spreecast airway kickoff 2014
TRANSCRIPT
Airway
Facial development
Dots
Connecting
the
Environment
Adaption
Genetics/epigenetics
The Multi-Disciplinary Airway Collaboration
Mission Statement
To bring together health care providers of all relevant disciplines to a convenient, easily accessible venue to discuss the significance and etiology of airway-related facial growth issues.
Goals• Develop a collaborative understanding
that integrates all relevant health fields.• Foster effective multi-disciplinary
collaboration• Develop a more accurate diagnostic and
treatment algorithm that will continue to evolve with the advent of novel, high caliber evidence and ultimately best serve the public.
The affect of airway
patency on facial
development
What is the problem? Faces
are not developing
properly
How are physiologic
systems adapting to
underdeveloped airways?
What are the physiologic affects of a changing modern
environment?
Does our evolutionary
history provide evidence for an
airway benchmark?
First Series of 25Discussions
I
II
III
IV
Spreecast Airway topics
• Epigenetics• Anthropologic etiology of the deficient airway• Facial development• Complex sleep apnea• Facial development• Orthotropics and the tropic premise• Ankyloglossia• The Silent airway problem• Dysfunctional breathing• Synopsis of AAPMD meeting• Sleep stability• Breathing physiology as a behavior• The etiology of Facial Dysfunction
Discussion
• 1) SDB, specifically an overview of the signs and symptoms that may be observed in the dental office in both the pediatric and adult population. What types of questions are best to ask of the patient and/or parents in regards to this issue.
• 2) how myofunctional therapy may be of a benefit for SDB. What types of patients would be best for this therapy? Does this group feel there are any contraindications for myofunctional therapy and SDB?
• 3) prevention of myofunctional disorders. Where, when and how to get this info out. I am having difficulties in my community with dental and medical professionals. I am now working on ways to educate the public
• The infant child is born as an obligate nasal breather which allows for proper craniofacial development via natural feeding and breathing patterns. As stated by Enlow, the airway is the keystone to facial development.
• The most important and immediate physiologic function at birth is the maintenance of breathing which is driven at the level of the brain stem.
• This necessary function trumps all other non-autonomic physiologic function as it is the CNS’ (central nervous system) drive to keep the individual alive from one minute to the next with less concern for all other physiologic functions from one moment to the next.
• This reality does not change for the lifetime of the individual and all physiologic systems are influences accordingly.
• Proper craniofacial growth and development is initially driven by brain development the first 2 years of life followed by facial development the following several years.
• This premise provides the context for the curriculum described below. It is a sea-change in how we see the role of the dentist, orthodontist and all related healthcare providers.
• Sleep disordered breathing, tempero-mandibular dysfunction (TMD), dental crowding, bruxism/clenching, craniofacial distortions, ADHD (ARCD: Airway Related Craniofacial Dysfunction) and many other medical sequelae are considered signs and symptoms of the deficient airway in the vast majority of case.
• It is our goal to provide a foundation to provide a wellness approach to dental health and development versus disease management of the various associated signs and symptoms.
• This approach does not obviate traditional dental intervention but rather enhances its delivery by taking a global approach to the many problems we manage on a daily basis.
Objectives
At the conclusion of the curriculum the participant will be able to:• Understand the concept of Airway-related Craniofacial
Dysfunctions (ARCD)• Assess patients for relevant Airway-related Signs and
Symptoms• Use a variety of objective instruments and interpret the
findings• Manage cases with Airway-Related Craniofacial Dysfunction.• Collaborate with other dental and medical professionals • Implement business protocols in your practice for these
services• Provide a foundation from which to further your education
toward more specialized focus ie, the pediatric patient, sleep medicine focusing on OSA versus UARS.
Concepts that will be covered• Sleep disordered breathing goes well beyond obstructive sleep apnea.• Deficient and aberrant craniofacial development are not just genetic disorders.• The deficient airway has many dental and medical sequelae.• Optimal physiologic management of sleep disordered breathing goes beyond
the use of a device, CPAP, BiPAP, jaw repositioning devices etc.• The worn dentition (posterior and anterior) can be associated with the
“constricted airway” versus a “constricted envelope of function.”• There is a relationship between ADHD (child/adult) and the deficient
airway/SDB.• The dentist can enhance the patient’s well-being beyond dental health.• There are benefits to a wellness model of care in dentistry.• The risk of SDB often begins at birth.• Genetics versus epigenetics in craniofacial development and function.• Aberrant craniofacial development poses as a major risk factor for TMD
(tempro-mandibular dysfunction).
Concepts that will be covered• Physiologic, organic occlusion is related more to proper airway function than
centric relation.• Quantify excessive vertical growth tendencies and how to mitigate in the
growing child.• Why SDB is so prevalent world-wide.• Sleep medicine is more about re-establishing proper nasal breathing function
than the use of devices in most cases.• There is a difference between disease management versus wellness long-term.• Long-term risks of CPAP, jaw repositioning devices’ and the various surgical
interventions.• How to properly titrate jaw repositioning devices objectively.• The role of the ANS (autonomic nervous system) in SDB and overall health.• How to intelligently collaborate with the ENT, pulmonologist, cardiologist and
family physician/Internist.• Evaluation of airway function is a global diagnostic consideration in
determining comprehensive dental well-being and optimal function.
• Directors:• Mark A. Cruz, DDS• Barry Raphael, DMD• Faculty: • Steven Park, MD• Ronald Harper, PhD• Tasha Turzo, DO• Licia Paskay-MFT • Olya Julie Zahrebelny, DDS• Roger Price• Ted Belfor, DMD• Bertrand DeSilva, MD
Airway mini-residency Structure and Details Calendar
• West Coast Class East Coast Class
•Session I March 28th-29th April 11th-12th
• Session II May 9th & 10th June 13th & 14th • Session III Joint Class: September 19th & 20th (location Orange County)
• Session IV December 5th & 6th January 9th & 10th
• Session V January 31 Study Club and case reviews• Format: 4 two-day weekends (Friday/Saturday) with a follow up
quarterly study group to review ongoing cases (tuition includes the first quarterly meeting).
Contact us
Relevant Organizations
AAGO