Friday, August 26, 2016

12 Warning Signs That Your Child Has a Breathing Disorder

Research over the past 20-30 years has established important links between a number of common childhood health issues and a single common root cause--the ability to breathe properly.  Because breathing is something which we all do subconsciously, many parents and healthcare providers fail to look at this critical issue when evaluating a child's overall health.  But the research is clear and compelling--children who have difficulty breathing properly tend to have a plethora of other debilitating health conditions.

Perhaps the most surprising aspect of the research has been the extent to which this condition is present among our children, and the wide variety of ways in which it can manifest in different kids. Things such as ADD / ADHD, daytime sleepiness, restless leg syndrome, bed wetting, aggressive behavior, difficulties in school, and low IQ are common.  In my experience, most parents are unaware that so many of their children's health issues are interconnected, so I have put together the following list of symptoms which parents can look for to see if perhaps their child is suffering from a breathing disorder.  Keep in mind as you read the list that every child is unique, and these issues need not all be present in order to indicate a serious problem.

  1. Sleep Disruptions / Restless Sleep -  Breathing disorders are so closely tied to sleep that the clinical term for this condition is actually Sleep Disordered Breathing, or SDB.  When a child has difficulty breathing properly (through their nose), the first sign may be a child's difficulty sleeping deeply for a full 9-10 hours through the night. 
  2. Snoring / Mouth Breathing - Snoring and / or mouth breathing are neither cute nor funny, but rather a clear WARNING SIGN that something deeper may be going on that can have serious health implications.  Human beings are designed to breathe through the nose, and we now know that nasal breathing offers a number of important health benefits, including a boost to the immune system, and better oxygen absorption in blood.  Moreover, children who mouth breathe are far more susceptible to dental cavities and swollen tonsils and adenoids--a condition which further restricts their airway.  Many children experience great difficulty breathing exclusively through their nose, especially at night.  Remember, normal breathing is nasal, relatively shallow, and SILENT.
  3. Crowded or Crooked Teeth - Having crowded or crooked teeth is often referred to as a malocclusion (bad bite).  Malocclusions are NOT NORMAL.  There are always reasons why teeth aren't where they belong.  One primary reason is that the upper and lower jaws are underdeveloped, are too narrow, and not set forward enough in the face.  No matter what your dentist or orthodontist may tell you, in 99.9% of cases, there is no such thing as "too many teeth" or "teeth that are too big to fit in your child's mouth" or "a mouth that is too small to hold all the teeth".  Never allow a dentist to remove permanent teeth in order to create space to straighten the rest.  Many prominent doctors now consider such treatment malpractice because of the way it disfigures the face and can constrict an airway.  So if your child's teeth are crooked, this may point to any number of other things such as mouth breathing, weak tongue, and underdeveloped jaws.
  4. Underdeveloped Jaws - In our modern Western culture, the tendency is for limited natural breastfeeding supplemented by plenty of bottle-feeding and non-nutritive sucking (pacifiers).  Then when "solid" foods are introduced, the diet is extremely soft and requires little actual chewing.  These factors all combine to create under-stimulated and weak orofacial muscles, which in turn fail to stimulate proper growth and development of the upper and lower jaws.  When the jaws fail to develop and move forward they can literally choke off precious space needed for a full and open airway.  Underdeveloped jaws can also lead to crowded and crooked teeth.  These things are all interconnected in important ways.  Fortunately, properly trained dentists have effective ways to help facilitate proper jaw growth, which can open up the airway.
  5. Bed Wetting - Most very young children have an occasional bed wetting accident.  But if your child is wetting the bed 2 or more times a week beyond the age of 5 it is considered a problem in need of treatment.  And while some do grow out of it, many children continue to experience this problem into their early teens.  The issue for parents, however, is that up until now, there haven't been any effective treatments available.  Now there are highly effective treatment options available from specially trained dentists for children of all ages.  
  6. ADD / ADHD Symptoms - One large research study published in 2012 looked at 11,000 kids over several years, and found a 50% increase in behaviors linked to ADD / ADHD in kids with SDB.  Remember that these diagnoses are fundamentally a list of behaviors based on observations.  Once diagnosed, most children are prescribed psychotropic drugs (stimulants) in order to help them regulate their behavior.  The research has shown, however, that a child with Sleep Disordered Breathing (SDB) is virtually indistinguishable in his or her behavior from other ADD / ADHD kids without SDB.  So when we get their breathing and sleep under control, the behaviors quickly change and kids become much more manageable.  
  7. Lower IQ / Difficulties In School - If your child is struggling to keep up in school, or has difficulty focusing and completing assignments, they may have a sleep or breathing disorder.  We have seen many kids who were previously failing out of their elementary school classes make complete turnarounds after addressing their SDB, exchanging D's and F's for A's and B's, much to the amazement of teachers and parents.
  8. Thumb or Finger Sucking Habits - Thumb or finger sucking habits can affect the proper formation of teeth and gums, often creating an "anterior open bite", meaning a gap between the upper and lower front teeth when the back teeth are touching.  This condition can also affect the way the upper palate forms, creating a high arch which can greatly diminish the air flow through the nasal passages.
  9. Dark Circles Under the Eyes - Known as Venous Pooling, purple-tinged areas below the eyes is another sign of a sleep and breathing disorder.  This one is easy to spot.
  10. Chronic Allergies and / or Headaches - When a child doesn't breath properly through their nose, their tonsils and adenoids can swell and their immune systems can be compromised.  If their jaws remain too far back in the head, the eustachian tubes can be pinched or reduced in size to the point of not being able to drain fluid from the inner ear.  This too can cause frequent infections, ear aches, and operations to place tubes in their ears.  Some SDB patients complain of frequent headaches and chronic pain (mostly in older children, teens, and adults).
  11. Teeth Grinding - Known as bruxism, there are two ways for parents to check to see if their children are grinding their teeth at night.  The first is to look at the shape of the teeth.  If they are flat on top or without "normal" looking cusps and crevices, then they are likely grinding at night.  The other way to check is to listen to the child sleep.  Often you can hear them grinding away.  If you suspect your children are bruxing, you can be pretty sure they have a breathing disorder.
  12. Defiance and Aggression - Anti-social and aggressive behaviors are quite common in kids with SDB.  We have seen amazing turnarounds in attitude and behavior once the sleep and breathing disorder(s) are addressed.  Some children are just chronically tired because of a long-term lack of sleep.  Without sufficient sleep, they are simply incapable of coping with the stresses caused by otherwise normal peer-to-peer interactions, and take their frustrations out on others.  With parents, they often exhibit rude or disobedient behavior, and seem incapable of following through on the simplest task.
One study showed that as many as 9 out of 10 kids suffer from at least one of the above symptoms related to Sleep Disordered Breathing.  Now that highly effective solutions are available, parents should not delay in seeking treatment.  Most of these issues can be resolved by assisting the jaws to properly grow and develop and by strengthening the key orofacial muscles that hold everything in place.  There are more and more specially trained dentists available around the country who know how to help.  

Thursday, July 7, 2016

People Say the Darndest Things…About Dentists

On my blog, I wrote: Working in the dental industry, I’ve heard just about every story and anecdote that you can imagine about dentists and teeth. 

Now, here are great tidbits from some super-famous and not-as-famous folks who also have a lot to say on those topics.

I didn’t want to be an actress. I wanted to be a dentist, but you never know what life will bring you.

-Sofia Vergara, award-winning actress, comedian and businesswoman
Now, most dentist’s chairs go up and down, don’t they? The one I was in went back and forwards. I thought ‘This is unusual’. And the dentist said to me ‘Mr Vine, get out of the filing cabinet.

Tim Vine, English writer, actor, and comedian
If suffering brought wisdom, the dentist’s office would be full of luminous ideas.

-Mason Cooley, American aphorist
Happiness is your dentist telling you it won’t hurt and then having him catch his hand in the drill.

-Johnny Carson, comedian and television host of The Tonight Show for 30 years
I told my dentist my teeth are going yellow. He told me to wear a brown tie.

-Rodney Dangerfield, stand-up comedian and actor
The grinding of the intellect is for most people as painful as a dentist’s drill.

-Leonard Woolf, British writer and husband of author Virginia Woolf
I am lucky: I have fantastic doctors and a fantastic dentist.

-Anna Deavere Smith, actress, playwright, and professor 
Faced with the choice of enduring a bad toothache or going to the dentist, we generally tried to ride out the bad tooth.

-Joseph Barbera, animator, director, and cofounder of Hanna-Barbera

I intend to be flesh and blood, not airy philosophy, for there has never yet been a philosopher who could endure a toothache patiently, even though they all write as if they had risen above human suffering and misfortune.

-William Shakespeare writing for the character of Leonato in Much Ado About Nothing
Dentist: a prestidigitator who, putting metal into your mouth, pulls coin out of your pocket.

–Ambrose Bierce, journalist, poet, and short story writer.
Some tortures are physical

And some are mental,

But the one that is both

Is dental.

-Ogden Nash, American poet
We do have a zeal for laughter in most situations, give or take a dentist.

-Joseph Heller, short story writer and playwright

Sunday, May 29, 2016

How to Fix a Gummy Smile

Research has shown the incidence of so-called "gummy smiles" to be as high as 26% in certain populations, and that women exhibit this feature at twice the rate of their male counterparts.

Gummy smiles are mild malformations of the human face, and typically arise through abnormal growth and development.  In most cases, they are not genetically determined.  They typically manifest early in life during crucial developmental stages and may or may not be associated with other health conditions.  They are universally viewed as being less aesthetically pleasing.  Often, patients with gummy smiles feel insecure about their smiles and seek to cover or hide their mouths when they smile fully.

Now there is a non-surgical solution that can completely eliminate a gummy smile in as little as 9-18 months.  It's called the DNA appliance, pioneered by Dr. Dave Singh.  It is available only through specially trained dentists located around the world.

This unique and proprietary technology activates stem cells in the mouth to remodel and redevelop the dental arches and remodel the jaws.  This realigns and restores the normal genetically coded placement of teeth and jaws, and by so doing, the gummy smiles just go away.

Go to for further information on Dr. Singh's amazing scientific discovery.

The Case for Non-Extraction of Permanent Teeth

I'd like to make the case for why, as a parent, I would never allow permanent teeth to be extracted from my child's mouth.  What follows are my personal opinions formed over many years of direct involvement with patients and dentists.  I am not a dentist.  However, I do have over 300 hours of continuing education in traditional orthodontics, functional orthopedics, epigenetic orthodontics, and craniofacial growth and development.

First, we should acknowledge that BY FAR the most prevalent reason for extracting teeth has been cosmetic, i.e., a desire for straight teeth.  Many doctors (even so-called specialists) have believed that some patients are simply born with either a mouth that is too small for their teeth, or teeth that are too large for their mouth.  To such doctors, the solution seemed simple enough--extract some of the teeth to create space for the others to be straightened and placed in a neat little row.  And if all one is attempting to do is straighten teeth, then we would concede that extraction therapy can be very effective.  Unfortunately, there are other serious considerations and implications.

What is rarely considered in such cases is the potential compromise that extraction therapy can have on other aspects of the patient's anatomy--particularly the airway.  Many excellent clinicians have observed that when permanent teeth are removed, and then braces are applied, both the upper and lower jaws can be retruded (pulled back) or are at least prevented from growing properly forward.  Jaws placed too far back in the craniofacial complex can impede on the functional space of the human airway and give rise to numerous other health conditions.

So the first issue against extracting teeth is that doing so may cause a compromise in a patient's airway.

The second reason is that extractions are almost never medically necessary.  The old adage of the teeth being too large for the mouth or the mouth being too small for the teeth is no longer a valid diagnostic paradigm for 99.5% of the population.   Moreover, excellent clinical techniques are now available which can guide the proper growth and development of the jaws and orofacial complex, widening dental arches while keeping things forward and preserving crucial upper airway space.  These techniques can often render traditional braces unnecessary.

One such treatment modality is the DNA appliance, pioneered by Dr. Dave Singh.  Dr. Singh spent 15 years in clinical research and development, and discovered that using epigenetic principles, it is possible to activate the body's own genetic code to remodel the oral cavity, expand the nasal cavity volume, and remodel the human airway.  His patented technology has successfully treated many thousands of patients around the world, including many adults who were suffering terribly from the effects of bicuspid extractions which they had earlier in life, and which they believed were now contributing to their Obstructive Sleep Apnea.

More information on this exciting and relatively new treatment can be found at

Finally, I would argue that patients who have received 2 or 4 bicuspid extractions have distinctively flat or even sunken facial features which are far less aesthetically appealing than if they had a full set of teeth with jaws placed properly forward.

The Surprising Root Cause of Your Child's Health Issues

Research over the past 20 years has linked many common childhood health disorders to a surprising single root cause.  These conditions range from ADD/ADHD to chronic allergies, to bedwetting, to swollen tonsils and adenoids, to snoring, to crowded or crooked teeth, to restless sleep, to daytime drowsiness, to aggressive or oppositional behaviors, to difficulties in school, and more.  One study even showed that as many as 9 out of 10 kids suffer from at least one of the disorders linked to this single causal factor.

You may be surprised to learn what's behind all of this--a compromised airway.  That's right.  For many children who suffer from one or more of these disorders, the fundamental issue is that your child's airway is underdeveloped and they can't breathe, or at least not as well as they should or the way they should.  

Further research has shown that when you fix the breathing issue, the other conditions will often simply go away.  We experienced this first hand in my own family when my nephew (age 11) experienced bedwetting episodes 4-5 nights a week.  Once his breathing issues were addressed, the bedwetting stopped completely and permanently within a week.  He's now 13 and has never since had a relapse.

Thursday, May 26, 2016

Thoughts on why things sometimes go well...

Fortunately, in the ebbs and flows of life, things will sometimes go well--perhaps extremely well.   And when they do, the tendency is to focus on the success itself, basking in the validation and accolades that often accompany such things.

There may be good reasons for this.  If you're a successful business owner or entrepreneur, chances are you had to overcome plenty of obstacles, including all the naysayers and others who refused to believe in your vision.  So to finally realize your dreams and experience that sense of accomplishment is a powerful feeling.  Taking time to consider well the fundamental principles that got you to that point is essential.

When I think back on the successful businesses I've had, I can see several things that I believe they all shared.  So here are a few of my top rules for success:

  1. Stay within your area of expertise.  Years of preparation and plenty of actual experience in the trenches were essential foundations on which I could build.  
  2. Test and prove the model before trying to expand.  Find your model and get it right--first.  Then grow.  That seems simple enough, but I've seen plenty of entrepreneurs violate that principle, and most have lived to regret it.
  3. Get the culture right from the beginning.  Startups are hard.  Everyone pays a steep price.  People put in long hours as they "live the dream".  It's during these formative stages that the true culture of an enterprise takes shape.  Start with "why" and lead by example.  Turning around a bad culture is incredibly difficult and painful.  Getting it right in the beginning pays dividends for a long time.
  4. Take nothing for granted.  Not your partners, nor your employees, and especially not your customers.  Express appreciation for those fellow soldiers who are likewise making sacrifices and contributions.  You'll need them when things get rough--and they will.
  5. Alignment.  Every successful business I've ever had has exhibited high degrees of alignment--between the company and it's customers, among senior management, and throughout the organization.  Where there is alignment, there is high levels of trust, and trust is the lubricant that allows an organization to run fast, run hard, and grow properly.
I'm sure there may be more I could add to my list, but those would definitely be among my top attributes of successful ventures.

Sunday, May 22, 2016

When things don't go as planned...

It is somewhat of a maxim among entrepreneurs, angel investors, and venture capitalists that no one gets it right all the time.  Sometimes, despite the best laid plans and every good intention, things just don't go as planned.  The hard truth is that companies fail.  Losses happen.  Not every startup evolves into Microsoft or Apple.  Some, perhaps most, end up as hard lessons in life for founders, managers, and investors.

Having myself experienced a few nice wins as well as some painful losses, I've found the losses stay with you longer.  They definitely take their toll--emotionally, financially, mentally, and even physically.  It's really hard to put your heart, mind, soul and fortune into something only to see it hit the wall and pass away.  It's hard to explain to your wife.  It's hard to explain to your employees, your vendors, and your customers.

Another thing I've found is that, more often than not, there's no one who you can talk to about these things in any sort of meaningful way.  People who haven't been through it, don't really comprehend what you go through when your business fails.  And it's not something you even want to talk about with just anyone, so you tread the winepress alone, so to speak.  The isolation of it all tends to make things worse.

I remember well when a few years ago I had a company that failed.  In that particular case, we were made aware of some extremely serious allegations of ethical and perhaps criminal violations that were happening in one of our locations.  We immediately moved to investigate the situation, and once we had confirmed what had happened, we terminated those responsible.  In the process, and in an effort to be totally transparent, we notified our bank as to the nature of the things that occurred, and tried our best to do the right thing for all concerned.  Unfortunately, the damage done was extensive, and the perpetrators held key positions in the operation.  Replacing them proved extremely difficult, and the revenues collapsed.

We tried suing them, but before long our legal fees approached $100,000 per month, and it was unsustainable.  So we had to drop any hope of recovery via the legal system, and decided to focus on saving the business.  We might have made it too, except our bank panicked, refused to play ball, and actually made matters worse by first cutting off all of our working capital lines, then moving to foreclose not only on that practice, but all of our other performing locations as well.  The irony there was that our other locations were performing quite well and were in no jeopardy whatsoever.

Before we knew it, things had begun to spin out of our control, despite our best efforts.  Eventually, the bank forced us to sell off all company assets at a fraction of their true market value, and we lost every ounce of equity.  In a little over seven months, we had gone from having a profitable, growing enterprise with a bright future, to having lost everything--our incomes, our dignity, our reputation, and millions in equity.  It was a complete nightmare.

However, even though the assets and remaining operations were sold, the nightmare was far from over.  Creditors demanded payment.  Vendors who had legitimate claims for products they had delivered and services they had rendered were understandably upset.  Unfortunately for everyone, there was nothing left.  The bank took practically everything from the sale.  Of even greater concern were the dozens of patients who were left hanging without knowing who to call or where to turn to get their work completed or their deposits back.  And the amount of money they were out was no small sum, either.  At the time, we didn't really know how big that number was, but we knew it was at least several hundred thousand dollars.

So some very hard decisions had to be made.  One thing that becomes very clear in situations such as this is the wisdom of our corporate laws and legal structure which provides individual owners and investors protection against claims against their LLC or corporation.   It's for precisely these situations that those laws exist.  Knowing we weren't going to be held personally legally liable was one small comfort, but it's all still really hard.  The whole affair is heartbreaking and just plain hard.

One call that needs to be made in these situations is whether or not to file bankruptcy.  In this case, we decided not to.  I can't recall why our lawyers gave us that advice, but every situation is different.  I've often thought since just how much easier it all would have been to just take that step.  It would have been infinitely easier to have a clean break and move on.  But we chose not to do so.

What I do recall is that most of the company vendors had to write off at least a portion of their invoices.  The patient claims, however, just felt different to me.  They had been our customers, and it didn't seem right to leave them hanging without any sort of settlement or closure, so one of my partners (my son in law) and I personally paid back or settled up with each and every one.  By the time we were done, we had spent many hundreds of hours and over $400,000.  It took us over a year to see that everyone got made whole.  But we did what we thought was right.

In these situations, it's important to recognize early on that you aren't going to be able to please everyone, and you may not be able to please anyone.   In the case I've just described, the bank was mad at us for allowing such a thing to happen (in their view), and in turn we were mad at them for completely abandoning us when we needed them most, and making a bad situation far worse.  Vendors were upset that they wouldn't be paid in full.  Employees were upset when they suddenly became unemployed and didn't get their last paychecks.  Our attorneys and accounts and landlords were upset.  Patients were upset.  I was upset.  My partners and our investors were upset.  My wife was upset.  Everyone, it seemed, was mad about the situation and needed someone to blame.

Well, it's really easy to blame the owners--you know, those rich guys who must be responsible, and who everyone is certain must have somehow made out like bandits.  I understand that.  The buck has to stop somewhere.  But very few people actually knew the facts, and in the absence of all the facts it is all too easy to draw conclusions that may not be accurate.

Moreover, as one of the guys in charge, I also felt responsible.  Why did I place my trust in people who could do such things?  How did I not see it in them?  Why didn't our operations people have better systems to detect such activities before they got out of hand?  The inner recrimination goes on and on, and can sometimes be worse than the criticism that a comes from outside.

When it was over, I had lost just about everything.  That's hard to admit, frankly, but it is true.  This was no small matter, as I'm certain every business failure is for those who risk everything to try and make something good happen.  It irrevocably alters the course of your life.  It changes you and those around you.

I write this here with the hope that someone out there who may be going through something similar may know that eventually things do settle down.  While you're going through it, it doesn't seem like it, but they will, and life will go on.  Don't despair.  Be patient.  See what the lessons are and vow never to make the same mistakes.  Pick yourself up.  Dust yourself off.  Give thanks to God that it wasn't worse.  It could always be worse.  Count your blessings and focus on the future.  You'll be alright.  The sun will come up tomorrow and it will be a new day.