681: Airway Dentistry IS Possible in Your General Practice – Dr. Elizabeth Turner

If you haven't already, it’s time to add airway to your practice. Not only is it possible, it’s becoming necessary to have in your general practice. To help you get started, Kirk Behrendt brings in Dr. Elizabeth Turner, an up-and-coming airway guru, with advice for approaching the topic with your patients. Airway is here to stay! To learn how you can guide patients to better airway health, listen to Episode 681 of The Best Practices Show!

Episode Resources:

• Send Dr. Turner an email: drliz@foxpointdental.com 
• Follow Dr. Turner on Instagram: https://www.instagram.com/drlizzzt
• Learn more on Dr. Turner’s website: https://foxpointdental.com
• Subscribe to The Best Practices Show podcast 
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Links Mentioned in This Episode:

Read Breath by James Nestor:

Register for Dr. Jeff Rouse’s course:

Register for Dr. Rebecca Bockow and Dr. Michaeal Gunson’s course (2024 dates TBA): 

Learn more about The Breathe Institute

Main Takeaways:

Listen to your patients’ goals. Don't jump into airway.

Build trust with patients before the airway conversation.

Start small when talking to patients about airway health.

Interdisciplinary care is crucial when implementing airway.

Educate your patients to guide them to better airway health.

Quotes:

“In our country, we look at the medical system as very reactive. We wait for something to get so bad, and then we attempt to fix it. Why are we not listening to our patients? And that comes in a dental setting. Like, what are our patients’ goals? If the patients’ goals are whiter teeth and they don't give anything about airway health, maybe it's not something we dive right into. We have to help them understand what's possible for them, but we can't ignore what's important to them from the get-go. But these families come in, and they're so often under-listened to, and they're so often disheartened with the care they've been provided or the opinions that they've had. I see that throughout my dental practice as well. So, when I look at who we can help and how we can help them, I think listening to our patients and finding out the way that we can help guide their treatment is the best possible thing.” (7:34—8:32)

“When I look at the cases that we've converted — so, the practice that I bought had been established 27 years prior to my purchase. We had patients that have been here for 27 years, and they stayed with me because I didn't come in and rock the boat too much. I came in and I said, ‘You know what? I'm so excited to meet you. Let's see what we have here. Let's see how I can help you.’ But then, we would start to plant little seeds. I would look at a patient and say, ‘Oh, goodness. This person clearly can't breathe through their nose.’ So, I'd start to bring things up. I'd say, ‘Hey, how is your sleep quality?’ They'd say, ‘You know, I've always been a terrible sleeper. I've got this deviated septum. I can't breathe very well.’ I'm like, ‘Well, have you ever had it evaluated to see if there's anything you can do to help you breathe better?’ They say, ‘No.’ I'm like, ‘Okay. Well, here's a referral to an ENT down the street.’ Well, they go, and they get their septum repaired. They start doing a little bit better. So, they have a faith in me and a belief in me that I have their best interest in mind because I'm helping them step by step along the way.” (9:31—10:29)

“So many of our patients come to us and they have a dental home. I don't want to take that from them because I don't really want to be everybody's dentist. There are dentists out there that are so much better than me because they have an artistic skill set or a passion that lies in that. I'm a really good dentist — I think. But I always think that there's somebody better than me. I'm not going to come out and say I'm the best dentist in the world because I don't feel that way. I feel really competent. I feel really capable. But at the end of the day, a lot of families come to us either for themselves or for their children because they're looking for answers they're unable to obtain within their normal dental setting.” (11:55—12:33)

“An airway health center, I think, really helps guide a patient to make the best possible decisions for themselves. Not everybody wants to have MMA, or have a mouthpiece, or have a full-mouth rehab. But is there something that's really low-lying that we could help them get that buy-in from? Maybe it's as simple as an ENT referral, or myofunctional therapy to build some strength in the muscles.” (13:44—14:07)

“I went to a lot of courses and training that really were looking at tongue-ties and treatment, but they weren't looking at arch size, space, and tone. I think when we come out of some of these courses, we’re so well-intentioned. I don't think anybody is doing anything wrong, intentionally. But I do think that if we're not addressing the entire picture, at least appreciating the entire picture, we could be doing harm for patients. So, it's really important for us to take a step back after the courses that we go to and say, ‘How can I implement this into my practice?’ but also, ‘Is this the best way to implement this in my practice? Is there something else I need to add on?’ So, you could go buy a laser, and you could learn how to do a very, very beautiful tongue-tie release. But will it be successful? If we don't optimize the function first, for example, we're never going to have a successful tongue-tie release because the tongue isn't going to do what it's supposed to. So, interdisciplinary care is important, making sure that we're doing checks and balances along the way to optimize our success, because we're skirting the line of medical here.” (14:28—15:39)

“The medical community can't ignore this forever. I think it's so misunderstood by a lot of medical providers because it's not a part of their education. So, I'd say that the people that surround me are those that are willing to look outside the box and recognize when they don't know enough to ask questions.” (17:22—17:39)

“I would say that the success of my dental practice has been 100% because I look a little bit deeper about the way people breathe.” (18:27—18:34)

“A lot of it is about patient trust. When they trust you, they'll be willing to do what they need to do to help themselves. I use an iTero for patient education — and so many people are unhappy with their smile. They're just not willing to admit it because they don't want to be vain. They don't want to say, ‘Oh, my smile matters to me,’ but it does. And so, when we're able to take the iTero and show them the way that their alignment is, and I'm able to talk to them about how their bite is changing, the tipping of the teeth inwards, how the crowding of the teeth is actually compromising their function and their breathing — like, we convert patients to Invisalign cases, no problem. I still have orthodontists that I work with consistently for some of these cases that I 100% don't feel comfortable managing. But in a general practice, we can do a lot with aligners. We can then do a lot with rebuilding this dentition that's been damaged. And I think even being cognizant that acid reflux isn't always based on diet and it's damaging the dentition — when we start to look at that, we get a referral going to wherever they need to help with that problem. We then will have the buy-in for patients to start rebuilding the dentition that's been damaged without risk of further damage. So, from a business perspective, like Jeff Rouse always says, just do dentistry. Just do dentistry but go into it with open eyes and look for little details, because that's what interests patients. That's what builds trust, and that's what increases what goes into your pocket.” (19:02—20:32)

“There are always going to be critics, and there are always going to be people saying, ‘Oh, no. That’s not a thing,’ or, ‘That's not how you do it.’ But either way, I think the more that we can continue to educate our patients, the more they'll continue asking questions that medical providers can no longer answer — both dentists and medical — and we’ll be forced to look at this layer, just like — I mean, there's still so much misunderstanding within the joint, but we have to pay attention to it. And it's also our duty. Like in 2017, the American Dental Association stated that we need to be screening for airway and airway health. Maybe that's as simple as giving a referral to a CPAP. But I have patients that come in and say, ‘You know what? You saved my life. I went and got a CPAP, and I feel the best I've ever felt.’ Sure, they could go have jaw surgery, and then I could do a full-mouth reconstruction. I don't need to do that because I made that patient happy, and I helped them be better.” (21:39—22:31)

“We need to continue to educate ourselves and each other. We can't go into every treatment plan with the same prescription every time. I'm really hopeful that through our generation of practitioners who are starting to ask questions of the medical community, we'll be able to prevent a lot of problems for our children that a lot of us face. And that's even down to worn teeth, or misaligned teeth, or an unattractive smile. If we can help our children be better, then I think we've made a difference.” (22:33—23:07)

“There is so much burnout in our profession, right? So, you have to find something that's interesting to you. The whole human has always interested me. I'm a runner. I appreciate what it takes to make me a better athlete. I wish I'd known this when I was actually competitive because I do feel it could have made me a much more successful athlete. And there's so much coming into the general conversation about lip taping, nasal breathing, proper breathing patterns, and Wim Hof. These are things you're going to run into, and your patients are going to ask you questions. But I do think it's so interesting, as you look around at your family and at individuals around you, how you start to think differently about how you could help them.” (28:37—29:20)

“I think we can look at dentistry with new, excited eyes when we appreciate the health of the whole human, and I think we can absolutely have better outcomes. They look better, they function better, and they last longer if we appreciate what's going on within that individual person.” (29:37—29:54)

Snippets:

0:00 Introduction.

2:04 Dr. Turner’s background.

5:28 Why this is an important topic.

8:33 Start small when talking about airway.

11:46 Airway health center, defined.

14:09 What people get wrong about airway dentistry.

15:57 It starts with one patient.

18:35 Build trust with patients.

21:06 The future of airway.

23:07 How to get your team involved.

26:05 Courses to get you started.

28:27 Final thoughts.

31:37 How to get in touch with Dr. Turner.

Dr. Elizabeth Turner Bio: 

Dr. Elizabeth Turner grew up in a small town on the coast of Maine and completed her dental education in Boston at Tufts University. Her love for the mountains and the big Western skies grew after completing post-graduate studies at the University of New Mexico. Since then, she has completed hundreds of hours of continuing education connecting the mouth to the whole body, including everything from nutrition to sleep and breathing! She strives to be on the cutting edge with techniques, technology, and the latest evidence-based research.

Dr. Turner’s dedication to airway development and infant lip and tongue-ties began with her son when she was able to watch him blossom and thrive immediately following his own simple tongue-tie procedure. She is a certified Invisalign provider and holds a certificate from the American Board of Laser Surgery for Laser Dentistry. She has additional training in cosmetic dentistry, root canals (endodontics), dental implant placement and restoration, family dentistry, Invisalign, occlusion and TMD, root canal, soft tissue grafting, oral surgery, and dental sleep medicine.