An ENT's Perspective on Airway & Orthodontic Treatment (w/Dr. David McIntosh) [Ep.75]

Dentists and orthodontists often debate the role we play in the detection and management of airway compromise, especially in children.  I had a fascinating conversation with Dr. David McIntosh, a highly regarded ENT from Australia, who offered his thoughts on the topic from a medical perspective.  We discuss:How David became passionate about airway and sleep, and why he is passionate about treating children.The influence that the 2012 paper by Karen Bonuck, MD about the impact of snoring and mouth breathing on the cognitive development of children had on David.The reason why ENTs and dentists should be collaborating more often.The fact that 80% of the children presenting to the orthodontist have an airway problem.The fact that pediatric sleep-disordered breathing is more common than asthma and diabetes combined.The role that cognitive dissonance plays in the resistance of both orthodontists and ENTs to change their approach to the diagnosis and treatment of patients with airway compromise.The signs and symptoms of airway compromise that ALL ENTs and dentists should be looking for in their patients.Why straightening teeth is great, but saving someone’s life is next-level rewarding.How the medical insurance industry is impacting the ability of ENTs to perform adenotonsillectomy on children.How the 2019 AAO White Paper got it wrong and the 2017 ADA Position Statement got it right.The reason why a sleep study and AHI are NOT reliable indicators of airway compromise in children.The AADSM position statement about the efficacy of monotherapies.The efficacy of CPAP versus mandibular advancement splint therapy.The importance of phenotyping to determine the etiology of airway disease before initiating treatment.What David feels about expanding on patients as young as 4 years old.Why orthodontists would feel differently about airway-focused treatment if they saw their patients 20-30 years after treatment.The importance of early detection and treatment of airway issues.Why saying that OSA is analogous to Stage 4 cancer IS appropriate from a medical perspective.And much more!! LINKS:-Dr. McIntosh’s books: >Snored to Death: https://a.co/d/0700GJj>Don’t Ignore the Snore: https://a.co/d/3P9lpXA >A Parent’s Guide to Pediatric Sleep Disordered Breathing: https://a.co/d/7qDRuJS -Karen Bonuck paper: https://pmc.ncbi.nlm.nih.gov/articles/PMC3313633/ -Chervin paper: https://pubmed.ncbi.nlm.nih.gov/11875140/