Dr Craig D Clayton (00:03.958)
Welcome to today's episode of Dentistry Disrupted. I am Dr. Clayton and I'm very excited to have my friend Paige here with us today. And Paige is gonna, we're gonna talk about her airway journey with her kids and we're gonna go over a lot of really good stuff. In this episode, I will refer to Paige and her husband, Salva, just by their first names and then we'll refer to her kids by their ages.
We won't be saying their names so there's a little intro but before we start I want to give some background about Paige and first Paige is a...
Paige is a born and raised Idahoan. She's married to her husband.
Paige is born and raised Idahoan. She is married to her husband of 12 years and lives in Boise with her three children, a nine year old and six year old twins. She has been a pediatric nurse for seven years and she also has family in hospital administration, meaning she's been exposed to traditional medicine her whole life in many, different ways. And today we're
I'm so excited to have you here, Paige. Thanks, Greg. I'm excited to be here, too. And thanks for taking the time to come in and do a podcast. With us, your story is very important for other people to hear, especially parents that have kids that are inevitably struggling with some of the same things that your kids have gone through and are not aware of how to proceed or even aware of what's going on at large.
Dr Craig D Clayton (01:50.01)
I was a little intimidated when you guys asked me to come on just because I am still so much in the self-discovery phase of airway health and I feel like I have so much more to learn and like so much more of a pathway to pursue especially with my kids being different ages but I do hope that talking with you a little bit here helps it feel a little more within reach for other parents because I am grateful that I have found the resources that I found and
Yeah, I hope to share with you guys a little bit more about the benefits we've noticed and yeah. Well, everybody loves a story. stories are the best way to help communicate these issues and how to address them because it's a lot more exciting to listen to than rather than just having our audience listen to me ramble off facts and talk about things.
First, let's do some background information and allow you to get to know Paige a little bit more. But can you share more about yourself, especially as it pertains to your background as a pediatric nurse and your experience in the healthcare industry at large? Sure, yes. I got my nursing degree at BYU. It's been probably 12, I don't know, 10 years, 10 years now. And since then, I initially went into the hospital, the traditional route for most nurses.
working with adults and after about a year of that I stayed home with my oldest and then wanted to get back into the nursing field and just felt like pediatrics was right for me. So I actually went outpatient, worked at a pediatric clinic where we lived in Omaha and then when we moved to Boise I just found another good spot that did very similar care here and I've been kind of just those two clinics. I mean just those two but I've been sorry I've been at those two clinics
for about a total of seven years now working with kids and largely what I do is nurse triaging. So I talk with parents through concerns, problems, and kind of help them decide if they need to speak with a practitioner further. So it's interesting getting into an avenue of medicine that I felt way out of my depths, like airway medicine. it's just been eye opening to say the least of how much more there is to learn always for.
Dr Craig D Clayton (04:16.022)
everybody. And this is what makes your story especially special. It's because you have such a background in in pediatric care. And a lot of these airway issues we can spot very early in the pediatric population. And if we treat them, it makes a massive difference down the road. So what first made you realize there might be an issue with your children's airway health? And did you notice any symptoms from the time
they were born that were a little unusual or concerning. So I didn't get any feedback on airway issues until, mean, there was a, at one, You don't have to get it perfect. Okay. When my twins were one year old, I did have the dentist that we took them to at that one year visit tell me that, Oh, that's,
Sorry, my husband asked, I'm not sure. That's okay. The pediatric dentist did notice a tongue tie on one of my twins, the boy twin, but not, didn't recommend any intervention, just made a note of it. I didn't think anything about it. And then not until the twins were probably three, I started noticing snoring in my girl twin. So not even the one that the tongue tie was mentioned on. So the snoring,
wasn't bothering me, it just kinda seemed like a cute little thing, like, yeah, she has a snore. But when it started keeping Owen awake, like he would wake up and tell Ellie to stop snoring. I was like, maybe there's something more going on here. Brought it up with my pediatrician. That was, but then it wasn't like, okay, just watch it. A whole year later, we started noticing other symptoms with it, like she was my really restless sleeper, wake up a lot at night.
the snoring, all things that I just associated with like normal kid behavior. And the really emotionally labile days that were often associated with the poor night's sleeping. So as I was putting together a lot of these pieces, the pediatrician went once they were five. So it took about two years of me kind of noticing snoring and then putting together pieces of other aspects of it that we decided to do an ENT visit.
Dr Craig D Clayton (06:44.586)
And that's kind of just how it all started. And then the snowball just continued to grow from there. Okay. So before that point, were you given any, any advice or solutions for these symptoms or was this largely a self, you know, sounds like it was a self-led journey until you got to the ENT. Right. Yeah. I don't remember anybody suggesting any solutions that I can recall.
That's so crazy. The only thing I, I had the dentist again, every visit would tell me at least tonsils were really large. sorry. said her name. That's okay. early on I had the pediatric dentist always comment about how one of my twins tonsils were really large and how she would get a buildup of plaque on the bottom of her. Yeah, and like tartar. And tartar on the lower teeth that was
as a result of mouth breathing. Yeah, yeah. And I just, that didn't sound right to me. I maybe credit some of my self discovery to maybe social media where like mouth tape has become a thing. You hear people talking about needing to have the lip seal when you're sleeping. And so just being like, well, if that's not happening for my kid and.
Dr Craig D Clayton (08:13.408)
See.
I didn't know you could set a timer for that. Yeah. You go, uh, go here and then you on the three dots or you can do it until I leave this location, which is nice too. That is nice. And then if you call twice, then it will allow a call through. Yeah. I guess I'm not, I don't, I don't work enough to meet those functions. Okay. Where were we?
Dr Craig D Clayton (08:48.078)
three year old having plat, okay so. And then social media. yeah, so social media really kind of helped me on this journey of self discovery with the mouth tape that everybody was using for sleep. And as I saw that, it made me think about Ellie and her mouth breathing that, no, but again, what like you were, gosh I gotta get better this. No, it's fine. With the mouth breathing.
I didn't feel like it was normal for my three-year-old if it wasn't normal in an adult. Yeah. And I just started to get curious about that. And so it was largely a self-led journey. and the dentist would also mention every visit that she had really large tonsils. Okay. But just to keep an eye on it. And I don't know what that means. Sometimes we, yeah, sometimes we decide.
or say, let's just watch it. And we have this phrase in dentistry that it's like, okay, well, if we just watch it, then we just watch it get worse. Typically we've got to make a plan of action. It's like watching a cavity. It's like, well, if we don't make a plan of action to actually address what's causing it, like, we're just going to watch it get worse. We're going to watch it until we have to treat it. So, for identifying like that and following your, your heart and intuition and looking into that because, there was a lot of unknown there.
There was a lot of unknown and I just became the breaking point with that snoring that was actively interrupting other members of my family's sleep. Yeah. So do you me to keep going with my story? Yeah, absolutely. Keep going. So what was that first visit like with the ENT when you cross that threshold of like, okay, this needs to be addressed and it made sense the next
the next provider to see was an ENT. So with that ENT visit, I went in really kind of thinking, okay, we're going to talk about a lot of things and they'll do a pretty extensive evaluation because this visit was going to, even with insurance, was still going to cost me quite a bit of money. And then we would talk about maybe surgery at the next appointment. So I assumed the first visit with ENT was going to be about just evaluation.
Dr Craig D Clayton (11:14.784)
Again, that wait and watch, maybe follow up in a couple months and then go from there. But right away at that first ENT visit, guess I checked all their boxes pretty quickly. mean, huge tonsils, disruptive sleep, snoring. There were like two others, but like she checked all the boxes. And so they right away, I mean, within the first 15, 20 minutes of our appointment, we started talking about surgery, which was shocking to me, but.
I kind of went in hoping for solutions. And if they're saying surgery, I felt good about it. So we then scheduled surgery for just a week later. It was so fast. So fast. And that, you know, something I looked up not too recently was reviewing the recommendations from the American Academy of Pediatricians on
the basically the workflow or the flow of treatment for snoring and sleep disorder breathing. And it was pretty alarming. You know, first was, okay, if they're snoring or just disrupted sleep, sleep study, or if they check enough boxes straight to tonsillectomy, taking the tonsils out, taking the adenoids out at the same time as well, if those are enlarged. And then after that, it's if snoring resolves,
Great, but if it comes back, the next treatment was using a daily nasal spray, a steroid nasal spray for these kids. And then if that doesn't work, then the next treatment suggestion was a weight loss program. A weight loss program for kids. Weight loss program for kids. Hilarious, right? And one of these kids are in you know, in the...
30th percentile because they're not thriving because they're not getting good sleep and they're not getting growth hormone release and then you put them on a steroid which further inhibits their growth and then if the weight loss program doesn't work, this will shock you the most. The final step, a CPAP. So you're gonna give a six year old a CPAP. I can't even imagine. This is published, the AAP guidelines. This is an official
Dr Craig D Clayton (13:42.348)
document statement of this is how we treat sleep disorder breathing. No mention of things like myofunctional therapy, tongue placement, tongue posture, tension in the body, you know, all of these other things where we have so much documented evidence that it helps. Right. It's crazy. Right? That is truly crazy. Yeah. Is this the first time you've heard this? That is the first time I've heard this, but even with Ellie's journey, I
Back off a little bit. my, thank you. That's okay. Thanks for catching up. Yeah, you're welcome. Now even with our journey, I feel like it's in this traditional medicine world, we are so solution oriented rather than like active treatment sometimes. Like we want to go in, the tonsils are big, we're gonna remove them. They're still snoring. There must be something wrong with the nasal passages. We're gonna spray them with a medicine. If that, like it...
It's shocking, I will say it doesn't surprise me. It's unfortunately the truth of it. Yeah. And a lot of the proper solutions are written off as nonsensical or they don't work or there's not enough evidence when we have a lot of evidence that it works. And tell, so, your girl twin got her tonsils out.
And then what happened after that? Well, what how did her story progress? Yes, so I was initially very pleased Ellie's snoring immediately resolved and I You know now looking back I do have some questions about removing tonsils like if it had to happen But I she did start getting good sleep and there was immediately be like I immediately saw behavior improvement and just overall
our house was doing better. And when I say immediately, tonsil surgery is very rough. Like the recovery is two weeks of very difficult nights and days for the whole family. So when I say immediately, I mean like the month after that. Okay. But then what started happening is that Ellie started grinding her teeth and not just a little bit of grinding, very loud.
Dr Craig D Clayton (16:08.654)
all night long. She would come and crawl into bed. One night she came and crawled into bed with us. I did not sleep almost the whole night. It was just so loud. When my husband and I would be watching TV at night, the kids are in bed, we would actively hear it from her bedroom. It's a terrible noise. It's a horrible noise. The first time I heard my son grind, we were camping two years ago. I could not sleep the whole night and I kept reaching over and like...
trying to relax. Closing his lips and like trying to prevent him from grinding and I felt helpless because I didn't really understand at that point what what to do either. Yeah and you just want to like go in and fix it but I was alarmed though like was she has she always been teeth grinding and I just didn't hear it over the snoring but I know I don't think so like looking back I it's so loud I think I would have noticed it too but when I brought that up with
my pediatrician, again, it was like, well, she'll just keep, watching it. She'll grow out of it. Yeah. and then I do have a sister-in-law that wears a night guard every night for grinding her teeth. And I just didn't, I'm like, I don't want to start at six with her having to wear a night guard every night for teeth grinding until she's like old and like,
That feels crazy that the answer is from six on she has to wear a guard every night. There has to be a... For the rest of her life. Yeah, there has to be a better solution than that. And so I was fortunate in that Eliza and I went on a hike together and we got talking about this and that just opened the door that I was looking for but didn't know I was looking for. Cool. And what was that next step after that? And if I remember right, her...
snoring returned, right? To a degree or noisy breathing and you You and we can cut this out if I don't felt like after six months. I Don't think her snoring returned It was just still mouth-breath breathing. Okay, still mouth-breathing. Yeah, still mouth-breathing and but not as much like it was it was Her symptoms were still improved greatly with the like she I could tell she had more access. Okay, it was more just that
Dr Craig D Clayton (18:34.414)
Grinding. Other things, yeah. Yeah, and grinding is often written off as something they'll grow out of, it's not a concern, know, feed them less sugar before bedtime, their brain's too active, and what we don't understand as professionals at large is that I compare teeth grinding to CPR. So when CPR is performed on a human, you tilt their chin up because it opens up their airway.
So similar to that, the jaw goes forward at night and because it pulls the tongue out of the airway. So that's why that grinding is happening. I tell parents, watch, if you have your child move their jaw forward, keeping their teeth together, all their teeth slide together as if you were sliding, you know, a card across the tables, just like an even plane, because that jaw is going forward over and over at night to open up the airway.
Because when we drop into REM sleep, which is when we have the growth hormone that's released and it's the most restorative sleep, all the voluntary muscles in the body become paralyzed, right? And so if the tongue doesn't have good posture and there's not enough space, then that tongue falls back and so the body responds by sliding the jaw forward, trying to keep the tongue out. But that happens after they wake up. So they go from REM
back up to a lighter stage of sleep, the jaw goes forward and then they start to drop, you know, it's just like... not getting that good sleep that we're searching for. Yeah, yeah. So our sleep improved, but then did symptoms return? Yeah, there was a backslide in the behavior that like the sleep again was not doing as great as initially. So better, but not...
Yeah. How it was immediately after surgery. Right, right. Or I guess two weeks after the surgery. still better. two weeks after. It was better. Her symptoms were still better, but not, but then, you better, a little backslide and just kind of hanging out in this area of I'm still not getting the results that I expected. And that was difficult because it's not like you go into this again, being in the medical world with so results driven.
Dr Craig D Clayton (20:58.082)
that it's very disappointing when there was no follow-up that I even could look to to try to look for next steps. It was just like, here we are. It makes you question yourself, your judgment as a mom. And that's something you should have to question because you really just innately, you know what your child needs, even if you don't know what that solution is, right? Right.
So what did you talk about with Eliza? What were some of the next steps that you started to put together of like, okay, this is how I keep moving forward. I wish I could remember that conversation better. But I just know she was, I mean, she's so passionate and she's such a good speaker and brings people in in a way of like, it just helped me to realize there was another door.
and got me looking at tools. think she must have mentioned BraceIt, like the myobrace that we use now. I feel like she must have mentioned something about that because it got me Googling myobrace, think tooth pillow is another one, and myofunctional therapy. So I'm sure those are like the hot words that I internalized and brought back with me to like start being the Google master. And with that, I did not know
my resources in Boise very well at the time still. Eliza was just talking to me from a place of friendship. Yeah. Which is what I needed and appreciated. So we went to a place, got an evaluation, and I again, Eliza is like checking every box. Again, my daughter is checking every box that's like, yeah, she would be a great candidate for, maybe not candidate, it's not right.
She would be a great person to undergo myofunctional therapy. We believe we would see a lot of positive results with it with her tongue tie release should be considered and you know, using other tools. If they had a different, think some type of Invisalign maybe or something that they recommended. Yeah. So I walked away with that with like more questions than I knew what to do. Answers maybe.
Dr Craig D Clayton (23:26.01)
so then I went back to Eliza and she was so great to talk through things with me and it led me to working with the malfunctional therapist that works with here with you guys and just then the, the, whole, pathway became clear. Okay. I'm so glad. And I imagine it brought you a lot of relief. It brought me a lot of
A lot of relief from just knowing there was a path that I could pursue, even if I still wasn't sure what my outcomes would be. Because the journey with myelofunctional therapy and with the myobrace that we're using, it is a long process. you don't, it's not a result. You don't go do one obsession and you're like, wow, look how strong my daughter's tongue has become. Yeah. It takes time. It takes time. that can be really difficult. with the kids, which is the hardest part.
And like even with the myo brace, it was, you know, we gotta get the kid used to the thing. So it's not gonna yield any improvement initially, really. We're getting them just familiar with this flimsy thing and then you get after a month or two of that. So it just is a lot of patience, which is a virtue that I have not like been blessed with in large amounts. So it's been good for me to like also take a step back and just like be present in these moments with the kids of like.
this type of physical therapy and just letting the journey kind of play out and see where we land rather than needing an answer right away. That's great feedback and great insight into your journey. And I just wanted to explain a couple things to our listeners. So myo brace or tooth pillow are basically one and the same devices. They're different companies. Myo brace is the one that
that innovated the product and is really the original and the tooth pillow uses a very, very similar appliance. And what it is is it's a sleep appliance used at night and it helps to encourage some growth of the upper jaw, but it also helps prevent against grinding and then it reinforces good tongue posture habits at night. And the myofunctional therapy is essentially
Dr Craig D Clayton (25:50.126)
physical therapy for the chewing, speaking, and swallowing muscles. And the main goal is to strengthen the airway which opens it up and to train the tongue to stay up and forward, sealed against the roof of the mouth. So it's... I got ahead of myself there a little bit. No, no, you're fine. You know, we talk about it as you and I both know what it is. And so, so no, you're totally fine. We have to sometimes take a... I have to...
clarify something so no you're good. Okay let's see and you know these are a lot of treatments to take on all at once and after especially after just got her having gone through surgery not that long ago. So the cost can be a definite concern you know my functional therapy a sleep appliance tongue tie release.
If you feel comfortable, how did you navigate that aspect? What's kind of your feedback and what would you say to parents who are worried about the expense of jumping into this, you know, intercollaborative approach? I feel like it might have been a little easier for me because no matter which avenue I took, there were going to be costs associated with it. So I just had to pick which path I thought led to downstream.
better outcomes. regardless, there was going to be money flying out of my wallet. Not flying. But regardless, it's a big investment. It is an investment for sure. And I think something that also helped me is just coming off of surgery, how expensive that was for the surgery and realizing I don't want to have to go through something like that again, whether it's, I mean,
I also had a neighbor who had to have a whole palette expansion as an adult. And that just sounded horrible. Yeah. So if there's an option out there, I feel like it's worth it to take a good look. And I did a lot of looking initially. And I think it's OK for you to take some time. The cost is a factor, and you have to wait.
Dr Craig D Clayton (28:17.066)
if you have to wait for the moment to be right for you. But again, it's like that window is pretty narrow sometimes with kids, especially if you miss it in infancy, which if I could go back and release tongue ties, would definitely, I would have different conversations now than I then. But I'm like, there's still this narrow window. I feel like we need to act while we can, how we can. And you know, really,
The cost is not much different in my mind than braces. And it would be a no brainer for me to put my kid in braces if they needed it. so I'm like, then why is this? I think it's just feels different now because it's not talked about more. But it really isn't that of a different of an approach. And in fact, I would say your airway help for just sleep alone, if it's nothing else, except for getting better sleep, that is more important than.
anything related to the braces which was like, yeah, of course we do that. Yeah, and treating it early, know, not only do we improve their sleep and then their growth and their ability to learn and be able to focus during the day and just be overall happier, we do prevent those bigger costs down the line. know, braces are a big investment, know, orthodontic treatment at large.
sleep disorder breathing as we talked about has significant is a significant concern at this point like they're they're already exhibiting that they have sleep disorder breathing but then down the road too as they become adults these are the it's not unusual for kids with these symptoms to then develop into adults that that
let's see, to develop into adults that then have sleep apnea at some point in their life. And then at that point in time, as you mentioned, like your neighbor, the only way, you know, not the only way, but one of the ways to actually get to the root cause of the cause of sleep apnea is to create more space in the mouth for the tongue so it doesn't fall back. And you have to do pretty aggressive surgeries, you know?
Dr Craig D Clayton (30:36.142)
Even the more conservative options, it's still surgery and it's still a lot to go through to fix the problem when if we address it early, we just take care of it now and then they don't have to go through that. If there's something I could do now, as I was thinking, there's something I can do now that's going to prevent a lot of downstream issues, it was well worth the time.
and the cost, really, again, comparable to braces for our journey. And I say that having two kids doing it at the same time. So I guess a part of my story that I didn't share is that while all of this started with my girl twin, I just brought along the boy twin, along for the ride too, I felt like...
He could benefit if we're gonna be doing this malfunctional therapy and if we're gonna be looking at the mild brace. I want him looked at too because who knows, right? Like he's not, he had other issues that weren't related in my mind, but again, some, but I had been told that bedwetting could also be a symptom of not getting the good sleep.
And that was really his only thing, but I was getting so tired of him peeing through his pull-up at night. So much laundry, I was like, you know what, let's just take him. Let's just bring him along for the journey. And I know I said that this is a long process. There are no results that you get right away. But with him, I have to retract a little bit because there was immediate results where his bedwetting improved almost, like within the first week, it was down to once a week.
by the end of a month, he was maybe twice a month. I'm like... That's amazing. It has been wild. That's amazing. That I can't even remember now the last time he went to bed at night. And for that alone, I'm like, obviously there was some functionality that needed to be addressed. And so even he could benefit from this better sleep that he's not getting. And as I was talking to my husband about like telling him I was...
Dr Craig D Clayton (32:58.286)
can be coming on this podcast with you. I was like, what would be your takeaway from all of this? Because we still don't know a lot of the downstream results yet. Right? We're still in the middle. for a couple of years. Yeah, and there's a lot to be, like, a lot of the rewards to be reaped in the, yeah, in years to come. But he was saying, even if the only result is that our kids are sleeping better, this has been worthwhile for us. If that's all that we gain,
We're happy. But then there's so much more hope, right? There's so much more that's coming. Yeah. I mean, to breathe well is to live well. That is true. know, something that Dr. Zaghi, one of the leading experts in the field, likes to repeat is, is breath is life. Yeah. You know, which is obvious, right? But it's something that we, that we, I mean, take for granted, something that we don't appreciate fully. When we normalize
Snoring at large and sleep disorder breathing as a result, know in the media, you know, you mentioned Snoring and how it can be, you know consider cute and little kids and then we see videos on YouTube they get millions of views and then we see shows and movies that Where you know when a person's you know Snoring is just something that's comedic right and normalized and then again we play
games like with our kids and pretend we're sleeping, what do we do? We snore, we sleep noisily when breathing should be silent and gentle night and day. it's just, it's crazy. And it makes it a hard uphill battle because there's so much, there's so much to fight against and it's very much an upstream battle. And so, let's see.
So we talked about the results. Okay, what are, you know, we'll continue to be real here. And thank you so much for your transparency and sharing the details of your story. What were some of the biggest challenges and setbacks along the way? How long have they been in treatment now?
Dr Craig D Clayton (35:20.43)
think it's been four months. Okay. That sounds right. We've had, we do our myofunctional therapy appointments every two weeks because I have to get on the ball. A lot of times it's me trying to I get it. We are there too. We ebb and flow with our consistency for sure. Yeah. So we've been doing myofunctional therapy. We just had our ninth session. So I think that's about four to five months. Okay.
And as far as challenges, the myofunctional therapy took a lot of getting used to initially at our house. think the first time, like the first week, it took me telling, and my battles might be a little bit larger than some because I have two at once that I'm trying to have both of them sit down and cooperate and listen. But I remember that first week it was like, well, I will wait. I'm just gonna wait until you're ready.
And it was like 45 minutes of them like sitting doing one and then getting up and I was like, well, we are going to continue to wait and there will be no story for bedtime until we finish. And that took a lot of patience on my part. But I'm, you know, after that initial battle, it's still, I'm not going to pretend it's perfect. There are some days where even I'm the one that just doesn't have the capacity. Yeah, I get that.
I totally fall into that same category too often. But you know that it really is true that the consistency is key not even for the results but also for them to to be compliant. They're like it's time and they get their stuff and you know if you can make a game out of sometimes I make a game out of it if we can do this in five minutes because it really should only take five minutes then you can watch
an extra episode of Bluey or something. There we go. Made some positive reinforcement. Yeah. So, I mean, there's been challenges with the, with the mild brace, that device that they wear at night and then, well, mostly at night. There was some challenges with them spitting it out, not keeping it or putting it half in half out. That was Owen's favorite. I would think that it was in, but it really wasn't.
Dr Craig D Clayton (37:43.854)
That'd be uncomfortable. That'd be more uncomfortable than having it all the way in. It's just stubborn. So we've had to just do adjustments here and there. I now tape their mouths at night after the story. They get their last drink of water. mean, it's like all the things. Then we tape. And that took, again, it was like probably a week long battle where it took like four pieces of tape because then they have 12 questions that pop up as
Yeah. Taping on taping, taping on taping. When we go through a bunch of tape. Yeah. And what tape are you using? You're just using the like across the lips, like center of the lips or? Center of the lips. Yeah. And that's something I like to point out to everybody at large. I don't like the hostage style tape as they call it. No. It's like just you just need a little just a little piece across the center to keep that. It's like that reminder. They can still open their mouth on the sides, but. And the tape was more just
to make sure the brace wasn't poking out or ending up on the floor. Yeah, to keep it in all night. Yeah. Yeah. And so that's been working great. So we've been doing that for about a month and it's been great. We're slowly overcoming the challenges and I do see great improvements in their sleep. I feel like the device, that myo brace really does help with that tongue, proper tongue positioning for them to get good.
deep sleep just on the drive home from, we were driving home from Sun Valley yesterday. My husband and I were just kind of patting ourselves on the back a little bit about how great sleepers our kids are. You know, we can make so much noise, all the cousins running around and they're just, they're just out. And I attribute a lot of that to this myofunctional therapy and the smile brace that's giving them the tools so they actually do sleep well because that has not always been the case. Yeah.
That makes, that's wonderful to hear. I mean, that's such a massive win. And I feel like the journey can be a series of small gains and then sometimes there's large gains, but certainly looking back, then we start to realize, wow, changes are big. You forget how far you've come when the process is slow. Cause I was like, hey babe, when was the last time Ellie came and crawled into our bed?
Dr Craig D Clayton (40:10.766)
When was last time? And he was like, shh. Our girl. that's okay. Like, Hey babe, when was the last time our girl came and crawled in here with us to sleep? And he was like, she still comes in all the time. I was like, no, think about it. When was the last time? And he's like, yeah, actually I don't know. I really don't know. So not only are they getting better sleep, but so are we. So
What advice would you give to parents who suspect, you know, who've identified with some of these symptoms that restless sleep, the bedwetting, behavioral issues, open mouth posture, snoring, what are some, what's some advice you would give to parents who suspect their child may have airway related issues based off of some of these symptoms?
I wish I knew how to give better guidance on resources because I wish they would have been available to me too. I mean, they're already ahead of the game just if they're on this podcast listening to you. you know, know that it's there. are options out there and the benefits aren't just theoretical. They're actually happening in real life for regular moms that didn't really know what they were getting themselves into. Yeah.
And I still have a lot more to learn, so I'm still on this journey of looking at how I can help my nine-year-old now, who's like in a much different place than my twins. But I guess the advice is, if you're noticing these things, the plaque on the teeth, the mouth breathing, the snoring, the bedwetting, I would delve deeper. I would just be curious and see what else you can find. That's great advice.
And we will link some resources in the show notes as well to give you some guidance on where to start and how to find some providers to perform an evaluation and help you on this journey. And as a pediatric nurse, would you like to see change in the healthcare field at large to help more people become aware of this issue? Because it is...
Dr Craig D Clayton (42:30.41)
It is pervasive. see it, you know, in my practice, we see it in the majority of children exhibit symptoms. I, again, I would have different conversations now as a first time mom than I had then. I feel like tongue tie releases felt kind of like kitschy. Like, Yeah. you know, maybe you could do it, but is it really going to help? And their latch is fine. So why even bother addressing it or looking into it? I,
If you notice a tongue tie, if you have any latched problems, if there's... I mean, just again, I wish I would been more curious. Be more, like, be more pushy sometimes. And I would love to see the providers even taking an opportunity to look for those things too. I know they have a lot, like, I don't, I adore the pediatricians I work with. Their intentions are great. Their care they give is great too.
I think as a healthcare system, we also rely on other people to have their specialties. So I know they rely a lot on lactation and they rely a lot on pediatric dentists to kind of do some of those evaluations. So I guess I would like that collaboration, just continue to have them all working more closely together to kind of help build the picture. You know, and I do see it starting to happen. I see there's a lot of great lactation.
specialists in the valley that I've noticed starting to bring up these tongue ties more. Yeah. And, um, you know, but again, it starts with education kind of at the provider front, whether it's the lactation specialist, the pediatrician for it to then trickle down into the patient population. I like that. We need to make those changes. So, so hopefully, you know, you know, hopefully you can put a little, a little, you know,
little bit of information out there to maybe spark some curiosity. Right. This is something that you're right. It's a little bit taboo.
Dr Craig D Clayton (44:38.988)
Because you're right, of these tongue ties can be little taboo. And another resource we'll link below is a book called Tongue Tied by Richard Baxter who is a dentist. And it is, I wish providers would read this book because it is very research intensive. It has study after study after study to prove the point that, this is something that's well documented and something that if we treat,
can make a big difference in many children's lives. And something that he reinforces that you've probably caught on to today is that it is an intercollaborative approach. Why it's gotten a bad rap is because there are providers that just snip and go. It's like, you have a tongue tie, snip it, problem solved. And that's why, and especially there are some methods that are not very effective, can be traumatizing.
And so it's important for listeners to know that it needs to be a functional tongue tie release. Functional meaning we've done all the work beforehand to make sure it's successful and to also make sure that it is necessary because not every tongue tie needs to be released. So I wish every provider, every parent understood that, but especially our pediatricians. So hopefully we'll be able to make enough noise to help.
people at large look at the research to research the literature for evidence because obviously we don't have a good, we don't have an approach that really treats the cause at this point time. Like we talked about earlier, just to do surgery and steroids. Eliza, did you need to come in? Eliza?
Dr Craig D Clayton (46:34.808)
Hey Liza.
Okay, I you guys drinks. Thank you. They're right there. Thank you so much. I just have stuff in my hands. Love you. Thank you so much for coming in. It's good to see Good to see you too. Thank you so much. Enjoy your drink. can fight over which flavor you want. Okay, thank you. We'll just finish up. We should wrap up because I to go pick my kids up too. Okay.
Well, thank you so much for joining us today. We covered so, so many good things. Thank you for sharing your story. Again, I believe that stories are the best, is the best way to teach people because it engages, know, engages our, everybody at large. You know, we all enjoy a story. We've enjoyed stories since we were young. So thank you for sharing your story. Yeah, of course. And I just, hope that by sharing this story at some, you know, for those kids out there that are snoring.
or are doing that mouth breathing all day long, you just start to notice and realize what's happening so that you can fix it a little sooner than maybe I was able to, or just start to get curious about it and find the solutions before you need the surgery. I love that, get curious. That's what leads to... three times. No, no, I think that's a good mantra, because that's what leads to change. That's what opens up our minds to the fact, you you had to open up your mind because you've been through...
training for, you you're in the pediatric space. And so you could have just gone along with the status quo of like, oh, this is, you know, this is the only solution. It's, you know, all the normalization, but it's because you got curious and, and this is how we change. This is how we improve as a society in the care we provide and how we treat these issues that really impact our health long-term. So.
Dr Craig D Clayton (48:31.65)
Thanks for getting curious and thanks for that new mantra because I love that. So everyone listening, get curious, get curious about these issues because that's where you'll find answers. That's the truth. Well, thank you so much for being, for coming in today to have this conversation. Really appreciate it. Yeah, you're welcome. Perfect. Okay. That was it. Well, thank you. I hope I didn't make you late. Nope, I was good. I was a little bit... You did great.
Do you do you like, have you ever had these?
Do you strawberry lemonade or cherry lemonade? Whichever one. You choose. Okay, let's try cherry lemonade. Okay, that's a good one. Okay, cool. You're so welcome. Woo! You did it! it was great. I feel like I have so much more to learn, but I'm like... Well, this is just like, can only give them, give so much information. Yeah, that's true.
Dr Craig D Clayton (49:31.374)
This is a really good place to start and this story was perfect. Just listeners will be see the natural progression of things.
Dr Craig D Clayton (49:52.686)
Did you? That's amazing. And that's what we need every provider in the pediatric space to read. And in every space. Yeah. ENTs, but especially pediatrics because that's when we can catch it. And that's what the trust. Yeah. They trust the recommendations. They've been seeing them for two, four, six, 12, know.
Yeah, because what if pediatricians were the ones saying, hey, you can go see a myofunctional therapist. And you can go see the therapy book. not a question. Then the parents would say, OK, that's what you say. And that book, I mean, I recommend reading or listening to it. It goes into detail about so much. Because even the AP has published that tongue ties don't affect speech.
which is wild, right? Unless it's a grade four. But even then, some say it just doesn't affect speech, It's like, okay, that's your opinion at that point time, because if you can't get the tongue where it needs to go, it's going to affect speech. So like Joanne's child, which...
Dr Craig D Clayton (51:09.849)
I mean this is where I say when I have so much to learn, my 9 year old, Calvin, he's been at speech.
It's crazy that even SLPs aren't taught, like, look at the tongue. Or if they can't get the tongue up where it needs to be. And he has a really sense of top-tie too. Yeah. And I bet with all this therapy, if you released it, it would probably just overnight, like, boom. Probably. All of a sudden, he's had the training. And he's still in
Yeah, yeah, so I'm like, gotta, the next step, I'm like, okay, the twins, you gotta eat them in before they have pig roast fruits, or they're gonna be like, pig roast!
Dr Craig D Clayton (51:53.198)
Most most the majority of patients are tongue-tied that we see majority. Hey you you've got it. Yeah, but you've got a good stretch I do so most people when they do that one can't open that wide and you probably didn't been doing my kids
Dr Craig D Clayton (52:23.922)
So it looks like they're not tied because there's a compensation. And so that's one thing that's missed with tongue ties is that's how you assess it. You take the tongue, you your fingers underneath it like that. come behind them, put your fingers underneath it, and pull the whole tongue up. And if that tongue can't get to the roof of the mouth without the mouth closing, that's a tie. Because so often it's like, OK, lift up your tongue.
You can touch the roof of your mouth with your mouth open all the way. It's like, yeah, but the tongue doesn't go like this. You're breathing. Right. The tongue needs to go up. if you can't get up there, you can't rest there. And what we see the most is you can't see a posterior tongue tie. So the front third may be up, but then the back isn't. So then the back is still in the airway. That's what I feel like.
So the release is going to do that. Because the release, all of a sudden you release here, but it actually releases it back. So then that tongue will be able to get up and forward out of the way. And that's another thing. can't observe that. And you can if you're trying to look at it in the mouth. But really to be able to diagnose that 100 % accuracy is to do a 3D X-ray.
because then you can see, especially with mild therapy, you can see that the tongue is trying to be where it needs to be, but then the back just can't. the majority of patients have it. And there's a lot of theories as to why. Well, good to talk to you Craig. Good to talk with you too. Thanks Paige.
Dr Craig D Clayton (54:17.92)
It was so great to have Paige here on this podcast today and I'm really grateful that she was able to come in and share her story. To learn more about Airway health and functional approaches to treatment, check the show notes below. We are going to link some resources and books that you can start to read and learn from to understand what those next steps are, how to find providers, and also to get some more.
Get some more information so you can really understand the underlying issue and how to treat it. So I'm really excited for you to start this journey again if you recognize any of these symptoms in yourself, in your children. This is something that is so overlooked in conventional treatment. And I always want to emphasize that we as providers are at large or just not receiving this training. As you saw
As you heard with with Paige, she is a pediatric nurse and this was all new to her and this should be something that is caught in the pediatrician's office, but they don't have research. mean, they don't have education in this. I mean in medical school, they don't even cover the mouth. They just go to the back of the throat. And so it's a totally, it's totally foreign territory for people. So I'm really...
I'm really happy to have someone share their story because I feel like, again, it's much, much easier to learn from someone and listen to their, by listening to their story than it is just listening to me regurgitate a bunch of facts and little snippets of stories from other people.
Dr Craig D Clayton (56:08.77)
And I know on tongue ties, not every tongue tie needs to be released. As I said earlier, that's where tongue tie releases have really gotten a bad rap is this tendency, especially a couple of years ago. I don't feel like it's as much now. I feel like things are changing. And maybe that's just pressure from other communities, legal pressure, but not every tongue tie needs to be released. And to evaluate it properly,
the child or the adults or the team that the patient needs to go through the proper steps of having a proper evaluation to see if they do have a tongue tie. These are water mist. These were looking at it the right, we're looking at it the wrong way. We're asking patients to just lift up their tongue, touch the roof of their mouth with the tip of their tongue. They can open all the way and we say, look, they don't have a tongue tie. When in reality, the proper way to evaluate is to hold onto the tongue, the entire tongue and try to lift the entire tongue.
flat against the roof of the mouth. And if we can't achieve that without the patient closing their mouth or only having their mouth open a little bit, that is a tongue tie. That is the right way to evaluate it. And again, these resources will help walk you through this more functional approach to actually identifying the root causes, treating them. Because if we don't do this, the tongue tie release is not going to be successful. It is not going to help the patient.
And it can actually make the problem worse. So that's why it's so important to understand this.
Dr Craig D Clayton (57:54.732)
As you can tell, I'm really passionate about this topic. I'm excited for all of you to learn more, rely on those resources. We will continue to put out content to help you on your journey.
Dr Craig D Clayton (58:14.046)
And a quick legal disclaimer, while I am a dentist, I am not your dentist. So please, for specific dental advice, oral health advice, consult with your local provider to get a proper evaluation and to identify those next steps that you need to take. Thank you so much for joining me here today on Dentistry Disrupted.
I hope you've enjoyed today's episode. It's been really, really fun for me. I feel so passionate about this topic. And until next time, hope you have a
Dr Craig D Clayton (58:57.43)
And until next time, take care. I hope you have a great day, great weeks.
And until next time, and until next time, take care and we'll talk to you soon.
