Every Generation Deserves Better Health: Perspective by Dr. Steve Carstensen

Steve Carstensen, DDS Diplomate, American Board of Dental Sleep Medicine

Have you thought about your growing dental sleep practice and how many people in your community remain to be treated? How many patients in our practices and how many people on the street are unaware, not only of their disease, but of the choices of therapy? It’s a very large number – the adults you treat, the ones you ‘recognize’ in public and the people in various stages of PAP therapy. How did all these grown-ups get to be poor sleep breathers in the first place?
Inadequate airways grow that way. Maybe there was a chance, unrealized while they were young, to influence that space. Consider a different path, one that would have them breathing easier as adults today. Imagine the impact and important role dentists have in this vital health initiative.
Readers of this magazine are interested in a whole-body approach to health – using therapy that affects physiology quite remote from the oral cavity. We must understand how to achieve maximum positive impact with what we can do. Research in pediatric populations is showing how helping the airway get bigger, through surgery or mechanics, can significantly influence the child for the better. Active treatment at ages where a ‘wait and see’ approach has been popular for years is looking to often be the optimum choice. Kids who don’t breathe well have wide-ranging problems – two physicians from Seattle Children’s Hospital have prepared an essay for us touching on some of those health areas. (see the article here)

Research in pediatric populations is showing how helping the airway get bigger, through surgery or mechanics, can significantly influence the child for the better.

Orthodontists, Otolaryngologists, and Pediatric Dentists are reading more and more studies about the importance of adding airway evaluation to their traditional preventive and esthetic services. I find it interesting that FDA clearance for oral appliances for treating SDB does not extend below age 18, yet a Herbst device can be used to treat “mandibular growth deficiencies” as soon as the dentist recognizes the problem. How they differ is a mystery to me, but I am happy dentists can employ known therapy to solve airway problems early, even if they can’t name it thus.
It’s not just about the appliances, of course – first we must change our point of view. Drs. Raphael and Maijer are putting tremendous effort into getting this message out worldwide. Leaders like these bring powerful teaching across the spectrum, from families to whole professions, raising awareness of possibilities and opening eyes to see. “Lips Together, Breathe Through Your Nose, Tongue In The Roof Of Your Mouth” This mantra, taught to me by Barry Raphael, may improve worldwide health more than any other thirteen words ever strung together. How do you do this? (read more by Dr. Raphael here)
Finding excellent teachers like Dr. Jonathan Parker, getting your team on board, using the right technology resources, and being brave about starting the meaningful conversations necessary to help grow these young airways represent the future of dental sleep medicine. (see the interview with Dr. Parker here)

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