Episode Summary

Dr. Vatish shares his unexpected journey from implant dentistry to becoming a leading practitioner in tongue tie releases and airway-based dentistry. The conversation covers diagnosis across age groups, the role of CO2 laser in treatment, the critical importance of myofunctional therapy, and the ongoing debate around evidence-based medicine in this emerging field.

Key Topics & Concepts

• Tongue tie diagnosis across age groups — From infant nursing and latching difficulties to speech issues in toddlers, bruxism and sleep apnea in adults, and why posterior ties are often the most symptomatic despite being called "mild"
• The three pillars of physiological health — Sleep, breathing, and eating as a diagnostic framework; the critical difference between surviving and thriving
• CO2 laser and modern release techniques — How laser technology, suturing for primary tension healing, and pre-/post-operative myofunctional therapy transformed outcomes compared to traditional scissors or diode approaches
• Myofunctional therapy is essential, not optional — Why releasing a tongue tie without concurrent therapy can make things worse; the personal trainer analogy for setting realistic patient expectations on duration and intensity
• Interdisciplinary team care — Orthodontists, myofunctional therapists, speech therapists, osteopaths, lactation consultants, and ENTs working together; why no single monotherapy solves airway problems
• Evidence-based medicine beyond RCTs — The parachute analogy; Sackett's triangular epistemology of research, clinical experience, and patient values; why absence of evidence is not evidence of absence

LINKS

• Happy Kids Dental Chelsea: https://happykidsdental.co.uk/
• American Smile: https://www.americansmile.co.uk/
• Instagram: @DrSVatishDDS
• 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/

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Episode Summary:
In this episode of The DOC Podcast, I sit down with Dr. Hal Stewart, a Texas-based dentist who transformed his practice from a traditional, restorative-based practice to one with a holistic approach, focusing on airway and TMD health. We discuss what holistic dentistry really means, how airway dysfunction connects to malocclusion, TMD, posture, and systemic health, and why the dental profession needs a paradigm shift towards a more proactive model of healthcare.

Topics Covered:

• Dr. Stewart's Journey from Restorative Dentistry to Airway-Focused Practice — How a meticulous, low-volume approach to comprehensive dentistry evolved after discovering the connection between underdeveloped jaws, malocclusion, TMD, and airway dysfunction — driven in part by the personal loss of his father to Parkinson's linked to severe sleep apnea.
• The Multidisciplinary Team Approach & Diagnostic Framework — Why airway patients typically need 3-7 healthcare professionals, and Dr. Stewart's 5-zone diagnostic model (nasal passages, nasopharynx, oropharynx, oral cavity, and TMJ) for evaluating patients from a whole-body perspective while staying in his lane.
• The "Straight Teeth Bias" & Why the Profession Needs a Paradigm Shift — How orthodontic and dental training focuses narrowly on tooth-based outcomes, the gap between the ADA's 2017 airway screening recommendation and the AAO's more conservative stance, and the double standard around evidence-based practice.
• TMD, Airway & Posture: How It's All Connected — Dr. Stewart's clinical finding that over 90% of TMD patients have a comorbid airway component, how addressing airway has transformed his treatment outcomes, and the overlooked relationship between occlusion, cervical posture, and breathing.
• Advice for Practitioners & A Call for Professional Unity — Practical guidance for dentists wanting to incorporate airway into their practice, why every practitioner who discovers airway never goes back, and the importance of replacing intraprofessional criticism with respectful, interdisciplinary collaboration.

Key Quotes:

• "There are multiple ways to treat things, but there's only one correct diagnosis."
• "Anybody that goes down this path, they see the truth is so evident to them that they cannot go back."
• "We're not here to put other professionals down. We're just here to speak the truth."

Resources:

• OT Article on Evidence Based Orthodontics: https://www.orthotown.com/magazine/article/9835/defining-evidence-based-orthodontics?fbclid=IwY2xjawP14fxleHRuA2FlbQIxMABicmlkETFrVWE3M3EwYWJTRWpEdENTc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHhwMNgFJyCJB6JMvVDSomu6drLwAym2SI7CDx-eXbuwrUwBxzP6NpyP7HpT8_aem_NmfJlB15aUQgioH6xWUu3A
• Link to Dr. Mike on Health & Harmony, Beyond the Teeth: https://www.youtube.com/watch?v=Ce9TrzrgkKg&list=PLPOppJciyu_pws_EOiyejTsxkOwSxtZzj
• Thestewartcenterforoptimalhealth.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/

Episode Summary

In this in-depth conversation, I welcome Dr. Ellen Stothard, PhD, a sleep researcher with expertise in integrative physiology, neuroscience, and data analytics. Ellen shares her unconventional journey from psychology student to sleep science researcher to clinical data specialist, offering a unique perspective on what "evidence-based" really means and how clinicians can become everyday researchers.

Key Topics Covered

Ellen's Journey

• From psychology and French double major to a PhD in sleep and circadian rhythms
• The famous "Camping Study" and how natural light synchronizes our bodies
• Why academia wasn't the right fit and finding purpose in clinical data
• Building Rebus Health: an integrative sleep medicine clinic

Understanding Evidence-Based Practice

• What "evidence-based" actually means (and what it doesn't)
• The difference between correlation and causation
• Why negative findings are crucial but rarely published
• Real-world evidence vs. randomized controlled trials

Research Methodology Demystified

• Small, controlled studies (N=30) vs. large observational studies (N=50,000)
• Understanding statistical significance and what research can (and can't) tell you
• The importance of understanding study assumptions and limitations
• Why averages hide responders and non-responders

Clinical Practice as Research

• How busy practitioners can gather research-quality data
• The power of before-and-after documentation
• Why consistency matters more than perfection
• Overcoming IRB fears: private IRBs and retrospective chart reviews

Early Intervention vs. Watchful Waiting

• The ethics of withholding treatment when harm is suspected
• Using "natural experiments" from patients who delayed treatment
• Why inaction carries responsibility too

Breaking Down Silos

• Why dentists, sleep physicians, and researchers need to collaborate
• The psychology of professional resistance to change
• Creating bridges between academia and private practice
• Speaking each other's "language" across disciplines

Memorable Quotes

-"The absence of evidence is not the evidence of absence."

-"You can only call it evidence-based if you know what the science says AND what it doesn't say."

-"If you're not looking, you won't necessarily find it."

-"We can't just say 'okay, you feel better, bye.' We need to understand: you came in, you tested this way, we did something, it made you better. What happened?"

-"Your clinical data IS evidence. You have the ability to generate the evidence yourselves."

Practical Takeaways for Clinicians

• Start gathering before-and-after data consistently
• Use validated questionnaires when possible (or create standardized questions)
• Document outcomes at regular intervals
• Consider hiring data analysts or partnering with graduate students
• Explore private IRBs for faster, easier research approval
• Retrospective chart reviews can be powerful research tools
• Looking at your outcomes makes you a better clinician

LINKS:

• Rebis Health:
• Research email: research@rebishealth.org
• Website: https://www.rebishealth.org/
• Social Links: FB | IG | LinkedIn | YouTube
• 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/

Episode Overview

In this episode of The DOC Podcast, I’m joined by Doctors Claire Ferrari and Allie Larios of Ferrari Larios Orthodontics in Kensington, California. Together, they discuss transforming patient care through a proactive, whole-body approach to orthodontics.

Topics include the need to integrate overall health into orthodontic residency programs, early diagnostic and treatment for pre-adolescent patients, the benefits of CBCT imaging, the relationship between tooth extraction and airway issues, building a trusted medical network, and the impact of corporate entities in dentistry. We also delve into the future of orthodontics and their decision to pursue a traditional business model to better serve their patients.

Don't miss this insightful conversation on advancing orthodontic care. Enjoy the show!

Timestamps

00:27 Meet the Guests: Dr. Claire Ferrari and Dr. Allie Larios

03:06 Dr. Ferrari’s Early Influences and Mentorship

04:14 Educational Path and Career Decisions

07:14 The Importance of CBCT Imaging

13:40 Dr. Larios' Experience and Insights

18:10 Holistic Approach in Orthodontics

19:44 Challenges and Rewards of Early Treatment

21:36 The Future of Orthodontics

30:33 Addressing Airway Issues in Orthodontics

34:30 Treating Young Patients: A New Perspective

42:36 Challenges in Pediatric Dental Diagnostics

43:52 Approaching Treatment for Young Children

44:40 Parental Involvement and Patient Management

46:34 The Importance of Early Intervention

48:41 Debating Traditional vs. Modern Orthodontic Practices

50:44 Evidence-Based Medicine in Dentistry

01:06:57 The Business of Orthodontics: Corporate vs. Private Practice

01:19:50 Final Thoughts and Contact Information

LINKS:

Dr. Mike’s Orthotown Article on Pediatric Sleep Disordered Breathing: https://www.nxtbook.com/farran/orthotown/orthotown-march-2025/index.php?startpage=36#/p/34

Dr. Claire Ferrari’s email:claire@ferrariortho.com
Dr. Allie Larios' email: drlarios@ferrariortho.com

Practice Website:www.FerrariOrtho.com
Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/

In this episode, I welcome Dr. Joseph Yousefian for an in-depth discussion on pediatric airway disorders and innovative orthodontic treatment approaches that can change lives.

🎯 Episode Highlights

Dr. Yousefian's Personal Journey

• His son Ryan's severe sleep apnea diagnosis and dramatic academic decline
• Ryan's transformation from a struggling student to a Washington University scholarship recipient after treatment

The Pediatric Airway Crisis

• Why pediatric sleep-disordered breathing has become a pandemic
• Evolutionary changes in jaw development due to modern diet and lifestyle
• The connection between crowding, malocclusion, and airway disorders

Revolutionary Treatment Concepts

• Teledontics & Telegnathics: Non-restrictive, airway-focused orthodontic treatment approaches
• Mandibular symphyseal expansion: 200+ successful cases over 23 years
• Early intervention strategies (ages 2-4) for prevention

Clinical & Professional Insights

• Why traditional orthodontic approaches may be inadequate for airway patients
• Interdisciplinary collaboration strategies with medical providers
• The future of orthodontics: paradigm shift vs. pendulum swing
• Insurance considerations and making airway treatment financially viable

The Future of Orthodontics

• Why this is a paradigm shift, not a pendulum swing
• The need for specialized training in airway-focused orthodontics
• How the profession needs to evolve to address the 1.3 billion people worldwide suffering from sleep apnea

💡 Key Takeaways

1. Pediatric airway disease is treatable and preventable when caught early
2. Untreated sleep-disordered breathing can cause ADHD-like symptoms, academic decline, behavioral issues, and long-term health complications
3. Orthodontists are uniquely positioned to be leaders in airway treatment
4. Early intervention (before age 7) can prevent a lifetime of complications
5. Treatment requires an interdisciplinary approach combining medicine and dentistry

LINKS:

• Comprehensive Treatment Seminars: https://www.ctseminars.org/
• ApnoMed: https://www.apnomed.com/
• Pediatric Treatment of Sleep Apnea with Teledontics and Telegnathics: https://www.routledge.com/Pediatric-Treatment-of-Sleep-Apnea-With-TeledonticsTelegnathics/Yousefian/p/book/9781032978994
• 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/

Thank you for your support of The DOC Podcast! Please remember to share the show with others and, if you feel we've earned it, we'd love to receive a 5-Star Review on Apple, Spotify, or YouTube.

Episode Description:

Join me for an in-depth conversation with husband-and-wife dental team Drs. Jeffrey Hindin and Jill Meyer, who are pioneering a whole-health approach to dentistry that addresses the root causes of disease rather than just treating symptoms.

Key Topics Discussed:

• Building an etiology-focused practice that treats underlying causes, not just symptoms

• Early orthodontic intervention and airway-focused care in children

• The significant overlap between TMD and sleep-disordered breathing

• Heart rate variability (HRV) and objective physiologic measurements in treatment

• Oral appliances for athletic performance enhancement

• Common signs of sleep disorders in children and adults

• Navigating resistance from traditional orthodontic approaches

• The future of sleep medicine, including emerging pharmacological treatments

Key Takeaways:

• Early intervention in children can prevent the need for invasive treatments and sleep appliances in adulthood
• Mouth breathing is a critical early indicator of sleep-disordered breathing and should not be dismissed
• The airway affects the autonomic nervous system, impacting everything from athletic performance to mental health
• Depression and anxiety are the #1 comorbidities associated with sleep-related breathing disorders
• Orthodontists are uniquely positioned to prevent adult TMD and sleep issues through early treatment
• Treatment should focus on normalizing anatomy and addressing root causes, not just straightening teeth

Resources Mentioned:

• Hindin Center: https://hindincenter.com/
• American Academy of Physiological Medicine and Dentistry: https://aapmd.org/
• AAPMD Collaboration Cures Meeting: May 15-16 in Pittsburgh

Connect with Dr. Mike:

• Website: https://theorthocoach.com/
• Email: dr.mike@theorthocoach.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/

**If you found value in this episode, please share it with colleagues and leave a 5-star review on Apple Podcasts or Spotify. Your support helps us continue to bring you conversations that challenge conventional thinking and improve patient care.**

In this episode of the DOC Podcast, I welcome Dr. Mary Motlagh to discuss one of dentistry's most critical yet overlooked issues: why beautiful dental and orthodontic work fails over time, and what we can do to achieve lasting stability.

Dr. Motlagh, a restorative dentist with over 25 years of experience, shares her transformative journey from creating stunning cosmetic cases that broke down within years to developing a comprehensive physiologic approach that consistently delivers 15-20 year stability. Through compelling patient stories and clinical insights, she reveals the hidden connections between airway health, TMJ function, neuromuscular balance, and long-term treatment success.

This conversation challenges fundamental assumptions in dentistry. From how we diagnose and treat TMD to the extraction debate, early intervention timing, and what "evidence-based" really means. Whether you're an orthodontist frustrated by relapse, a restorative dentist dealing with occlusal breakdown, or any dental professional seeking better outcomes, this episode offers a paradigm shift in how we approach comprehensive care.

Timestamps

[2:27] Meet Dr. Motlagh
[4:43] Why beautiful veneer cases started failing
[5:45] Muscles dominate and airway always wins
[9:54] Why teeth break at the gum line despite perfect crowns
[13:37] Evidence-based dentistry: beyond randomized trials
[16:52] Dentists are trained as tooth mechanics, not doctors
[22:57] How posture affects occlusion
[27:47] Signs and symptoms we miss: scalloped tongue, tinnitus, vertigo
[37:15] The 17-year-old who couldn't open her mouth for 2 years
[42:57] The extraction and airway debate
[48:20] Introduction to MyAligner and the diagnostic phase
[49:30] Ultra-low frequency TENS and neuromuscular CR
[57:27] Case presentation: correcting facial asymmetry in 40 minutes
[1:05:35] Final message: it is essential to screen for TMD and airway issues

Notable Quotes

• "We were trained as tooth mechanics and not the doctors of the oral cavity. We learned to look inside the mouth, not sit back and look at the face, look at the body, look at the connection of the orthopedic alignment of the head and neck." - Dr. Maryam Motlagh
• "When you do the diagnostics more thoroughly, your work gets easier and becomes more profitable because you cut a lot of the noise out, a lot of the headaches. It's not profitable to do a hundred aligners on somebody - you're paying the patient to treat the case at that point." - Dr. Mike
• "This is a complex problem, but once you see it, you cannot unsee it, and it becomes such a simple solution." - Dr. Maryam Motlagh

Links

• Bite Circle: https://www.bitecircle.com/
• Myoaligner: https://www.myoaligner.com/
• IG: @drmotlagh_
• Maryam’s Signs & Symptoms Sheet: https://www.myoaligner.com/_files/ugd/06070e_03dd7aac8db8431782111c81c1018d50.pdf
• Dr. Mike’s Orthotown Article on Evidence Based Orthodontics: https://www.orthotown.com/magazine/article/9835/defining-evidence-based-orthodontics?fbclid=IwY2xjawP14fxleHRuA2FlbQIxMABicmlkETFrVWE3M3EwYWJTRWpEdENTc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHhwMNgFJyCJB6JMvVDSomu6drLwAym2SI7CDx-eXbuwrUwBxzP6NpyP7HpT8_aem_NmfJlB15aUQgioH6xWUu3A
• 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/

In this deeply personal and inspiring episode, I sit down with Dr. Brett Christiansen, an Army veteran and board-certified orthodontist who has transformed his practice to focus on treating the root causes of malocclusion and sleep-disordered breathing.

Dr. Christiansen shares his remarkable journey from growing up on an Idaho farm to becoming one of only five orthodontists in the country board-certified in sleep medicine. He opens up about surviving a widow-maker heart attack at 45, losing his son in a tragic accident, overcoming depression, getting hit by a car while training for an Ironman, and enduring multiple heart surgeries—all while revolutionizing how he treats patients.

This episode explores Brett's pioneering data collection using rhinometry on thousands of patients, his transition from traditional extraction-based orthodontics to skeletal expansion techniques, and why he believes orthodontists must become true doctors who treat patients, not just symptoms.

TIMESTAMPS:

04:02 - Farm Kid to Orthodontist
06:00 - Military Service & Dental School
09:00 - Discovering Orthodontics
11:00 - Starting Practice in Lewiston, Idaho
14:46 - The Turning Point: Expansion & Snoring
18:20 - Personal Health Crisis: The Heart Attack
24:00 - Dad's Sleep Apnea Discovery
28:00 - Introduction to Sleep Apnea Treatment
32:00 - Collecting Data with Rhinometry
38:00 - Kevin Boyd's Life-Changing Phone Call
42:00 - Transitioning to MARPE & Skeletal Expansion
56:00 - The Key to Sleep Apnea: Nasal Breathing
1:00:00 - Recovery & Becoming an Ironman
1:13:00 - The Bike Accident & Heart Failure
1:18:00 - Everly's Story: Treating a 3-Year-Old
1:21:00 - Parallels Between Dr. Mike & Dr. Brett
1:10:00 - Facing Opposition from the AAO
1:30:00 - Why Orthodontists Must Become Doctors
1:38:00 - The Future of Orthodontics
1:45:00 - Surprise Guest: Everly Visits!
1:51:00 - Final Thoughts & Closing

THREE SIGNIFICANT QUOTES:

"We need orthodontists to become doctors. Most orthodontists out there that are straightening teeth, taking out teeth and lining teeth are tooth technicians. We need to become doctors of our patients. We need to be treating the patient, not the symptom of the crooked, crowded teeth."

"The key to sleep apnea is not worrying as much about the tongue, it's worrying about getting the nasal passage opened. When we expand that maxilla and the nasal passage opens up and that pathway of airflow is just smooth, that patient can now breathe through their nose."

"My daughter changed my life. She looked at me and said, 'Dad, you say that you're the airway doctor. Kids die on the operating table from general anesthetic. I don't feel right about sending her. What are you gonna do?' That's when I started treating 3-year-olds."

KEY TOPICS: Early orthodontic intervention • MARPE for adults • Rhinometry data on thousands of patients • Nasal volume changes (3-8 cubic centimeters) • Treating children as young as 2-3 years old • The connection between sleep apnea and heart disease • Overcoming professional opposition • The future of orthodontics

CONNECT:

• Dr. Brett Christiansen - Christiansen Orthodontics (Lewiston, Grangeville, Moscow, ID): https://christensenbraces.com/
• Dr. Mike DeLuke - TheOrthoCoach.com | Dr.mike@theorthocoach.com
• Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/
• Check out the DOC website: https://theorthocoach.com/