79. Is Your Child's Mouth Breathing Causing ADHD, Bedwetting, and Sleep Problems? A Myofunctional Therapist Explains

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In this episode of Oral Health: The Root of the Matter, Dr. Rachaele Carver sits down with Karese Laguerre, registered dental hygienist and myofunctional therapist, founder of The Myo Spot. Karese's journey into myofunctional therapy started at home, with four kids whose struggles, ranging from ADHD and bedwetting to chronic ear infections and sleep issues, turned out to have one surprising thing in common: airway.

What unfolded was a story that so many parents will recognize. And what Karese discovered changed everything for her family, and for the families she now helps every day.

4 THINGS YOU'LL TAKE AWAY FROM THIS EPISODE

• Your child's "common" symptoms may not be normal. Bedwetting, teeth grinding, mouth breathing, crowding, and chronic ear infections can all point to an underlying airway issue, and there's a lot more that can be done than waiting it out or reaching for a prescription.
• There's a 70% overlap between sleep deprivation in children and ADHD symptoms. That's not a small detail. It's a conversation worth having with your child's provider before trying a fourth medication.
• Myofunctional therapy is not just exercises. It's a step-by-step process of retraining the muscles of the face, jaw, and tongue, in the right order, for lasting change. Think of it like physical therapy for the mouth.
• It's never too late, but earlier is easier. Whether you're looking at a five-year-old or a forty-year-old with TMJ, the body has an incredible capacity to adapt and heal. Starting sooner just means a shorter road.

WHAT THEY COVER

Dr. Carver and Karese unpack what myofunctional therapy actually is, and why so many people have never heard of it until something goes wrong. They talk about the four pillars of healthy oral function, nose breathing, lips closed at rest, tongue resting on the palate, and teeth slightly apart, and why getting these right from an early age can shape everything from jaw development to immune health to anxiety levels.

RESOURCES + GUEST INFO

Karese Laguerre, RDH Myofunctional Therapist | Founder, The Myo Spot Serving patients in-person in New Jersey and Florida, and virtually worldwide 🌐 www.themyospot.com | Free consultations available

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Transcript

Welcome And Why Myofunctional Matters

Dr. Rachaele Carver 0:00

Hello, everybody. Welcome back to another episode of The Root of the Matter. I am your host, Dr. Rachel Carver, and today we have the pleasure of chatting with Carisse Laguerre, who is a registered dental hygienist and a myofunctional therapist. So she's going to tell us a little bit about her story, how she moved into this myofunctional space, and why, first of all, what is myofunctional therapy, why it's so important, why it's becoming a little bit more well-known and absolutely vital for proper growth and development of the jaws. So welcome, Chris. Thank you so much for taking time to educate us today. Thank you for having me. I'm so excited to be here. Awesome. So again, yeah, tell us a little bit about, you know, your journey from clinical hygiene into myofunctional therapy.

SPEAKER_00 0:46

Yeah, so I just happened to fall into myofunctional therapy by just being in the right place at the right time. I was working as a pediatric dental hygienist and I'm a mom of four. And as many parents know, you know, a lot of our lives get turned in all these different ways that we didn't anticipate because of our children. And for me, it was positive with the biofunctional therapy because there were a lot of issues going on in my home that were very common and things that you really wouldn't talk about. I often say that most parents give the highlight reels, right? When we're asked about our children, how's everything? This one's in soccer, this one's in dance, life is great. But actually, out of the four kids, I only have one boy. He's my oldest. He had a lot of impulse behavioral attention issues that really started to manifest themselves from when he was very young. I remember his kindergarten teacher would tell me that he couldn't pay attention. And I'm like, he's five. He doesn't want to be here. And we played that game with every teacher for a few years. Um, and then we got an official diagnosis when he was roughly in sixth grade, so maybe about 11 or 12 years old. And so I'm gonna pause my story right there with him. I promise we'll come back to it. My oldest daughter had every sleep issue under the sun, you name it. We dealt with it, and this went on for the first 10 years of her life. Every night we were guaranteed bed wedding, but it would be accompanied by something else. So we always had either the tossing and turning, she's falling out of bed, there's the snoring, the grinding, the sleepwalking, which is very scary. The night terrors, also scary because the screams that would come out of this little person's body, it was just yeah. So we had every slipping shoe under the sun. But the pediatrician said, Don't worry, she'll grow out of it. So I was like, okay, sure, I guess she'll grow out. And then my youngest two, we had a lot of issues from the start. Like breastfeeding was not great. And I found out later on that they had tongue ties and we had a lot of upper respiratory issues. They were chronic ear-throat congestion, ear-throat congestion, like infections everywhere all the time. It felt like we were on antibiotics nonstop. And most of this stuff isn't very uncommon. Most parents are dealing with some bit of this. I just had all of it all at the same time. But it was a pediatric dentist that I was working for that kind of put the pieces together for me to say that, hey, all of this stuff is actually really related. And all of it has to do with how they're using their facial muscles and how they're growing and developing. And, you know, selfishly, I got into this to help my children. And I'll come back to my son, and I promise I'll wrap this up real quick because, like, this is a really long story about me. It's great.

Dr. Rachaele Carver 3:46

It's very relatable. So keep going, tell us everything.

Sleep Loss And The ADHD Overlap

SPEAKER_00 3:50

So my son, um, we took him to a pediatric neurologist, and we waited like six to eight months or something like that for this appointment to see the top neurologist in the state. And that person sat with us for about 15 minutes, asked us a few questions, and boom, just like that, he was diagnosed with ADHD. And for the next year and a half, we would see her periodically, once every six months, and nothing was working. We had three different medications and nothing was working. This all sort of collides with my, you know, information being highlighted about airway and what's going on and sleep and so forth. And so I'm at the very, very beginning of that journey. But at this time, I'm ready now to see the pediatric neurologist, and we are about to be given another prescription for a fourth medication for his ADHD. And I say, you know what? I don't, I don't want to. I don't want to give him another medication. What I want to do is I want to actually check his sleep. And before I could say anything else, she stopped me. She said, Whoa, whoa, whoa, you never told me he had issues with sleep. Now, mind you, I was never asked if he had issues with sleep. But she's like, You never told me you had issues with sleep. Had you said something, I would have told you there's a 70% overlap between sleep deprivation in children and ADHD, and that we could have gone down that route. And this is for medications in that the first time, something that, you know, the pediatric dentist gave me almost right away after I started working with her this information. So selfishly I dove into myofunctional therapy to help my children and my family. But I when I say, and I'm not kidding, I feel like at the end of that journey, I met my kids for the first time. When they were able to breathe better, sleep better, focus, and like present as their fullest self, I feel like that was the magic that was like, I have to help more people discover this.

Red Flags Parents Often Dismiss

Dr. Rachaele Carver 5:57

Yeah. No, it's awesome. And I think your story is incredibly relatable, especially with the four kids, right? They all were manifesting it a little bit differently. And I think that's so important to understand because most pediatricians, they don't know anything about myofunctional therapy. Most physicians in general have no clue about the oral cavity or how any of that. I mean, most of us dentists really don't. We understand kind of the teeth and the gums, but we don't necessarily understand how it all works together, right? You know, fascia. Whoever heard the word fascia in dental school? No way. Right. So um, so I think this is lovely, and this is why these things go undiagnosed for so long, because like you said, you kept saying, right? It's common, it's common, it's very common, but there's a difference between common and normal, right? Um so that's, you know, unfortunately, like a lot of physicians, a lot of patricians are like, oh yeah, you know, we'll just give them some drugs, or let's just take the tonsils out, you know, everything's fine. Or they do the little tongue tie clip at birth, you know, and then it's never really followed up on. And like I said, even a lot of us dentists don't, you know, we can obviously identify a tongue tie when it's on the tip of the tongue, but that posterior tongue tie, which is much more common, often goes completely un undiagnosed because again, we're not trained in that. We don't know. Uh so yeah, frustrating for you with the neurolog. At least the neurologist knew about sleep. It's unfortunate that, you know, that wasn't brought up in the beginning before they, you know, just pushed the drugs, unfortunately. But I think this is amazing. And most of us, how did I get into this story? Because I had eczema all over my hands, right? And then, you know, going through by firing all my traditional doctors and just trying to learn myself, right? And then I brought that into dentry. It's always whether it's our kids or ourselves or another family member, there's always some kind of story. And that's why I like to hear it, no matter how long it is, because so many of us have our own story. And that's what brings us. And to me, as an as an energy medicine enthusiast, I'm always thinking, you know, I was meant to have the eczema because I was meant to go on this path. I was meant to teach people about the root cause of disease, right? There's so many, unfortunately, medicine has become a big business now. And we're not really trained in, you know, the whole human side has really been taken out of medicine and dentistry, right? With the business taking over and it's creeping into dentistry too. So, how do we get back to human-centered care and whole body care? And this is where I think, you know, that myofunctional therapy is the missing piece to a lot of dental issues that we don't understand. So let's kind of, if you can list them out again with your kids, you know, what are maybe the top five conditions that are related to airway that maybe our pediatrician just pushes aside and diagnoses as something else?

SPEAKER_00 8:40

Yeah. So I would say some of the top ones that I hear about, absolutely the ADHD. And I think the best part of my story was that what I was hearing from the pediatric dentist was confirmed by the neurologist. And I think that's what really pushed me. So even though I didn't hear about it the right way from the neurologist, it really did solidify that. So that ADHD and that overlap, absolutely. I would say 100% it's the bed wedding. I hear about that one a lot, or audible grinding. If you can hear the teeth gritting together at night, it's such a painful sound. But that is a big red flag in and of itself. Uh, severe crowding of teeth, and that's a big one when you look at your children, you're like, oh man, they're they're definitely gonna need braces later. That's probably your first red flag. A lot of times in adults, there's some red flags too. I would say a hundred percent you have, yes, the bruxers, the people who clench and grind there absolutely. But the TMJ disorders, oftentimes it's muscularly involved. And that's a big window for myofunctional therapy to really come in and to help stabilize the things that otherwise people are injecting to paralyze. And we don't want to do that. We want to stabilize, not paralyze.

Triage Steps And Key Referrals

Dr. Rachaele Carver 10:02

That's a good line. I like that. Stabilize, not paralyze. Please, people avoid the Botox. You see, in the in the name itself says tox, it's a toxin, you're putting it so close to your brain. Please stop doing this. There are better approaches understanding what's going on versus just, you know, oh yeah, that's upsetting to me, you know. And now, you know, they have all these courses to train dentists to give Botox. And I just think, oh, how about neurotherapy and stay? Procaine injections are so fabulous. And then again, the muscles, you know, and and even and then also the nervous system. Like, why are muscles tensing? You know, it really stems from the nervous system, you know, what what is going on in the thought process and and the the balance, right, of our nervous systems. So it's key. So absolutely. And what what I really, you know, wanted to have you on, and really, you know, we've talked about this on the podcast before, but I think it's such an important topic. We need to, you know, keep talking about it, getting all these different perspectives that the sooner you identify these issues, the easier it is to correct them, right? Traditionally with braces, we wait till the kids 12 or 13. We've already missed 90% of the growth. That's 12 years of poor tongue habits, poor swallowing, you know, and leads to, you know, with braces, once the teeth come in, like the fibers form in that position. So while braces can move the teeth, unless you really cut those fibers, they're always going to have that tendency to want to kind of go back, right? I think the other important thing that you mentioned with your younger kids, right, was the congestion. So if you have a child who is chronically getting these ear infections, it's an airway issue, right? When that lower jaw is farther back into the airway space, that tube between, you know, the throat and the ear is much shorter. So it's much more easily, you know, bacteria and stuff gets in there so much more easily. So chronic ear infection. And then, you know, when your little kid is on chronic antibiotics, that creates a lot of gut issues, which can be future immune issues. So again, let's identify that. I had my my nephew, just absolutely adorable, was born whose jaw was so far back, you could tell him. And he used to fall. I mean, every other time I would see him, he had a huge egg on his head, and I was like, oh my god. And again, like his sense of what's the right word? I don't know, he just where he was his body in space, right? Yeah. Because that jaw was so far back, you know, he was constantly falling all over himself, you know, and ended up once he got tubes in his ears, you know, again, op opened up that space and they could drain, you know, he stopped bumping his head constantly. But, you know, again, who would have thought, you know, nobody talked about I kept telling them, but you know, they weren't listening to me. That's how it goes with family sometimes, you know.

SPEAKER_00 12:42

The hardest to work with is always family.

Dr. Rachaele Carver 12:44

Yeah, yeah. So so okay, so when we identify these things, now now what do we do?

SPEAKER_00 12:51

Well, I think the first step, honestly, after you've identified it, well, as a clinician or first step as a parent.

Dr. Rachaele Carver 12:58

Let's say, yeah, let's say, okay, you've they've come to you, let's pretend you are still practicing, right? And you're noticing I'm seeing these issues which indicate that there's an airway problem. So how do we do you do a sleep study for a kid? You know, do you get them right into exercises? What is what is, you know, as a parent who's listening, what and maybe their dentist doesn't know, right? So maybe they're they're gonna want to reach out to a myofunctional therapist and we'll we'll give all your contact things at the end. What would be kind of the next step? What are you looking for as a myofunctional? Let's say they contact you. Yes. What are you gonna do?

SPEAKER_00 13:32

First step. My first thing is as a clinician, I think your very first step is to contact a myofunctional therapist. Myofunctional therapist, my first step is to sit with them. We do a consultation, we really sit and go through all of the experiences. What's linked? Where? What have we crossed off? Have we had an ENT evaluate if the kid sounds congested all the time? Is there a physiological reason why they might be so congested? Is it adenoids, enlarged turbinates? Is it is there's something going on that we can't see? That would be step one. If we've already crossed that off, they've already done that step. Great. Well, let's start looking into what's going on with the sleep. Do you have any sleep concerns? Do you have any dental or oral issues? Sometimes it's more about the dental cavities and less about the sleep. They'd be like, oh, they sleep well, but they don't have any issues with, you know, anything else. Oh, the cavities. They have a large instance of cavities, or we're about to go into some whatever appliance. And so we're crossing off a lot of the things and kind of strategically formulating what the next plan is. I think myofunctional therapists are like wonderful highways of information, honestly. We send a lot of people outside of myo or tell them when to come back in. Um, myofunctional therapy for a good bit of cases is not necessarily the next best step. Uh, a lot of times you gotta check some other stuff off or get some other stuff dealt with and resolved before we can start, such as like expansion, or if something's going on and we have to deal with it medically with an ENT or if there's a sleep study that needs to be had. So we send them out that way. So clinically, send to a myofunctional therapist. They're gonna be able to dedicate the time because as a former clinical dental hygienist, I know how busy dental offices are. You don't have the time to sit with them to really like dive into these things. So send them out with somebody who can sit there and do all of that work, send them out to where they need to be, and then collect all that information. And we're also a wonderful just like triage point too, because we keep all the information from all the places and keep everybody connected and informed.

Dr. Rachaele Carver 15:52

Yeah, that's fantastic. So, um, so as you said, we kind of clarify what's going on. So let's say, you know, they have a lot of crowding. So we're going to consider, you know, you need an expansion device, whether, you know, so if you're with a biologic dentist or, you know, a pediatric dentist who understands, you know, kind of functional orthodontics. The thing we want to expand as soon as possible. So when the even when they're like two years old, we have special, you know, mouth guards like take away the binky, okay, guys, that's no good. And they have, you know, they have something called a mile munchie that what this is what I gave to my nephew, you know, one one, two years old, just something that they can chew on, right? And that starts, you know, the process. So the most important things we want for good muscle and airway steps, right? We've got to breathe through our nose, right? Very, very important for balancing the nervous system. We need to make sure that the lips are closed at rest, right? We need to make sure that the tongue is on what we call the spot, right? So ideally, the tongue is supposed to lay flat against the palate because it's the tongue's job as a very strong muscle. It's the tongue's job to expand the arch and to push it forward. And I think evolutionarily, that's what we're seeing most is that upper jaw is not growing forward enough. So if you have a tongue tie that prevents that tongue from getting up there, then you're not getting that expansion, you're not getting that movement. And therefore, the lower jaw is only able to move as far as the top jaw will allow it. So that's why most of us will have a little bit of a retruded jaw that then is encroaching on that airway and can be creating some problems too. There's a fourth one, which one am I missing? Lips closed at rest, breathe through the nose, tongues up, slightly apart. Yes, teeth are not supposed to necessarily be touching at rest, right? They're supposed to be a little bit open. But some of us have these, you know, especially if you're breastfeeding, we talk about this all the time. Yes, it's great for traditional the breast milk, but beyond that, the way that a child latches onto a breast and drinks actually is forming, is ensuring that they're breathing through their nose. It's ensuring that the tongue is going on the roof. They need it up there, right, to express the milk. And there's proper swallowing. So beyond just the nutrition in breast milk, there's a lot of functional and physiological impacts that breastfeeding have on the baby's early development. So if you have, like you said, you know, breastfeeding issues, you know, we want to look into that, right? We want to look, is it a tongue tie issue? You know, is are is there a congestion, right? Maybe they can't breathe through their nose. So, you know, it doesn't feel safe to breastfeed. So those, that should be a clue, you know, and that you know instantly almost, right? You know, when the baby is brand new. And so now, since more and more of us have been educated about this, the myofunctional therapy and all of these associations, we can get treatment for kids so much sooner. And, you know, that's the purpose of us doing this interview today, right? Like just get that news out there. Your children don't have to suffer, right? Once you understand, we can really make so much, like you said, you know, after 10 years, you're like, you finally got to meet your kids. So it's amazing when a kid can breathe properly, when they can sleep properly, when their brain is balanced, like they're completely different. We don't have to, it's I don't know what the statistics are, but I just see in my my own teenagers and my patients, the amount of medications young people are on today for these things that that, you know, are diet and and breathing related. I mean, think about the the anxiety. If we could teach kids how to breathe properly from an early age, could we reduce a lot of this anxiety we're seeing today? It's gonna help. It's not the only factor, but man, trying to teach them how to keep that nervous system balanced is gonna go a long way for their, you know, growth and development and mental health.

SPEAKER_00 19:45

Absolutely. And it'll help with their diet too, because many of them don't have the ability to process different textures, right? Chewing something that is harder and crunchier requires a lot more musculature and jaw development, requires a different type of swallowing and collecting in order to really manage it. And you if you can't breathe through your nose, if you're a mouth breather and you're trying to do all that and you can't breathe while you're trying to do all that, it just wrecks them. And so you could definitely get the diet on a better trajectory starting early.

Tongue Tie Release Needs Rehab

Dr. Rachaele Carver 20:19

Yeah. Yeah, that's a good point. You know, the a lot of kids who are more sensitive, you know, they don't like certain textures or whatever, but is there more to the story versus just saying, eh, you know, that's just that's just the way there are. Is there anything we can do as parents and clinicians to improve that? So they have they do have that better diet, right? And then then their whole microbiome is improved and therefore their immune system, their brain function, all that is is greatly improved for sure. Absolutely. So let's say the person has a tongue tie. What does a myofunctional therapist do to help with that?

SPEAKER_00 20:53

It is our role to really see if functionally is it restrictive. So we can measure, we can look at the structure of what it looks like, we could feel it, but how does the tongue perform? There's all these muscles that work the tongue. It is a muscular hydrostat. In that it means that the muscles have to work together, some have to contract while others relax in order to help it make different shapes and move in different ways. We've got vast range of motion for our tongue, or we should have vast range of motion for our tongue. And so what we do as myofunctional therapists is we start maximizing what's there presently. Because if you can imagine, let's say instead of a tongue tie, let's say it's an arm tie, right? Anywhere else in the body, people would look at this totally different. So if it's the arm and the arm is tethered to the torso, and somebody comes along and says, Hey, do you realize that you have an arm tie? Like your arm should be able to raise up high, you should be able to throw a ball. Like, you can't do that over there. Did you know that? They're like, Oh no, I didn't know. And somebody comes along and they just snip some of the tissue. What are the Odds after however many years of life that you've been around not using your arm, you haven't been able to lift it up, raise it up, your traps, your triceps, your biceps. Like, how would you be able to functionally do that? Conceptually, we're like, oh no, you would need like physical therapy. Like, you have to actually like move those muscles. Yes, that's what we do in myofunctional therapy. We start maximizing the muscles and we develop that muscle memory that would be essential. That way, post-operatively, you can rehabilitate better. And so it's really important beginning with myo before you go into any release and then ending out. That way you would be able to functionally do the task that you're looking to achieve post-op.

Fixing Tongue Thrust For Good

Dr. Rachaele Carver 22:45

So that's really important. And I want to highlight that. So, you know, when you're going to have tongue tie release therapy, no matter what mechanism you use to do that, it's very, very important. I really love your analogy about the arm. Like that really puts it into perspective. I never thought about that, and then like, oh, it's a really good point, right? You have to have that pre, the exercises, right, beforehand, and then have the procedure to release the tongue tie. And then you have to have the post-exercises, right? So we're prepping the muscle ahead of time. Then we have the procedure and then the post, right? The physical therapy that we need for the tongue. So, really, really important. If you're somebody or know somebody who's going to have that procedure, please make sure that that doctor is ensuring that you are getting that therapy. You're going to have a much better outcome because a lot of times we'll see if they're not done properly, that tissue will just tether right back, right? You'll go right back to if you have the same habits, you never change anything. Well, it's going to go right back. So you're that procedure will bend for nothing. So, really, really important that we, you know, we're training the muscles of where they're supposed to be and how they're supposed to be. Yeah. What about I think the other one I see a lot is a tongue thrust. So at rest, when you and and oftentimes what we see in the teeth is that there might be what we call an open bite. Instead of the teeth overlapping each other, we'll see a gap. There's like airway space. And when I see that, I'll always ask the patient, swallow for me. And when they swallow, you'll see the tongue push forward into those open spaces. And many of those patients have had braces for five, six, seven years, and they never, never corrected. They could never get the bite to close because they never corrected them. Again, tongue is one of the strongest muscles in the body. So if how many times do we swallow a day? I don't know, hundreds, thousands, thousands of times a day, your tongue pushing on those teeth, you're never gonna, and no matter how many brackets and invisalign and all that stuff you're gonna have, it's going to want to stay open. So one, tell me, like, why would somebody have a tongue thrust and what might be one of the ways we help correct?

SPEAKER_00 24:46

A tongue thrust could be a number of things, but primarily what it winds up being is like a detention of that immature swallowing pattern. And so there's just no integration of a more mature swallowing pattern where the tongue would be up, and it would have a more peristaltic or wave-like motion to it where it would press against the palate instead of pressing against the teeth. So that upwards pressure we want against the palate at all times, that same force against the teeth very much does change and alter the way the teeth are positioned and influence, I should say, the way the teeth are positioned. And so the tongue thrust is something that we deal with a lot in myofunctional therapy. I will say though that that's like a later stage of myofunctional therapy. As far as myo, I think everything, when everybody goes to look it up or find something about it, people talk about exercises. And exercises are great, but there's not enough exercises in the world that can get you to fix tongue thrust. We've got that second phase of the program where we start coordinating musculature and so we start repatterning muscles through activities. And so we start collaborative tasks. And that's much more than isolated exercise. It's really working through tools, working with, you know, water, liquids, solids, all sorts of things to start developing this coordinating new patterns. And then after that, we start integrating it into daily life, and that's where the tongue thrust really starts to eliminate itself. Once we get past, okay, this is how it's supposed to work, but now we start putting it into daily life tasks. So myofunctional therapy, we're we're always dealing with tongue thrusts for most of the people that we see. Uh, but I will say it's like the end of the program. So if anybody's like in active myofunctional therapy now and they're like, hey, they haven't been working on that yet, they're they'll get there.

TMJ Healing And Whole Body Links

Dr. Rachaele Carver 26:38

Yeah, yeah. No, that's really important to say too, because you know, before I learned this or I had any connections to any myofunctional, I was like, yeah, just go onto YouTube and look up myofunctional exercises. And yeah, that's better than nothing. But like you said, there really is a core, just like if you had a bump shoulder or your arm, right? There's a certain set of exercises and you need to train the muscles in a certain order for them to work properly, right? There's there's, like you said, coordination of everything and going in the right order is really helpful. So we know how you know beneficial this is for kids early. Let's talk a little bit what you mentioned about in adults with the the TMJ. How does myofunctional therapy help TMJ patients?

SPEAKER_00 27:21

So we're looking to really deal with the muscles that are involved. So all of our muscles of mastication and how they're really managing and manipulating the joint itself. So sometimes people have issues where there is a disc displacement, which will just mean that they're starting to hear the clicking and the popping. And so that's essentially how a lay person might understand a disc displacement. But you're hearing that clicking and that popping. And so what we're getting there is not necessarily all muscularly involved. Now we've got a little bit more of the muscle because we've got some connective tissue involved, and we've got that disc that we need to work on too. However, it's typically an altered functional range of motion. And so we actually go in there and we start to repattern how they are functionally using and working the joint. So we're working on depression, elevation, protrusion, lateralization of the joint, and really helping to calm down some of the muscles that might be overdeveloped. And in that, we start developing a new disc, a pseudo-disc. Then the other disc that is anteriorly placed starts to resorb. And so that's why we get so nothing magical happens, discs don't just, you know, pop back into place. And that's why clicking and popping stops. It's really the creation of like a new disc through the functional work that we're doing and trying to repattern how those muscles are working in those different ranges of motion for the jaw.

Dr. Rachaele Carver 28:49

So that's really exciting, what you said. So basically, through myofunctional therapy, we can see regeneration, you know. Traditionally in conventional medicine and dentistry, it's just like, well, just throw a splint in there, you know, use your bike guard and you know, just deal with it, right? Like clicking puppy, it doesn't hurt, right? I mean, I would say this it doesn't hurt, right? Okay, well, just let it leave it alone because I didn't know any better, right? So, um, but I didn't know that. That's news to me that you can actually regenerate a new disc. That's so exciting. Because I think so a lot of things that we do right in dentistry, it's kind of a band-aid. We're we're gonna just throw these splints in here. And I don't, you know, I do some of them, but I don't, you know, I'm always having that conversation. You know, this is kind of a band-aid. We really need to understand the deeper functioning, you know, why is there so much so much muscle tension? So much of my conversations with those patients now starts with the breathing. Let's get you breathing better, let's get you into that parasympathetic nervous system because the tension. So I I spent, I don't know how many patients I talked to yesterday about breathing patterns, but I was like, if we can all just learn how to breathe deeper and slower, you know, get that parasympathetic. Like we will, you know, a lot of things are going to improve. So trying to teach everybody six seconds in, six seconds out, you know, and the more that you train yourself to do that, you know, because I think a lot of my issues stemmed from that imbalance in the nervous system, you know, being stressed out all the time, not needing to be, but just, you know, wired that way. So I think the biggest game changer for me has just been recognizing my breath pattern. I would, I was be holding my breath right while I was working on patients. And then, you know, my husband used to say I would like stop breathing and like kind of gasp or sigh when I sleep, not not really apnea per se, but just weird holding my breath and stuff like that. So I was like, oh geez, I gotta, you know, repattern all this. Um, but that's that's really, really exciting. So what I like, what I'm always trying to do, right, is get at the root of the disease, right? You know, and sometimes the bite is off, right? Or we had ortho, never had an equilibration, right? And so a lot of times we can slightly adjust the teeth and get things better, but sometimes it's more, you know, deeper than that. And it's the musculature. So I think that's um really, really exciting and good to know, right? So before we start just band-aiding everything, let's see if we can, because I think we can regenerate, you know, well into our, you know, mature elderly hood. I think the body has an amazing capacity to heal itself. And so that's really exciting to hear. What else uh can we do with myfunctional therapy? What are some other like symptoms or ailments?

SPEAKER_00 31:23

People don't think about the digestive impacts. Like we know digestion starts in the mouth with saliva breaking things down, but there are so many issues that mouth breathing can cause for your digestive system. So leaky gut or sometimes irritable irritable valves. When we're mouth breathing, we're introducing new bacteria to our flora of our GI tract. And a lot of times that causes more inflammation. Inflammation of the intestines is often where we get leaky gut, like things coming out of the intestines. So that wall is inflaming and becoming more permeable, and then that's now creating a separate issue. And sometimes people don't even realize that these things are correlated. Like if you are on a medication or you're trying to manage your irritable bowels or your leaky gut, a lot of times if you don't resolve the mouth breathing as an additional factor, you're just going to keep having this wall that you keep hitting and you can't get over. And so we collaborate really well with gastrointestinal physicians to help to eliminate that aspect of things. I think another thing adults don't think about, uh, and a lot of dental clinicians don't think about is periodontal disease as well. And sometimes perio isn't just like the biochemistry. So it's a lot of the bacteria and so forth, but it's also the biomechanics. So a lot of these parafunctional habits are creating these spaces, these vertical bony defects or inflammation within the gingiva or the gums, I should say, inflammation within there that creates a wonderful space for opportunistic anaerobic bacteria to just sit in there. And now we've got perio and we can do the scaling, the root planing, we can do the flap surgery, we can do all these things. But if we're not addressing like this parafunction that's happening as a compensation to something else, likely an airway problem, that's going to be another factor that now, okay, we can't stabilize this period, even though they've bought all the things. They're being compliant, they're doing the flossing, the brushing, they're they're doing what they're supposed to do. Why are we not seeing stability? Biomechanics, I think, is the next frontier.

Dr. Rachaele Carver 33:43

That's so important too, right? And then that makes me think about the just ginger recession, too, right? And your gums start to recede a little bit. You know, traditionally, a lot of hygienists or dents will tell you, oh, you're just brushing too hard. Ah, bogus. It's so much about the bite, right? And so, like you said, the biomechanics of how the teeth are coming together. Um, you know, that's another good clue for dentists and hygienists out there listening. When you start to see the recession, that is a clue, hey, the bite mechanics are off. So let's refer them to a myofunctional therapist. If we can correct that now, we'll prevent that, you know, prevent them from needing gum surgery or anything, you know, or from cracking a tooth or something like that, right? Because the the mechanics are off there. So those are really, you know, really important points, you know, to think about that, you know, even I'm like, hmm, hmm, this is good food for thought, you know, thinking about all these things and how, you know, I'm I've I've talked about like the bite causing a lot of these things, but didn't really before think, oh yeah, the myofunctional therapy would be really, really good. You know, I use some other tools to try to get the bite right, but but we really need to do the muscles as well, too. So so that's really, really great to to think about. So wow, you've given us in such a short time like some amazing food for thought, so many for myself too. I'm like, I love doing these interviews and learning something new. So very, very exciting. What else should we know about myofunctional therapy?

SPEAKER_00 35:06

There's so much to know about myofunctional therapy. I think myofunctional therapy is good for a number of things. It goes through all ages. I did want to touch on um, I know you said earlier, and I just wanted to reinforce that, but also expand on it too. But it's easier when they're younger to make changes and to see changes, but there's never a time that it's too late. It's just a little bit more lengthy in us having to work together. It takes a little longer to see some of the changes. If I'm working with a five-year-old, that's gonna be easier than working with a 15-year-old, which is gonna be easier than working with a 30-year-old, because as we grow with most things, it doesn't get easier. Like things don't get easier as you get older. Um, and so it just becomes a little bit more work, but we can make changes and you do see changes.

Dr. Rachaele Carver 36:05

And, you know, as you said too, you know, we didn't talk too much about sleep, asleep and even like acid reflux, right? That can be um, you know, a problem with mouth breathing and and all those kind of things that that a lot of people haven't put together. You know, we're just so quick to take some Tums or, you know, get on previous or something, which have really a lot of negative consequences, really. You know, again, getting, I mean, the diaphragm, that's a big muscle too, right? So if you're having reflux, a lot of it sometimes is because your diaphragm isn't working properly. So again, that's a bigger, a bigger problem, and that that needs to be addressed. A lot of myofunctional therapy goes beyond even just the mouth, right? Right, you know, it's looking at your posture, right? How is your overall posture? Because most of us are cramped over looking on our phones or computer screens all day long, right? We're really our whole diaphragm is completely compressed, right? That thing needs to be expanded in 360 directions. Modern living today is not really amenable to good diaphragmatic breathing, right? Probably why we're all anxious messes, right?

SPEAKER_00 37:04

Absolutely. And don't forget that the diaphragm is the top of that pelvic floor. So a lot of times when people have pelvic floor issues, I mean, look at the breathing too, that diaphragm. It's it's all so very cool related.

How To Work With Carisse

Dr. Rachaele Carver 37:19

It is, yeah. And so it's exciting to have, you know, the specialty, this myofunctional, you know, therapists who are looking at how everything is coordinated together. And um, it's really exciting that the more of us who are starting to learn about this to provide such a great service to our patients because like again, this sets a kid up for success for life, right? And like you said, but it's never too late. You know, maybe you've had TMJ issues forever, you know, and yeah, it's okay with splendid, but do you want to have to wear that forever, you know? And some people are concerned, I don't want to have plastic in my mouth, you know, or silicone, whatever it may be, right? So it's exciting, you know, thinking about the CPAP. So many people hate CPAPs. So what if we train ourselves how to breathe better, get all the muscles functioning better? You know, maybe we can we can do a lot to correct some of these, you know, inflammatory diseases if we're able to, you know, catch them at an early stage. So really exciting. So tell us a little bit about your myofunctional therapy, how we can connect with you and learn from you.

SPEAKER_00 38:21

Yeah, so I have a myofunctional therapy practice, the MyoSpot. We are in person in two states, in New Jersey and in Florida. Uh, but we see people from literally everywhere, all across the globe, uh, virtually. And I think that's the beauty of myofunctional therapy is that it's not necessarily like a hands-on thing. And so we can see people just about everywhere. But my biggest passion is just really spreading the word and getting people informed. So you could always visit my website, themyospot.com, and request a free consultation. I'll talk to anybody that wants to know more about myofunctional therapy, and we will absolutely deep dive into whether or not it's the next best step for you or where I might have to point you in the path of. But yeah, I'm super passionate about this, and I really appreciate being able to be here and to talk about it. And anybody who wants to chat with me, I'm open.

Dr. Rachaele Carver 39:20

Well, I love it. And and that is one of the great things about it is having that virtual ability because you know, not, you know, not everybody knows about it, right? Or it's not, you know, convenient to you, but it's something that can very easily be done, you know, via Zoom or whatever other telehealth platform that you have. So it's very, very um exciting. Now it's becoming very accessible. And again, you know, we've got to think about the impacts of this. And it's not just, oh, God, dentists are trying to sell me on some more procedures now. But again, this is going to benefit not just the mouth and the teeth, right? This benefits the entire body and almost every single system in the body. Right. So we have learning how you know to get that body working properly and coordinating the body, right? So it continues to work properly as we grow, is just in my opinion, just absolutely vital. So thank you so much for doing what you do and sharing the love. And I think we all learned quite a bit from this interview today. So again, thank you. We'll leave all of her website information in the show notes so you can reach out to her. Thank you everybody for listening. Hope you have a wonderful day, and we'll see you on the next episode. Huge thanks to you, our amazing listeners, for helping us climb into the top 5% of podcasts in the oral health space. With all the love and support, we've been getting many requests for one on one consultations. So we made it happen. Are you ready to take your oral health to the next level? Click the link in the show notes to book your personalized consultation and let's kick start your journey to a healthier, brighter smile starting today. We'll see you then.