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960: What Airway Health Really Means – Dr. Meggie Graham & Dr. Liz Turner

Airway dentistry isn't just a fad — it’s here to stay! In this episode, Kirk Behrendt brings in Dr. Meggie Graham and Dr. Liz Turner, founders of the Untethered Airway Health Center, to talk about the growing field, what airway health really means, and why it’s important to integrate it into your practice. To learn how you can impact your patients’ health no matter their age, listen to Episode 960 of The Best Practices Show!

 

Learn More About Dr. Graham & Dr. Turner:

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Main Takeaways:

  • Airway is not just a fad — it’s that dentistry has been missing it for years.
  • Help patients identify their breathing dysfunctions and become aware.
  • Don't push airway onto patients who aren't ready to hear about it.
  • Implementing airway isn't all or nothing. It’s okay to do it slowly.
  • Stay curious and excited to learn to be fulfilled in your career.

Quotes:

“Whether or not you acknowledge that breathing is part of dentistry, it is.” (3:16—3:21) -Dr. Graham

“For us, airway health in a dental setting has to do with the structure and the foundation of the bones of the teeth, of the jaw position, so that we can make sure that we're enabling somebody to breathe as passively as possible while alert and at rest, because the trickle-down effects of narrow jaws are seen in the literature for impacting high-risk factors for tonsil and adenoid enlargement, high-risk factors for deviated septum, high-risk factors for OSA and sleep-disordered breathing. These have all been independently proven. The argument that we’re always going to get is, ‘Where’s the research?’ Well, it's multifactorial. You can't take a seven-year-old and withhold beneficial treatment from them since infancy and be like, ‘Let's see what happens if we leave you tongue-tied to the tip.’ Anecdotally, we'll see children that are tongue-tied to the tip and how that impacts them. But we can't put someone in a bubble and isolate for a growth factor over a period of years. We can follow cases, and a lot of the great studies that have been done show how tonsil and adenoid removal, coupled with maxillary expansion, reduces the chance that there's sleep-disordered breathing at the 12-year follow-up. So, there are certain things that we can start to lay down foundationally when it comes to growth and the impact on health. So, airway health, to us, is always going to be structural.” (11:48—13:15) -Dr. Turner

“Because the body is learned in compartments and annexed to specialists, it doesn't get learned as a whole. This area, the mouth, has been separated from medicine, and we have done our patients a huge disservice to not understand the impact of where we work. So, as dentists, I think it's our responsibility not necessarily to offer a whole bunch of treatment modalities. Ideally, we can change structure, and we can offer treatments that can help people breathe better. But if we can just help identify, ‘Hey, you're breathing dysfunctionally.’ At the beginning of this journey for me nearly ten years ago, I didn't know I was a mouth-breather. I didn't know that that was a problem. I think even just starting with that simplicity of, ‘Do me a favor. I'm going to see you in six months. Nothing catastrophic is likely going to happen in six months. Pay attention to how you're breathing. When you check in during the day, where is your tongue? Are your lips parted?’ Start to create an awareness in your patients. Oftentimes, they'll come back and say, ‘You know what? Ever since you've been here, I noticed I breathe through my mouth,’ or, ‘I do wake up with my mouth open,’ or, ‘I do have poor sleep.’ So, I think that creating an awareness in our patients — because we see them so frequently, more than they see their primary care physicians — is a great opportunity and honestly a responsibility for us to start bringing that into the conversation. Even if we're not diagnosing sleep apnea, even if we're not offering a menu of service options, giving the patient the opportunity to understand that something is happening in their body that might be pathologic.” (13:43—15:17) -Dr. Graham

“Just like we do with blood pressure, it's not any different. We screen people for blood pressure every six months, and we alert them to a number that's high. We're not diagnosing hypertension, but we're using that information to make a referral to where they need to go. So, for people that don't necessarily want to offer that menu of services, that's okay. It’s if you've got an 80-year-old who has suspected sleep apnea and he doesn't know it, I mean, you could prolong a life by just making a referral. Then, you've got a happier, healthier patient who's going to keep referring to you. You've got dentistry that's going to be more stable because they're not going to brux into it quite as much. So, there are a whole lot of different things that you can do for your own practice. It doesn't have to rock the boat all that much.” (15:18—16:00) -Dr. Turner

“One of my biggest mistakes that I made that I would love to share with new dentists or dentists that are on this journey for the first time is, take it in and sit with it for a second. Don't jump in and try to make changes rapid-fire. It didn't work for me.” (19:17—19:32) -Dr. Graham

“You don't have to go in and rock the boat, and you don't have to make this seem salesy in any way. It's more about planting those seeds so that you can help nurture patients to where they want to go. You'd be surprised how, when you open the door, so many say, ‘Well, yeah. I've been worried about this, and I've asked questions, and nobody has given me an answer.” (19:37—19:56) -Dr. Turner

“What do you like to do? What do you enjoy? Because if you have no interest in learning how to do functional frenuloplasty . . . you have no interest in learning how to do orthodontics or maxillary expansion, you don't have to. You don't have to bring in new treatment if you don't want to. If you do, great. There are tons of support and courses out there. But I think recognizing what you do like and then starting to ask your community and your interdisciplinary team members how you can work together is so powerful. That's been a huge part of my enjoyment in the career and the success of patient cases, is starting to really collaborate with my team and my community and knowing how and when to refer, because even if you're an airway-aware dentist that doesn't want to implement any new treatment modality, you can be the quarterback. You can be the one that says, ‘Hey, these are the issues. Here's the diagnosis. This is where we're going,’ and you can still offer this amazing service by just aligning the specialists and giving your patient a roadmap.” (21:41—22:51) -Dr. Graham

“One of my hopes is that we start paying more attention to children. In traditional orthodontics, even the American Academy of Orthodontics recommends that they have an orthodontic screening by the age of seven — at the age of seven, not necessarily by . . . Most kiddos still aren't seeing an orthodontist till they're 10, 11, 12 years old. Most jaw growth is complete by the age of six. We're missing a significant window for growth by not systematically assessing for functional underdevelopment of the jaw. The development of the jaws comes from the function of the muscle and pressure outward. If that musculature isn't working well because of poor feeding as a child and infant, poor solids, poor speech development, we're also going to see genetic underdevelopment of the jaw. So, it's multifactorial, nature and nurture. If we pay more attention to children when they're four, five, and six years old, we can improve upon the canvases that we have to work on in adult-related dentistry. With adults, change is harder. We have a canvas in front of us, and we have to work with what we've got, unless somebody's ready to take a step that's more expensive and more involved. A lot of people are, but not everybody. If we can work on foundational stability earlier by looking closer, we're going to have a better population of faces for us to do dentistry on down the line.” (26:33—28:06) -Dr. Turner

“So many people out there learn what they learn in their residency program or their grad school program, and then that's kind of it. They might get their bare bones CE requirements either out of disinterest or busyness in life. It's really hard to shift how you started practicing in a monumental way. So, if this kind of [airway] education can get to the pediatric residency programs and the general dental programs, we're going to start to see a shift in how people practice, because if it's only available at the higher continuing education level, it's not going to get to the patients.” (28:39—29:17) -Dr. Graham

“[Airway is] not a fad — it's just we've been overlooking and asking the wrong questions. I tell my parents stuff all the time, and they're on board. My dad is on a CPAP. I videotaped my mom not breathing. I've got 15 videos of her stopping breathing for a minute at a time. She goes to the physician, and they're like, ‘You know what? I think you have sleep apnea,’ and she gets a sleep test. I had already run one on her, but she forgot. She goes, ‘By golly, I have sleep apnea! Can you believe it?’ I was like, ‘Yeah, I've been telling you for 10 years.’ We lean into reactive medicine more than prevention, and so much of that generation — no offense to my parents — are like, ‘What medication can we throw at it to fix it?’ We could have reduced the risk of you even needing that medication, the CPAP, the mandibular advancement appliance, if we had addressed it sooner. So, it's not a fad. We've just been missing it, and we've been asking the wrong questions.” (31:26—32:24)  -Dr. Turner

“If you're a dentist, and you're listening, and you say to yourself, ‘I feel like this is my patients. I feel like this is myself,’ you don't have to do everything. But doing something, even down to a little piece of lip tape, can change a life — maybe yours, maybe your patients'. Build a trusting relationship with the patients that you have. Help your family. So, it doesn't have to be all or nothing. Start small, begin to look at things through a different lens, and then start to integrate.” (34:50—35:21) -Dr. Turner

“Keep being curious. Don't ever get comfortable, thinking that you've learned it all. I have so much more respect for a provider that says, ‘I don't know,’ as opposed to, ‘Oh, that's not a thing.’ And that's across any discipline or any niche. The chances of us ever knowing it all is zero. We're never going to learn it all. It's impossible. So, continue to be curious, keep asking questions, and stay excited to learn. Otherwise, you're not going to be fulfilled in your career, and you're going to miss an opportunity to make a really big impact.” (35:29—35:58) -Dr. Graham

Snippets:

0:00 Introduction.

1:23 Dr. Turner and Dr. Graham’s backgrounds.

3:33 Dr. Turner and Dr. Graham’s aha moment.

10:25 What airway health really means.

17:34 Common mistakes dentists make when looking at airway issues.

20:51 How to integrate airway into your practice.

26:09 The future of airway in dentistry.

30:01 Is airway just a fad?

34:20 Final thoughts.

35:59 The origin of The Untethered Way.

38:26 More about The Untethered Way course.

39:45 More about the No One Told Me podcast and how to get in touch.

Dr. Meggie Graham Bio:

Dr. Meggie Graham helps patients of all ages breathe better and live healthier lives. As both a mother and an airway patient herself, she understands the challenges families face with breathing disorders, tongue-ties, and sleep problems.

A faculty member at The Breathe Institute, Dr. Graham specializes in non-invasive solutions that address root causes of breathing issues. Her commitment comes from years of advanced training in sleep-disordered breathing and facial development, combining personal experience with professional expertise to create lasting solutions for her patients.

Dr. Liz Turner Bio:

Dr. Elizabeth Turner helps families overcome feeding difficulties and breathing challenges at every age. As a mother who watched her own son transform after tongue-tie treatment, she understands both the concerns parents face and the care needed for optimal results.

A certified laser surgeon and Tufts University graduate, she specializes in infant tongue-tie release, children's airway development, and adult breathing solutions. Dr. Turner combines advanced laser technology with gentle, personalized care, regularly educating both families and healthcare providers about early intervention in breathing health. 
ACT Dental Team

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