — Dr. Grummons on his clinical history: Ricketts, Bench, Gugino, and learning to think in 3D from day one 7:03 — "It's a fad" — addressing the critics of airway orthodontics and why this work is decades old 21:03 — The 2026 AAO: only 1 out of 155 lectures addressed early treatment and airway 24:44 — Why orthodontists fear lower arch expansion — and why they shouldn't 30:57 — Advice for colleagues who want to shift toward earlier, airway-focused care 38:26 — Why residency programs are still teaching that mandibular expansion is malpractice 47:30 — The science behind slow maxillary expansion and why RPE may be the wrong tool for young kids 1:01:22 — "Flying the maxillae": face mask therapy, tip/yaw/roll, and 3D orthopedic planning 1:19:32 — CBCT and 3D imaging: why the debate is still happening and why Dr. Grummons can't practice without it 1:28:39 — The power of parent testimonials and capturing outcomes on video 1:33:59 — Facial descriptors, the hyoid complex, and why diagnosis must go beyond the teeth 1:38:36 — Closing thoughts: health span, brain longevity, and rising above the circumstances Summary: This episode is an essential listen for any clinician serious about comprehensive, patient-centered orthodontic care. Dr. Grummons reminds us that the science has always been there, and that the most powerful thing we can do is go deep on diagnostics, treat early when the face is developing, and never stop learning. LINKS: Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

Airway, Wellness, and the Patient-Centered Private Practice (w/Dr. Trevor Nichols) [Ep.161]

Episode Summary Dr. Trevor Nichols returns to The Doc Podcast for his second appearance, and a lot has changed. Since opening Nichols Orthodontics and Aesthetics in Gilbert, Arizona, in August 2024, Trevor has grown from a two-person operation to a team of 20, with a waitlist. In this rich conversation, Dr. Mike and Dr. Nichols cover the full journey: the leap from corporate/DSO orthodontics to private practice ownership, the vision and systems that fuel their growth, the personal wellness habits that keep them grounded, and, most passionately, the case for early airway-focused, craniofacial orthodontic treatment. This episode is a must-listen for any orthodontist, dentist, or healthcare professional who wants to treat the whole patient, not just the teeth. Timestamps 3:29 — Welcome back: Dr. Nichols returns to the show after ~2 years 4:33 — "Probably the best two years of my life" — Dr. Nichols reflects on opening his practice 5:27 — Starting with just two people, leasing space from a general dentist 6:29 — "Fight for your dreams" — the case for private practice ownership 6:53 — Why private practice better protects patients and the profession vs. corporate/DSO models 22:03 — Building the vision: how to define what orthodontics truly fulfills you 23:29 — "Do a true audit of what in orthodontics brings you happiness" 29:34 — The three pillars of Nichols Orthodontics: patient experience, culture, and results 40:24 — Why Dr. Nichols hired a CEO (formerly at Crumbl Cookies) to run the business side 50:44 — Balancing plates: weekly date nights, gratitude practices, and intentional reflection 57:32 — Shifting to the clinical: why diagnosis is what separates orthodontists from OTC aligners 1:00:57 — "We're not just orthodontists — we're craniofacial orthopedists" 1:02:58 — "I don't really care about the teeth right now" — diagnosing profile, growth, and airway first 1:11:06 — Treating 3- and 4-year-olds: when early intervention is warranted and how to screen for it 1:17:44 — 45% of Nichols Orthodontics' practice is now airway-focused treatment 1:27:43 — The key to phase one braces success: bond ALL the primary teeth + disarticulate 1:29:00 — The tongue as nature's expander: ~400g of force at swallow — why we don't need more 1:37:18 — "Early adopters take the most scrutiny — and then we find out they were right all along" LINKS Register for the In-person Early Treatment Comprehensive ($1000 off if register by June 30): https://www.earlyorthotreatment.com/ Episode 50 w/Dr. Nichols: https://podcasts.apple.com/us/podcast/finding-living-your-purpose-w-dr-trevor-nichols-ep-50/id1689703392?i=1000655038062 Connect w/Dr. Nichols: https://www.nicholsortho.com/?utm_source=GBP Instagram: @dr.trevornichols Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Enroll in one-on-one coaching w/Dr. Mike: https://theorthocoach.com/doc-coaching/ If this episode resonated with you, please take a moment to share it with a colleague, friend, or fellow healthcare professional who would benefit from hearing it. Word of mouth is the single most powerful way to grow this community and spread this message. Leave us a rating and review on Apple Podcasts or Spotify; it makes a huge difference! And if you haven't already, subscribe so you never miss an episode of The Doc Podcast. Thank you for your support! Together, we're changing lives, one conversation at a time.

More Than The Mouth: Dentistry's Role in Total Health (w/Dr. Staci Whitman)

Episode Summary In this powerful episode, Dr. Mike sits down with Dr. Staci Whitman, a board-certified pediatric dentist, functional and naturopathic dentistry expert, and one of the only dentists in the world certified by the Institute of Functional Medicine. Dr. Staci shares her remarkable journey from nearly leaving the profession entirely to becoming a trailblazer in functional pediatric dentistry. Together, they dive deep into the critical connections between oral health and whole-body health, exposing the gaps in traditional dental education and offering a roadmap for how dentists and patients can do better. Show Notes 0:00 — Introduction & welcome 1:49 — Topics covered today: fluoride, oral-gut microbiome, airway health, burnout, and more 3:33 — Dr. Staci's journey: from a childhood dental trauma to nearly quitting the profession 5:47 — "I almost left dentistry" — how debt kept her in and what ultimately changed 6:57 — The pivot to pediatrics and a root-cause, upstream approach 15:36 — Her three diagnostic priorities: nutrition, gut health, and airway (not the teeth) 16:11 — "We don't have dental physicians" — connecting the mouth to the whole body 33:12 — The fluoride debate: how Dr. Staci went from advocate to skeptic 37:06 — Fluoride works topically, not systemically — what the science actually says 56:06 — The oral microbiome: nitric oxide, the oral-gut axis, and why it matters 57:02 — "You cannot have a healthy patient without a healthy gut" 58:00 — Oral microbiome testing: options, tools, and why it should be standard of care 1:05:46 — Top action step #1: nutrition and reducing snacking frequency 1:07:40 — Top action step #2: hydration, saliva, and minerals 1:08:02 — Top action step #3: airway and the dangers of mouth breathing Resources & Links Mentioned: Register for the In-person Early Treatment Comprehensive ($1000 off if register by June 30): https://www.earlyorthotreatment.com/ Oral microbiome testing resources: https://www.viome.com/products/oral-health-intelligence; https://www.bristlehealth.com/ Cochrane Review on Fluoride (2024): https://pubmed.ncbi.nlm.nih.gov/39362658/ The Institute for Functional Dentistry: https://functionaldentistry.com/ Episode with Beth Lambert: https://podcasts.apple.com/us/podcast/whats-causing-the-chronic-disease-epidemic-in-our/id1689703392?i=1000716655495 Connect with Dr. Staci: https://doctorstaci.com/ Dr. Staci on Instagram: @doctor_staci Connect with Dr. Mike: theorthocoach.com Dr. Mike on Instagram: @theorthocoach Email: drmike@theorthocoach.com Join the DOC Community on Facebook: https://www.facebook.com/share/g/1Cb9rkQVde/ The health of our patients and our profession depends on dentists willing to think differently. Please share this episode with a colleague or fellow parent who needs to hear it!

Real Estate, Taxes, & The Power of Planning: Inside the Generational Wealth Code (w/The Vento Family)

Episode Summary Dr. Mike welcomes a powerhouse family of financial professionals to The DOC Podcast: John Vento Sr., his daughters Christine Vento and Nicole Vento, and his son John Vento Jr. Together, they discuss their brand-new book, The Generational Wealth Code, and share decades of expertise in tax planning, real estate investing, and wealth management. John Sr. traces his journey from doing his first tax return in his parents' Brooklyn basement in 1985 to building a comprehensive wealth management firm. Each of his three children - all CPAs and securities-licensed - shares how they found their own specialties: Christine in 1031 exchange real estate solutions and Delaware Statutory Trusts, Nicole in tax-smart investment management and financial planning, and John Jr. in dental CPA and proactive tax strategy. The conversation spans the importance of year-end tax planning (not April 15th), the power of passive real estate income, how to raise financially literate children, and why paying for expert financial advice is an investment, not a cost. This is the first of a five-part series with the Vento family, with each member returning for a dedicated solo episode. Timestamps 0:00 – Introduction & welcome to the Vento family 2:01 – Overview of *The Generational Wealth Code* and the five-part series 3:09 – Guests introduce themselves 5:04 – John Sr.'s background: From Brooklyn basement to building his own firm (1985) 6:03 – John Sr. on leaving KPMG and why he added a securities license to his CPA practice 9:20 – Christine's background: From KPMG deal advisory to real estate and 1031 exchanges 10:48 – Christine explains 1031 exchanges and Delaware Statutory Trusts (DSTs) 14:47 – Nicole's background: Goldman Sachs, JPMorgan, and returning to the family practice 20:53 – John Jr.'s background: Working in the firm as a teenager, Pricewaterhouse, and becoming managing partner 27:09 – Why year-end tax planning matters: "Once December 31st passes, there's nothing you can do" 30:02 – The origin story of John Sr.'s first book, *Financial Independence: Getting to Point X* 32:04 – What's new in *The Generational Wealth Code* and the impact of the One Big Beautiful Bill Act 38:37 – John Sr.: "Financial literacy should be required in every high school" 1:07:32 – John Jr.: "Almost every decision in life has a tax consequence" — preview of his solo episode 1:12:39 – Book release date, where to buy, and how to contact the Vento family firm Resources & Links The Generational Wealth Code – Available June 9th on Amazon and Barnes & Noble (pre-order now): https://a.co/d/0iHwEITG https://www.ventotaxandwealth.com/ Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com YouTube: @theorthocoach Email: drmike@theorthocoach.com Instagram: @theorthocoach

Should 3D/CBCT Imaging be the Standard of Care in Orthodontics? (w/Dr. Dania Tamimi) [Ep.158]

In this episode of The DOC Podcast, I sit down with Dr. Dania Tamimi, an oral and maxillofacial radiologist, Harvard-trained dental educator, and holistic health advocate, for a wide-ranging conversation on why diagnosis must come first in dentistry, and why 3D CBCT imaging is no longer optional for orthodontists who want to truly serve their patients. Dr. Tamimi brings a uniquely multidisciplinary perspective, weaving together radiology, yoga therapy, kinesiology, and craniofacial anatomy to make the case that the mouth and the airway cannot be treated in isolation. Together, we challenge the "tooth straightener" mindset still dominant in orthodontics, break down the science of nasal breathing and its profound impact on facial development, and take a critical look at recent AAO position statements on airway and CBCT. Whether you're a seasoned clinician, a young provider, or a curious parent, this episode will change the way you think about dental imaging, airway, and what it means to truly diagnose. Timestamps: 0:00 — Introduction & Meet Dr. Dania Tamimi 4:01 — Dr. Tamimi's background: oral & maxillofacial radiology explained 4:46 — A parallel career in fitness and why it matters for TMJ 6:55 — "It's all connected" - the TMJ, airway, and the whole body 10:01 — Dr. Mike's airway awakening: how getting a CBCT in 2014 changed everything 12:37 — Why we image: diagnosis is the single most important step 18:38 — CT vs. CBCT: what's the actual difference and why does it matter? 21:58 — Cone beam CT explained: lower dose, dental-specific, and what it can (and can't) show 25:52 — Why is 3D CBCT adoption still debated in orthodontics? 30:09 — Fear, comfort zones, and the cost of not knowing 36:07 — "Knowledge gives you power, fear takes it away" 38:59 — "I don't want to be responsible for what's on the scan" - the liability fear no one talks about 44:07 — Should orthodontists rename themselves craniofacial orthopedists? 52:00 — No such thing as a routine X-ray: why clinical exam must come first 1:13:34 — The science of nasal breathing: nitric oxide, filtration, and why mouth breathing changes your face 1:14:35 — How mouth breathing narrows jaws, crowds teeth, and displaces the tongue into the airway 1:19:01 — Challenging the AAO white paper: "No craniofacial phenotypes can identify airway problems"? 1:23:25 — Can orthodontists read their own scans? How to know when to refer LINKS Register for the In-person Early Treatment Comprehensive:https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Enroll in one-on-one coaching w/Dr. Mike: https://theorthocoach.com/doc-coaching/ Link to Dr. Mike’s review of the AAO White Paper Update on SDB: https://youtu.be/pKSD_PVO4G0?si=CSxQy4V6tZoe551t Dr. Tamimi TEDx talk: https://youtu.be/zlYuHwqrsPo?si=30NiJu_UiuPeKRlX Contact Dr. Tamimi: https://inspire-imaging.com/

Rethinking When, Why, & How We Treat Patients (w/Dr. Mike DePascale) [Ep.157]

Episode Summary Dr. Mike DePascale is a Connecticut-based orthodontist and co-owner of a multi-location practice with his partner and mentor, Dr. Jeff Kozlowski. In this episode, Dr. DePascale shares his remarkable personal journey from suffering severe obstructive sleep apnea in his early 20s and undergoing orthognathic surgery to becoming a passionate advocate for airway-focused, early-interceptive orthodontic care. The conversation covers the philosophy behind their thriving partnership, why airway is still woefully undertaught in residency programs, how to practically integrate early airway-focused treatment into a busy practice, the critical role of interdisciplinary collaboration, and what it takes to maintain peak fitness while building a career and a family. This is a conversation about so much more than teeth, it's about breathing, thriving, and never settling. Timestamps 0:00 — Introduction to The DOC Podcast and Dr. Mike DePascale 10:57 — Dr. DePascale's origin story: cold-calling medical offices to find his path 12:30 — Diagnosed with severe sleep apnea in his 20s: 3 car accidents, 2–4 hours of sleep a night 15:30 — Choosing orthognathic surgery over CPAP — and how it saved his life 19:00 — Finding Dr. Jeff Kozlowski: choosing mentorship over immediate money 24:00 — What makes a practice partnership actually work: communication, consistency, and commitment 33:00 — Residency training: what it prepared him for — and what it didn't 38:00 — Why airway is barely taught in orthodontic residencies (and what needs to change) 45:00 — The 1968 Salzman Index, Medicaid, and how the system trains orthodontists to pull teeth instead of treat early 53:00 — How to practically integrate airway screening into a busy multi-doc practice 58:00 — Team training, sleep questionnaires, and the power of interdisciplinary referral networks 63:00 — The emotional reality: a mom crying after finally hearing "tongue tie" for the first time after 5 specialists 68:00 — How early is too early? Dr. DePascale's own son: frenectomy at weeks old, T&A at age 2 75:00 — Why orthodontists are uniquely positioned — and obligated — to lead in the airway space 80:00 — Fitness as a non-negotiable: from not finishing a mile to running a 4:53, and why he never gets out of it Links Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Website: theorthocoach.com Email: drmike@theorthocoach.com Instagram: @theorthocoach Thank you for your support of The DOC Podcast, and please share the show with others who may benefit from hearing this conversation!

The Good, Bad, & Ugly of the AAO White Paper Update on SDB and Orthodontics [Ep.156]

In this episode, Dr. Mike breaks down the 2024 update to the 2019 AAO White Paper on obstructive sleep apnea and orthodontics, published in the AJODO in April. After presenting to hundreds of medical, dental, and myofunctional therapy colleagues across the country, he recorded his full presentation for listeners worldwide. Timestamps 0:00 – Introduction, episode overview & why Dr. Mike recorded this presentation 1:17 – Context: Presenting across the U.S. (Houston, Bronx, Long Island) — the near-universal reaction was shock at the document's flaws 3:07 – THE GOOD begins 3:07 – Good #1: Acknowledges the full spectrum of sleep-disordered breathing (SDB), not just OSA 3:55 – Good #2 & #3: Calls on orthodontists to screen all pediatric patients for SDB, emphasizes early detection, and acknowledges multifactorial etiology requiring interdisciplinary care 5:07 – THE BAD begins 5:07 – Bad #1–2: Author panel was 8 orthodontists + 1 librarian (no physicians, no myofunctional therapists); document inconsistently uses "OSA" vs. "SDB" throughout 8:03 – Bad #3–5: Minimal screening guidance (32 signs & symptoms largely ignored); only briefly mentions comorbidities; never discusses the importance of nasal breathing 13:00 – Bad #6: Overall focus is on what not to do rather than guiding orthodontists on how to help patients 14:00 – THE UGLY begins 15:01 – Ugly #1: Reliance on PSG-confirmed OSA to justify intervention — challenges with pediatric sleep studies (access, sensitivity, first-night effect, lack of standardization); what Reference 34 actually says vs. how it was cited 22:40 – Patient case study: Child with AHI of zero but severe signs of airway disease — the ENT said "what does the orthodontist know about sleep medicine?" 26:34 – Ugly #2: "No way to determine if a patient is a mouth breather" — justified by a study of 9 adults on a cycle ergometer; Dr. Kandasamy's 2025 AJODO editorial; what the actual research shows (European OJ, AHA, ADHD literature, microbiome) 36:51 – Ugly #3: "No craniofacial phenotypes can identify SDB" — directly contradicted by Reference 34 and the original 2019 white paper; Harvold primate studies, Hew et al. (2011), Principato's tongue mechanics explained 43:03 – Ugly #4: "Most children with SDB will outgrow it" — both cited references (Refs 17 & 18) actually contradict this claim; cardiovascular, neurocognitive, and ADHD consequences of waiting 53:03 – Ugly #5: "CBCT has no diagnostic value for SDB" — contradicted by Reference 34; what CBCT can detect; the radiation argument debunked 57:29 – Ugly #6: Must refer to a physician for diagnosis before any intervention — ignores lack of access to pediatric sleep physicians; a formal diagnosis does not change the orthodontist's treatment plan for normalizing craniofacial growth 1:00:00 – Ugly #7: Misleading analysis of tongue tie (ankyloglossia) and PSDB — references were miscited; what the scoping review (1,228+ patients) and 2026 systematic review actually concluded 1:07:27 – The evidence-based medicine argument: what David Sackett (founder of EBM) actually said — and how Class I occlusion, ceph norms, clear aligners, and IPR are held to a different standard than airway treatment 1:19:20 – Ugly #8: "Orthodontic extractions have no impact on airway" — the Larson article debunked (patients didn't even necessarily have orthodontic treatment); extractions treat the symptom and ignore the underlying etiology 1:28:20 – Path forward: "Straight teeth bias," the need for a paradigm shift, and the vision for a profession that creates both beautiful smiles and healthy nasal breathers Resources Mentioned AAO White Paper Update: Sleep-Disordered Breathing in Orthodontics (https://www.ajodo.org/article/S0889-5406(26)00035-1/fulltext) Dr. Mike's OrthoTown article: Defining Evidence-Based Orthodontics (https://www.orthotown.com/magazine/article/9835/defining-evidence-based-orthodontics?fbclid=IwY2xjawP14fxleHRuA2FlbQIxMABicmlkETFrVWE3M3EwYWJTRWpEdENTc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHhwMNgFJyCJB6JMvVDSomu6drLwAym2SI7CDx-eXbuwrUwBxzP6NpyP7HpT8_aem_NmfJlB15aUQgioH6xWUu3A) Early Orthodontic Treatment Comprehensive – 2-day hands-on course with Dr. Mike & Dr. Daniel Camacho, Fort Lauderdale, FL, November 13–14. Save $1,000 by enrolling before May 31st. Limited to 20 docs. (https://www.earlyorthotreatment.com/) Connect Website: theorthocoach.com Email: drmike@theorthocoach.com Facebook: The DOC Community (https://www.facebook.com/share/g/1Cb9rkQVde/) Subscribe on Apple Podcasts & Spotify Subscribe to the DOC YouTube Channel (https://www.youtube.com/@theorthocoach) Please share this episode widely — with medical, dental, and myofunctional therapy colleagues, parents, and anyone invested in children's health.

Do Kids Outgrow Their Airway Issues? An ENT's Perspective (w/Dr. David McIntosh) [Ep.155]

In this episode, I sit down again with Dr. David McIntosh, an ENT surgeon from Australia and one of the sharpest medical minds I know when it comes to pediatric airway and sleep-disordered breathing. We dig deep into the recently updated AAO white paper, including what it got right, what it got dangerously wrong, and why publishing a document about interdisciplinary care without a single interdisciplinary author is a problem we can't ignore. Dr. McIntosh also walks me through one of the most eye-opening breakdowns I've ever heard about Scammon's curve, and what orthodontists were never actually taught about what that data really shows. This episode is a must-listen for any dental or medical professional who works with children and cares about more than just straight teeth. Timestamps: 0:02:40 — Welcome & introducing Dr. David McIntosh back to the show 0:04:35 — The AAO white paper update: eight orthodontists, one librarian, and zero medical or myofunctional colleagues 0:09:51 — The quote that stopped Dr. McIntosh cold: "Pre-pubertal OSA tends to resolve naturally" 0:11:34 — Dissecting the flaws in reference #17: small sample sizes, changing scoring rules & selection bias 0:13:01 — Reference #18 from a 2010 Journal of Pediatrics paper that actually contradicts the white paper's own conclusion 0:22:59 — Why the CHAT study should have been their starting point 0:23:09 — The Karen Bonuck study: 12,000 children, 7 years of data, and what early SDB really does to development 0:27:54 — Christian Guilleminault and why he wished he'd never invented the AHI 0:38:16 — Breaking down Scammon's curve: what it actually measures (and what it doesn't) 0:40:25 — The original data came from the spleen and thymus — not tonsils or adenoids 0:53:30 — "I don't care about teeth" — Dr. McIntosh on why craniofacial outcomes are the wrong finish line 0:55:34 — Straight teeth bias: why orthodontists need to think like dentofacial orthopedists 1:04:08 — Mouth breathing and craniofacial growth: why the debate doesn't even matter anymore 1:20:41 — Dr. McIntosh and Bill Harrell's upcoming Airway Breathing Academy — what it is and who it's for I hope this episode challenges the way you think about what we're really treating when we treat children's airways, because it's never just about the teeth. If you found this valuable, please follow me on Instagram at @theorthocoach, join our community at The DOC Community on Facebook (link below), and subscribe on YouTube at @theorthocoach. Your support helps keep these important conversations going. See you next episode. LINKS Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Guillimenault & Huang article in Sleep Medicine Reviews, 2018: Guilleminault C, Huang YS. From oral facial dysfunction to dysmorphism and the onset of pediatric OSA. Sleep Med Rev. 2018 Aug;40:203-214. Connect with Dr. McIntosh: Facebook: https://www.facebook.com/david.mcintosh.180 Instagram: https://www.instagram.com/dr.mcintosh.ent/?hl=en

What's Causing the Chronic Disease Epidemic in Our Children? (w/Beth Lambert)

In this episode, I sit down with Beth Lambert - bestselling author, founder of Documenting Hope, and creator of the CHIRP Study - for a deep dive into the skyrocketing rates of chronic illness in children. Beth shares her personal journey from pharmaceutical consultant to healthcare reform advocate, explains the "Total Load" theory of disease, and discusses the environmental, dietary, and systemic factors driving conditions like autism, ADHD, autoimmune disease, and allergies. The conversation covers vaccines, fluoride, gut health, sleep, and practical steps parents can take today, all grounded in science, and without the usual gatekeeping. Timestamps: 0:23 – Introduction: Meet Beth Lambert 8:01 – Beth gets kicked out of 3 pediatricians' offices for asking about root causes 15:50 – How post-WWII pharmaceutical culture shaped modern medicine 17:57 – Direct-to-consumer drug advertising: the U.S. is one of only two countries that allow it 22:07 – The data: from 2% of kids with chronic illness in 1960 to 54%+ today 24:23 – What's driving the epidemic? Food, air, water, antibiotics, toxins — the "Total Load" 25:48 – Explaining the Total Load Theory and why no single cause explains it all 30:40 – The CHIRP Study: Child Health Inventory for Resilience and Prevention 31:15 – Preliminary findings: more health stressors = worse health outcomes 36:32 – The vaccine-autism debate: why we need open, unbiased science 37:59 – Antibiotics and the microbiome: the biggest signal in the CHIRP data 43:13 – "The science is settled" — why that phrase has no place in real science 54:38 – Fluoride: Beth hasn't used it in 20 years — here's why 1:06:25 – Gut health: why the microbiome is foundational but not the whole picture 1:12:22 – Is it ADHD or is it sleep deprivation? The airway-behavior connection 1:19:57 – Biohacks (peptides, red light, vagus nerve stimulators): helpful tools, not solutions 1:23:16 – Take-home message: clinician-parent partnership and owning your child's health 1:25:37 – Where to find Beth & Documenting Hope: documentinghope.com LINKS: Epidemic Answers: www.epidemicanswers.org The Documenting Hope Project: www.documentinghope.com A Compromised Generation: http://sentientpublications.com/shop/books/all-titles/a-compromised-generation/ Brain Under Attack: http://www.brainunderattack.com Follow Beth on Socials: @documentinghope Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ REGISTER: 2026 Early Orthodontic Treatment Comprehensive: https://www.earlyorthotreatment.com/

A Drug-Free Approach to the Management of Nasal Congestion (w/Drs. Hwang, Gopi, & Lin) [Ep.153]

Episode Summary In this two-part episode, I sit down with the founders of Sound Health and the Sonu Band - one of the most innovative products in the airway and sleep health space. In Part 1, Dr. Paramesh Gopi shares his personal journey from tech entrepreneur to co-founder of Sound Health, driven by his own debilitating struggle with chronic sinusitis and allergies. He explains how a chance meeting with Stanford physicians, Drs. Peter Hwang and Bryant Lin led to the world's first FDA-approved AI wearable using acoustic resonance therapy to decrease nasal congestion. In Part 2, Drs. Hwang and Lin dive deeper into the science. They discuss the neurogenic underpinning of nasal and sinus disease, how acoustic vibration at individualized resonant frequencies modulates the autonomic nervous system (specifically the sphenopalatine ganglion), and why neuromodulation, not just mechanical mucus clearance, may explain the device's broad effectiveness. Together, all three guests explore the future of the Sonu Band, the potential to bridge the gap between ENTs, dentists, orthodontists, and primary care physicians, and the exciting platform that pairs face scanning and voice analytics to deliver personalized airway data at scale. Timestamps 3:22 — **PART 1 begins: Interview with Dr. Paramesh Gopi** 4:11 — **The personal health crisis that changed everything** — Multiple sinus infections, rounds of antibiotics, a lifetime of allergies, and why a life-threatening level of illness in 2019 forced a new path. 11:25 — **5 years without antibiotics or sprays** — Dr. Gopi describes his transformation after becoming the first patient to try acoustic resonance therapy with Drs. Hwang and Lin. 16:57 — **Shared stories: empathy in medicine** — Dr. Mike and Dr. Gopi connect over parallel personal experiences with chronic sinus disease and how those experiences drove each of them into broader airway-focused work. 24:23 — **The Sound Health app & free nasal airway report** — Anyone can download the app, speak into it, and get a quantified nasal airflow report — no purchase necessary. The role of voice biomarkers in identifying breathing patterns. 29:53 — **How the Sonu Band works: the physics of resonance** — Dr. Gopi explains the mechanism using the analogy of resonating a bottle to pop a cork. Sound waves at the right frequency physically alter aerodynamics inside the sinus cavities to clear mucus blockages. 32:28 — **AI-powered facial scanning replaces the CT scan** — How Sound Health trained AI on hundreds of CT scans to predict internal sinus anatomy from a simple face scan using your phone's camera. 43:54 — **Why avoid single-solution thinking?** — A conversation on multifactorial airway disease and why combining therapies (expansion, resonance, surgery, pharmacology) with no-downside non-pharma options makes sense. 48:19 — **Data-driven treatment and longitudinal tracking** — Sound Health's published 2,375-person usage study, correlating face shape with symptom improvement over 12+ months. 52:21 — **The "Screen, Treat, Monitor" platform** — How Sound Health envisions its technology becoming a reimbursable remote therapeutic monitoring tool, usable by dentists, orthodontists, speech therapists, and physicians. 1:01:07 — **Dr. Mike's personal Sonu Band experience** — Noticeable improvement in nasal patency, reduced reliance on nasal steroids, and sleeping on his "bad side" for the first time in decades. 1:08:17 — **PART 2 begins: Interview with Drs. Peter Hwang & Bryant Lin** 1:09:18 — **Origin story: humming, singers, and a hallway conversation** — Dr. Hwang recounts a 1990s residency comment about singers having fewer sinus problems that incubated for 20 years before becoming a product. Dr. Lin describes early prototyping with cell phone vibration motors and buzzer kits. 1:23:29 — **Long-term real-world data** — Beyond the FDA trials: adherence patterns, frequency of use, and what happens when patients stop using the device. The difference from rebound effects seen with decongestant sprays. 1:38:59 — **Why sleeping position affects nasal congestion** — The science of nasal cycling, pressure receptors, and dependent venous congestion. Why lying on one side makes the other side open up. 1:43:06 — **What's next for Sound Health** — Upcoming indications: facial pain/migraines, rhinitis of pregnancy, younger pediatric patients, and a sleep entrainment product (Spatial Sleep) designed to guide brainwaves into theta for insomnia relief. LINKS REGISTER for the 2026 Early Orthodontic Treatment Comprehensive: https://www.earlyorthotreatment.com/ Sound Health Life: https://soundhealth.life/ Sleep Help Products: https://spatialsleep.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/

From Restoring Teeth to Transforming Lives (w/Dr. Chad Capps) [Ep.152]

Episode Overview I'm excited to share this week's episode, and I have to say, this one really hit home for me personally. My guest is Dr. Chad Capps, a board-certified orthodontist practicing in Rockwall, Texas, who also serves as adjunct faculty in the Department of Orthodontics at Texas A&M University College of Dentistry. What makes this conversation so compelling is that, like me, he didn't set out to be an airway-focused orthodontist. He evolved. And the path that got him there, full of personal health struggles, defining patient moments, and a relentless pursuit of deeper purpose, is one I think so many of you will connect with. You'll get to listen to two board-certified orthodontists who were not trained in airway-focused treatment share how their thinking evolved and why we believe orthodontists are uniquely positioned to change lives, not just straighten teeth. We dive into the science, the clinical realities, and the politics of our profession, as well as the reasons we are both so passionate about airway-focused treatment. I hope you enjoy it as much as I did. Highlights & Timestamps 2:24 — **Welcome & Introduction** The conversation kicks off with how our shared work on an upcoming publication brought us together. 3:18 — **A Career Path Redirected** What started as a passion for restorative dentistry led to a defining patient moment — a mom in tears handing over a teacher's note about how her child's life had changed after expansion and an ENT referral. That was the turning point. 6:01 — **"That's What I Want to Do for the Rest of My Life"** The moment the decision was made to pursue orthodontics — with airway and growth at the center of it. 7:41 — **Personal Health as a Clinical Lens** After attending an airway-focused CE course, the pieces fell into place personally — UARS misdiagnosed as narcolepsy, multiple tongue surgeries, atrial fibrillation, and two children who also struggled. Living through these experiences has shaped an extraordinary level of clinical empathy and insight. 17:46 — **Building a Practice That Can Actually Do This Work** The practical side: how do you restructure your schedule, limit new patient exams, build a stable and educated team, and create systems that allow for the depth of care airway treatment demands? Spoiler — it's not easy, but it's worth it. 32.13 — **The AAO White Paper on Pediatric Sleep Disordered Breathing** A candid breakdown of what the updated white paper gets right — and where it falls short. We discuss the dismissal of craniofacial phenotypes, the role of CBCT, the spectrum of SDB beyond OSA, and the troubling contradictions within the paper's own cited references. 54:25 — **CBCT in Everyday Practice** How CBCT is used not just for diagnosis, but as a communication tool — with ENTs, with parents, and with patients themselves. When patients can see their own airway on screen, they become partners in their care. 1:16:31 — **Extractions & Airway: The Real Conversation** It's not the extraction itself — it's the failure to diagnose and address the underlying skeletal issue. A thoughtful breakdown of why this debate is often argued on the wrong terms, including a close look at the Larson article frequently cited by AAO leadership. 1:23:00 — **Not Everyone Has to Practice This Way — And That's Okay** A mature and respectful take on the diversity of orthodontic practice. Not every provider needs to be an airway orthodontist — but everyone should be aware enough to recognize it and refer when they see it. 1:27:59 — **Closing Thoughts** Why this work is "the most rewarding thing you will ever do in your life" — and a call to keep the conversation going, keep the community growing, and keep moving the needle. Connect: Capps Orthodontics Website: https://cappsortho.com/ Email Dr. Capps: drc@capsorthodontics.com Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Enroll in one-on-one coaching w/Dr. Mike: https://theorthocoach.com/doc-coaching/ Dr. Gozal Episode: https://podcasts.apple.com/us/podcast/the-irreversible-consequences-of-pediatric/id1689703392?i=1000758827479 If this episode resonated with you, please share it with a colleague. That's how we move the needle together!