Episode 201: Dr Karen Benitez, DDS: Never Stop Learning!

Hi and welcome to episode 201 of the Untethered Podcast. Today we have one of my colleagues, Karen Benitez joining us. Karen is the founder and designer of Chevy Chase Pediatric Dentistry in Chevy Chase, MD. She is originally from St. Louis, graduated from the University of Missouri in 2002 in the University of Missouri Kansas City School of dentistry. In 2006 she ran off for an adventure in NYC and completed her residency in pediatric dentistry at St. Barnabas Hospital in 2009. In 2010 she moved to Washington D.C. and since then she she has fallen into the airway space. So join us to learn all about what she has to share regarding pediatric dentistry airway, what she's doing in her practice and her son's journey. Quick Disclaimer all information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider. Welcome to the Untethered Podcast. I am your host, Hallie Balkan.

Hi.

I'm a certified orofacial myologist, feeding specialist and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, tethered oral tissue and airway space. I challenge you to keep an open mind and join my mission to get this information out to the masses.

Let's get started. Erin, welcome to the podcast. I'm excited to chat today.

Likewise Hallie. Thank you for having me.

Of course. So I always like to ask everybody, you know, when you're in the airway space and maybe you haven't always been, what was the catalyst? Like you, is there something personal? Is it patient caseload? What was your journey into this airway focused phase?

I would say both, but you know, I see more patients than I had children. Right. So I would say some of it was just this realization as I was doing more and more toddler screenings I'm starting to understand like I'm seeing a generalized phenotype or a postural presentation of similarity across the board. And I'll delve in later about my son, but I'm starting to notice a lot of open mouth resting posture in babies with like cute little T protrusions which at first you think is just so charming until you see it time after time. The allergic shiner presentation on these children which LLM should not be exhausted. Right. You know there is a certain amount of drooling that we might see with the anticipation of emerging primary teeth, but not to that extent. So I started to look more into this. And in fact I did that study club with yourself and Jennifer Tippograph. But that was a time in my life in which I was far too busy. I had two children, one on the way, I believe Jennifer was expecting at the time. And I was commuting a very, very long distance, so it was just not the time for me to pursue further. But it was a great starting ground of knowledge and it, it gave me direction like from here. Who else is tied into these airway centric focuses in what's my role in it or what should I be identifying? And so I learned a lot. And then I was starting my practice. At that time, my son, he got ill, as do most children in the winter. But then I noticed, oh my gosh, my child cannot breathe. Um, I worked part time. I had this blessing of being with them. But you know, sometimes they're at different nap intervals. I'd put them in the car, run here, and they're asleep. And it took all these muscle groups to get him to breathe in his car seat. And I just like put on the brakes, start recording him. And at that time I was looking to open adjacent to an ENT practice. So I took my recordings to that provider and luckily enough, she rendered tonical surgery new boy thereafter. So it gave me a lot of relief. But then it helped me to speculate what else am I missing in these children and who else is like me as a parent? And from there I just feel that unfortunately Covid took on, you have to find your silver linings in life. And the silver lining was vast plethora of virtual courses available. And with that, I started to study and study and study. Maybe some of that also helped to alleviate the nervousness of what life you are living. It was dubious. We had no end goals, you know, end sight. So studying and committing myself to the children, the resurrection of my practice, and these courses that were now available to me then I felt like this is the time. It's the time to learn what I'm observing and understand what I can do to help these families.

That's incredible. And I think that a lot of us thankfully have found those silver linings in those, you know, in those years. It's actually like right when I launched my course, not knowing what was coming. March 16, 2020. And I, I remember sitting there being like, do I do this? Do I not? And I'm so glad I did. Like you said, people were home and we had no Idea, like, what was next. But I think that's incredible. So if you don't mind me asking, like, what. What happened next? Your son. What? You know?

Well, his was a big solution in that. But I did start to really focus in on his sleep. And so I started to notice, yeah, I'm hearing snoring. Yeah. Actually, he does sleep with his mouth open. And at the time, I was actually working with a hygienist who's also on board with these airway centric things. And she's now practicing myofunctional therapy. And it was really nice to kind of have a tit for tat conversation about things like that because I was living it in my life and then I was looking to see who is going to put me in the right place for this. I took courses with Dr. Zaghi of the Breathe Institute, and that was about sleep disorder breathing. From there, I did the Tufts Pediatric Sleep mini residency, and that really helped. I have a colleague who graduated the year after me in pediatric dentistry, Faye Bracey. She practices in upstate New York. Brilliant woman. And so she and I really started jiving and talking. We were in the mini residency together and it was just like 13 years since I'd seen her. We started talking about caseloads again. What are you doing? What do you see? And then it landed me on tethered structures, which I felt like I was crazy in seeing it all the time. But I think it's the same as the statistics for sleep disordered reading in children. They're probably slightly off. It's just the more that we educate our communities, the more that we're going to recognize. And we need more metrics. Right. So understanding what does that mean? Sleep studies, unfortunately, are challenging for children to perform in. So are we really misdiagnosing their symptoms? How can we make this comfortable? And it's similar to what I tell my parents. I'm like, you have soft tissue concerns, which is why you have visuals on that. I'm like, look at the alignment of the tongue, the palate, the nasal cavity, the eustachian tubes, the adenoids, the tonsils, soft palate to tongue junction, uvula tonsils. But there's a lot of soft tissue occupancy there that we're just kind of like, oh, yeah, it's there. Children do groom into their enlarged tonsil, but at what consequence?

In what rate?

So I started to reflect on the things that I'm told from my medical colleagues, from my dental colleagues. Now I'm talking to a sleep surgeon taking class from him. And it really helped to open my eyes to the fact that, like, I have a greater responsibility and there are more metrics that I could apply. I joined ASAP Pathways ladies whom I love and adore so deeply. They really helped me to understand more about what I was seeing and the resources, the literature, sightings, and from there to talk about infrastructure. So I'm seeing bony skeletal changes as a consequence of low tongue posture. And so what are, what are the ramifications of this? What are the growth tendencies? We talk about clockwise and counterclockwise facial growth patterns if you look from the side. And I started to identify, oh yeah, that's that. And I feel like, you know, we did orthodontics in residency and I was pretty blessed to have a strong orthodontic background in my residency program. So it really helps me to correlate these oral manifestations, the noxy of habit, their consequence, or even the why, like, why are these kids, like, really diligent about thumb sucking? And you, you know how to measure it, you know, the intensity, the frequency, the duration. But some kids, almost like you, you can't withdraw that without a strong suction recourse. Um, so I sympathize with parents. I was starting to understand what this is and not to hit too heavy, there's no shame, but trying to understand as a parent, they don't know so much. So what can I do to help them identify key features and put them in contact with proper referral sources so that they can, you know, you unlearn what you've been doing. And so much of this is from in utero. So thanks to persons like yourself, your podcast, and just the capacity to learn in modern times is extraordinary. Sometimes you, you're trying to decipher in what order do I work and what where do I work? How soon should I share this with this family? I mean, depends how many struggles they're presenting with. So it's hard to identify tongue ties and not shy away from conversation because in a way some of us do shy away because there's a lot of stigma surrounding it. I think you've shared your experiences as well on this, but it does matter. I'm sure you have your own struggles within your own SLP community, but the more that we talk about this and probably more between colleagues, so it's across different fields, like normalizing these findings and trying to say, hey, what are you suggesting in this capacity and what was the benefit that you saw from that? So I think in essence you'll find more interdisciplinary Contact and relations. And that might be between pediatricians, pediatric dentists, entrepreneurs, SLP and ot. In seeing newborns in their nursing struggles, I started to really understand a lot more about oral motor function. And that has been, gosh, just such an enormous blessing. I love working with new moms. I love it. You know, mom, I'm still a mom, but the nursing chapter of my life was a glorious one. So if I can give back, I would be more than happy to give back.

I love that. I love that. And I think you, you touched on so many amazing points. But I think to bring it full circle, you know, it goes back to that team approach and being able to work in a multidisciplinary way where we can even discuss among colleagues, like, I know we have shared patients and we can kind of talk to each other and say, hey, okay, here's what I'm seeing. Okay, here's what you're seeing. Okay, what's next for this patient? Because that's like the age old question. That's what's coming up a lot.

Right.

Seeing a lot of parents who are more informed and more armed with information. And a lot of them are now coming to me on social media, which is a totally different conversation than I would have had, like when I started the podcast in 2019. You know, they're coming to me, they're saying, okay, I recognize this symptom and this system is it. So I'm like, what do I do first? And I'm like, oh, this is such a great. We're already seeing the evolution of a lot of this, you know, education that we're putting out there.

There's no care.

Yeah. And it's, it's, that's, you know, and I know not everybody is right. We still get, of course, a lot of parents who are brand new to all these conversations, and nobody is teaching parents this unless they seek it out or unless they stumble upon it on their own usually, or unless they happen to fall into a provider's office like yours or mine or similar, where we are educated and we are making an effort to educate. And so I think we still have a long ways to go. But I, I love that question of, like, what's what's first? And I think it's so independent of, you know, it's based on the case, individualized. How does this child present? What are the family's goals for their child? What is it family capable of taking on right now? Because sometimes it may not even be like what we ideally want. The next step. Right. It may Just be. What do they have energetically? What do they have timing wise? What do they have financially? Like, what are their capabilities and how can we best support them so the child's still make progress, still working towards optimal health. It may just look different than we originally thought or maybe another case. And, you know, and I think that's, like I say, it's an art and a science, and there's sentience between the art and the science of, like, navigating these journeys with families. And so I love that, you know, you. You touched on a lot of this because it is so different. Even though we may see the same symptoms present across various different kiddos, you know, the next step may be so very different. And I like how you also touched upon how, you know, tongue ties were kind of like this taboo thing. And I. I don't know the actual numbers. I always say, oh, there's just like 50 people in the SLP world. I'm just making that up. But there is this heavy split, especially when you go on social media and you see a lot of influencer accounts and, oh, yeah, information and everything. And, you know, it. It's also one of those topics where I like to spend time with families and talk about, well, how is it impacting your life? How is it impacting your child's life? And just like with the tonsils, you know, you brought that up especially with your son. You know, you removed them, he improved dramatically. And then you ask the question of, like, at what expense do we either, like, leave them in and let them grow into their tonsils or hope that they decrease over time? Which, you know, for me, I am always thinking of, okay, we know there's research now that supports, like, early expansion and that can, you know, and then myofunctional therapy, whether it's slow or rapid, we can definitely see a improvement in those soft tissues. And, you know, in other words, decreasing tonsils and adenoids, which I saw with my daughter, I didn't know at the time that was like, a thing. And I think there's earlier levels of research on that. But if a child is presenting in such a way that we're concerned about obstructive sleep apnea or, you know, their health is dramatically being impacted by it, then, you know, I always tell parents, I'm like, follow your gut. You do what feels best for you. Yeah, absolutely. Yeah.

Know what their greatest fire is like? Oh, just even recordings like the Snore Lab app. You don't know you're tired yourself as a parent at the end of the day, I don't know what my child's doing when they're asleep. I put them in the room and I don't go check. Well, rightfully so, because we never wake a sleeping baby. Right. But then you're like, but there's some, there's some manifestation of something going on. So how can we gain metrics? And it's really about the metrics. The metrics surrounding sleep, the metrics surrounding audible sleep noises, sleep apnea, moments of the gas.

Right.

Seeing that some kids, and pretty confident, you know, myself, my husband. So the end journey, the decades ahead, trying to understand, if I don't stop this now, here, will those progress to. Right. And I mentioned to you before, when you graduate from dental school, you do a table clinic. And with Denise Hamlin, my classmate, we had done mandibular. With Denise Hamlin, my classmate, we had done obstructed obstructive sleep apnea and mandibular advancement appliances. At the time, they kind of suggested, oh, that's not super relevant in dentistry. But honestly, everything changes and there's an evolution. So it was, it was what it was. I learned a lot from it. And then here it's like God was saying, hey, Karen, you're going to touch base on this again at a later part of your life. And so here I am, full circle again. And I do have a lot of those questions being asked of me. Well, there's a lot of grinding at night, I would say most pediatricenists are hearing that. And we were taught it can be stressors, anxieties. And sometimes I felt like, okay, but like, what anxiety is a child having at this point? And it made me think, it made me think, what does the research really mean about that? Because it's like, in a way, exhausting. And I felt silly. I have all these parents acting, asking.

Asking the same question.

So then I started looking more. No, it is an early sign. Just like you shouldn't be hearing your children's story. So what should we look at? And parents are aware and they kind of already feel in your gut like you're suggesting, what's the greater fire? So the timing to me is like, where are my ENT for pediatric? Even the pediatrician, like, how can we kind of sit at a conference table together and understand, like, where should you really start prioritizing and leaning in like, hey, emt, I, I kindly ask of you to really think about removing these. Or let's start even earlier expansion methods, because we're seeing a reduction in tons of size now. You're not going to see a grade four, grade three touching the UV lot. Like I have a clear view into your airway. I often snap a little image of it so parents can see what is she talking about? I'm like, look, when you lie flaccid in paralysis of sleep. I was like, no wonder you're constantly advancing your mandible and grinding because they're all coming together upon one another and cutting it. So a lot of it is just visual cues for parents giving them documentation, whether they take that to their medical providers or not, I'm not sure. But trying to get more and more visuals. And so that's become a big part of my practice for peer to understand both intra oral for their child. What am I talking about? What am I showing you on your facial profile of growth? Even gummy smiles, which I have and I've had a very long standing habit myself as a child that we just didn't know enough about. But the research is there, it's growing and a lot of it is the emphasis between us. I love my FLPMT community. I just feel like I might be burdening you guys a little bit, but I'm right. There's so much that I learned to lean into. And I always tell my parents, I am such an irreversible part of your equation if you're coming to me. Or even skeletal growth modification or tongue tie. Of course tongue tie release is a lot more irreversible, right? And like you have got to condition this muscle group because that is actually the friend, the strength within the tone of all these back tons or pharyngeal muscle groups that are going to help you when you're asleep at night. And everybody kind of gets a little lazy, you know, they too go to sleep. So like you have to strength train everything the same as we talk about the rest of our butt, our body muscle groups, right? These are the cohorts. I was like, but if these functional assessments I'm also learned like they're going to look into your feeding, your drinking. I was like, your, your resting postures. I was like, I did the class and I tell you. And maybe it gives us a little ADHD dentist because we are really kind of like immediate result, right? I was like, I can tell you your cavities, I can tell you the tongue tie. And you give me about 30, 40 minutes and one up, you're done, right? And it was humbling for me to understand and it was a little antsy. I was like, you guys, it takes time, it takes Time. And I, I have to put these parents in that format sooner because it takes time.

Yeah. I love how you mentioned conditioning the muscle because, you know, in what other arena do we not do that? Especially before procedure? Like, you know, I talked about physical therapy. Go for physical therapy before a hip replacement or a knee surgery or really any other major type of surgery. And so while a tongue tie may be a quick release of tissue, it's still going to have an impact on the entire body. You know, I think a lot of the debate that surrounds tongue tie releases falls from individuals who have had that experiences and that when it's individuals like yes, mother, infant dyads and patients and things, because they were not educated on the need for pre op, the need for post op therapy, you know, so for me, like you said, conditioning that muscle is so important because babies start swallowing about 12 and a half weeks in utero. They're born with the swallow that they're going to have for life unless we intervene. And some babies are going to compensate better than others. And then that tends to snowball if they're not compensating well, or maybe they're okay feeders in infancy and then that later turns into, you know, issues with swallowing or chewing or speech or airway. You know, we've got the jaws that are now shaping themselves around what the tongue is or isn't doing in the, or you know, in the oral cavity. And I know we can talk about this all day long, but I just, I love the emphasis on the need to condition the muscles because after that release happens as well, we have to do that neuromuscular reeducation. So that neuromuscular reeducation essentially is, you know, it's not just important, it's mandatory. It's not something that we can say, oh, you know what, maybe I'll do it, maybe I won't. Because in some situations, patient may be better off not even having the procedure. Yeah, I'm going to do it properly because of the ramifications. Or now we've got this tongue that's quote unquote free, but it doesn't have to function. And now it's been sitting in different ways and now we're having struggles. Yeah.

I mean, do you, do you see.

Do you get patients?

I would not that. Yeah. And say this, but not to be intimidated by patients.

Right.

I am. Myofunctional therapy takes a while, so that in itself is a time gap between procedure. But I always say it's really the determinant of the procedure. Right. Like with a myofunctional therapy, are you getting the functional component that you were missing before? Because you never that muscle. So I'm like, you could reset with a tether. But you know, some of them I seen, they're soft, they're supple. I still get the tongue up to the palate doing clicks and clucks. I'm like the chicken. You know, I feel like that really helps kids. But I'm like, if they say, hey, you're a Heather, but we're hitting all the right metrics, then leave it alone. Leave it alone. You can address that later. The symptoms that present themselves later, right? I'm like, but you first have to learn how to use the muscle. And me being intimidated sometimes put me in the wrong spot. And I have now learned how to better assess as a provider what I should do when I should say I'm so sorry or how can we do this differently? Right? So some of these things have been my own provider error in learning. And I think anybody who's provided this has gone through the same realization themselves. Even in newborns. I will say I'm like, in those first few days after, whoa, hang on a minute. Like, who's on your team? Who's your lactation counselor? I mean, did you just meet today? So there's so much that needs to come in because it's very intimidating working on a newborn. They're so tiny and delicious as they are. I was like, now I really need to understand what was the parents history, was there trauma involved? How much healing does the mom need to do to unwind her body, the fascia of her own body, the fascia of this baby who, you know, be it or in tension, right? So so much of it is just letting them unwind, find their own dance partner together. And then who is in the nursing capacity to get you going? I'm not qualified to determine milk supply. I'm not qualified to give you what skills you should use. I learned lactation so that I understand what should I be assessing for the feel of the suction during my assessments. Oral motor functions, it reinforce with the parent. But now that I'm at that level, there's only so much that a pediatric dentist can do, right? And I stick to my, my metrics, my profession, and I deviate out to give enough information to support when they discuss that in that realm of therapy or in this lactation, listen, listen intently because that's the same thing I want you to chive on, right? I want you to learn these things and parents are going to be, I mean, so much more prepared than we were. Right, Hallie? Like, I didn't know anything. And I studied to be a pediatric dentist. I thought I knew a lot. I been with children my whole life. But once you have this vulnerable young baby and you're like, where's the milk gauge? I was like, there's no milk gauge. I think I literally said that to my pediatrician. I was like, I'm really. Because there's no middle age. I have no idea what you're talking about. You asked me to count wet. Is it dirty? And I was like, my mind is just everywhere. I'm exhausted. Hormones. Oh, hormones can take a normally seen person and just send them off kilter. So there's a lot of emotional component behind newborns that I've also learned to refrain. I'm like, give it a moment. Let's keep in communication. But who's on your team? And let's talk between us as well. There's so much to learn. It's really the interdisciplinary committee, let's say that these parents need. And that's begins from newborn, and it does carry through later. I'm used to referring between dental colleagues and now I'm really used to now referring across the board with you guys as well. And it's brought me a lot of joy. My parents are happy. They're like, oh, my gosh, you alleviated so much. I was like, oh, I'm so happy to have made that connection for you guys because I was doing you no good. It would still have consequence, even cavity risk.

Right.

So cavity wrist with a tongue tie. I was like, how crazy am I to have not seen it? They can't use the tongue to debride the surfaces of the teeth as they should have, or even just the blanket coverage of the lower teeth. And this exposed upper teeth. Right. You have lip tethers that are of significance. I also tell my parents, try breathing with this amount of tension right here. Your cupid's bow area. I was like. And then when you remove that, you really do feel a difference. I was like, there's a lot of tension and I can't lift your upper lip. I was like, imagine all the muscle inactivity that's going on with that, you know, upper lip area. There's just. There's much to learn, there's much to implement, but a lot of time out educating parents, giving them resources, and then I can deliver something up. Pretty irreversible, right?

Right.

Yeah.

Well, and I. I think that's Incredible. I mean, you talk about like your vulnerabilities, which I think so many have.

Oh yeah.

So like we've all kind of been there, whether it's just professionally or it's also as a parent and having gone through this journey like you were the dentist, I was feeding the, you know, therapist, speech pathologist, having a little, I know nothing. Like it's, it's both humbling and, you know, it's almost life saving because then we're able to turn it around and help others too. And I, I love that you're doing this. I love that you're able to connect these dots for parents and connect them to helpful professionals and you know, even just help them understand. We don't want to rush into this, like, unless we are 100% sure, which we never are. We need to in there and work with the tissue. Because that behavioral, you know, approach. When I say behavioral, I don't mean like a child misbehaving. I mean behavioral therapy, meaning like the actual intervention, not tissues, oral motor therapy, that kind of thing. Sometimes a tongue tie may present as a tongue tie. And then when we go in there and we trust that we actually realize there was so much tension being carried by the tongue for others, the tongue, the frenum appears differently now and we don't actually need to release it. Like that does happen, right? And you know, and that's the other thing I've been trying to like scream from the rooftops on social media is, you know, there's these posts where it's like everyone's butting heads over this, this tongue tie or lip tie topic and you have like something, oh my gosh, it was life changing for me and my child. You have other parents going, oh, I was told to do it and I reg it. And you know, you ask them if they had surrounding therapy and they're like, what are you talking about? No, nobody told me I had to do that. Or they'll say things like, oh, I was told by this person that, you know, my child had a tongue tie. But like we were feeding fine. They've never had any breathing, feeding, sleep issues. I'm like, then your child didn't have a tongue tie. Because the definition of a tongue tie requires that it's not just tight appearance or the appearance of it. It's that in addition to the symptoms, like you have to have a functional implant for it to truly be defined as a fun tie or a lip tie or tie. And I just think that, you know, I don't expect parents to Know that, but I'm like, that falls back. I'm like, okay, now I'm seeing gaps in some of the conversations out there. And I think when parents realize, like, okay, maybe somebody missed it, or maybe somebody over diagnosed your child and you're however you feel, but let's have a yes so that we can do better as a profession and collaborating professionals. And I think that that growth that so many of us are willing to take on and to experience and that that road that we've all gone down is, it's commendable that, you know, you put all this time and money and energy into learning so many things during a time with so many unknown and really just like significantly advancing your own specialty. Right. And your patients are so for it. You know, it's, it's exciting and we love collaborating with you. So.

I think if I'd never changed it, where would it be? Right? What point would I have seen it? And then obviously, me being a seeker of friends, I'm always like, okay, where are my pediatric dental friends? And how can we share this with one another and support one another? Like, if I've started this journey, how can I get you on this journey? Because the need is there. I'll argue the need is there. It's just we need better metrics on maybe a few caveats, right? So it's the metrics part of this next stage of my career, right? Like, what can I identify? And going back to the tongue tie, it's a structural component, but what's the functional definition of it? Is that, is that the function that you need to relieve or just you carry on, you know, progressively? Um, so I think that the next part of my evolution is better metrics and a cohort of colleagues for that. So I'm at the beginning, like I said, it's a new journey. I always approach things with trepidation. I'll be honest. I'm a measure, measure, measure the carpenter who maybe measures more and then executes. But I'm like, I really feel like slow and steady wins the race. And I need to understand there's so many different kinds of patients that I receive and parents and the emotional background of the parents or how much new information am I providing them versus like, oh, I came in kind of at this level. I'm, I'm no longer a novice on this subject of parents. Oh, I wanted to, you know, be able to meet all the needs, understand. And I'm excited to see, you know, five years from now, what's my five year professional plan right and then my 10 year. And then, I don't know, I've been doing this for a while, so I might be creeping towards retirement. Before I knew it, I was like, wow, that's extraordinary. You practice for so long and then you're like, you're not the dictive learning, helping. I'm like, do I really have to ever quit? You don't.

You don't ever. It's interesting, though. I'm seeing. I'm seeing different individuals move out of practicing and then moving into, like, in normal retirement age, but moving into educating and, you know, working on really passing that knowledge to the next generation of professionals who want to learn from which I think is a beautiful thing. And I think it's, you know what I mean? Look at it as like, you know, yes, there are people who are never going to teach and never want to teach, and I'm not knocking that. But I came to a point even early on where I was like, there are so many gaps and no one's connecting. Yes, Pediatric feeding, you know, especially in the infant and toddler, like, birth to three range, no one's connecting this with airway. And when I say airway, I don't mean, like, you know, pulmonology type, you know.

Yes, right.

We work with pulmonologists and we do have kids with significant other types of airway diseases, disorders and issues. I'm talking about, like, upper airway, not talking about, like the lower part of it. You know, I'm talking really about what we're seeing, what we're talking about here. And I'm like connecting those dots that orofacial myofunctional disorders that these infants are born with, where they need to be treated through a feeding approach, a sensory, oral, motor feeding approach, you know, and then the tepidural tissue, of course, that whole conversation too. And I kind of just went like, all right, I'm not bringing them, like, groundbreaking information that I've done the research on myself. I'm basically just creating a place where I pull it all together like nobody else has, and I teach it in a digestible way where they actually take it back and use it in their practice on Monday. And like, that I'm like, exactly. We need more people, like, educating on topics like, you know, not just that, but just any of these related topics. And so I love, I get excited because I've seen this, like, I think three times in the past, like, I don't know, couple months of individuals who normally could have just gone straight into retirement and they went into educating and basically took their practice to the next level in that regard. And I was like, oh, this is so much experience. Yeah, yeah.

Yeah. It's extraordinary. I think, you know, there's always an introductory level. Like when you graduated. When I graduated. And I'm very grateful for all my attending. But those decades of experience are monumental. I mean, they're gold. So to take a provider who has evolved and really push themselves in being able to say, okay, now the latter phase of my career is to revolutionize the way that the first decade they're practiced by said professionals. Because I'm giving you my experience, I'm sharing through my lens so that you don't make the mistakes I made. You're not not seeing the things you should be seeing. And then you're learning not to just work with yourself. You're not the doer and capable of all things. And what aren't you seeing? That you need an outside influence or so I think some parents will say it's more holistic, I guess though. But that's its own definition within dentistry that maybe hole is stick. But I definitely enjoy this facet of my professional life. I'm excited. My kids have learned so much, by the way. Sometimes I'm like, who's going to be a pediatric dentist? Which none of them are jumping to the table. I think I work too much. But I'm always like, but you're learning so much. And they'll tell me, they're like, so and so, like, has his mouth open all the time. I'm like, chin up, buttercup. You know? But I'm like, there are things that we also mimic the behavior, like, what are parents doing? And then we're mimicking that posture. So it was like, oh, yeah, your son's doing it. Because look at this. In that mimicry component to evolution, right? I was like, I'm seeing so much. Oh, man, I wish I could go back to that college version of evolution and understand it from this perspective as well. And. Yeah, yeah, exactly. Yeah. I mean, just so much of our in utero gestational growth and development. I mean, when you're not even sure you're pregnant, right? You've already got primary and secondary palates. Like, that's crazy. And you had not a clue you're even expecting. And. And how does that change along the course? And this is all without your influence. You can't modify it. It's genetics, right? It's behavioral parts of your gene expression. And you have to wait, you have to wait until the birth process to understand now, how do I rehabilitate this baby moving forward? But, yeah, it's exciting. I'm thankful and I'm really so grateful to have met you. I owe an enormous amount of gratitude to Jennifer Tippograph, a dear friend of mine. And having put us in touch, it was a hard time in my life. I had. I had way too much on me, Hallie. But I listened to you guys. I listened. I took on. There was dental hygienist on board with that, and it was nice to hear that and reflect back on it. I went to Manny Kim's lecture, also with the Alpha Omega Study Club here in Bethesda, and it really afforded me a lot of insight into understand fascia, fascia, fascia, fascia, and that intricate nature, because we always think about, you know, arterial Venice and nervous system, but we're not really taught much fascia. And to have that interconnection, aside from dissection, right. We get. Here's a fascia. But duh. Like, how did one fascia lend to the other? The muscle group bundles work cohesively now, but there's just so much to learn. I'm excited, and maybe I've become a CE junkie.

I think.

First things you could do.

Right. It's a side effect that we all kind of fall into, especially in this space. I feel like we're just like, more. Please tell us more. Like, what. What else you got for us? But I love that. And, you know, it's funny because I.

Think I'm, like, hungry. The photo, I think.

Yeah. When we met with Felix Liao, was it when he came and joined us with his.

No, no, I wasn't at that one.

Okay.

Oh, no, I was. I was commuting Kent island, and I think I told Jennifer, like, it's just not feasible for me. But Jennifer and I still remain in contact on a lot of issues. And she really is just such a brilliant mind and so courageous. And I, you know, I think she and Kim are creating extraordinary, healthy environments for children, all of which traditional dentists could learn from.

Absolutely, absolutely. But I was. Yeah, I was just saying we. A photo, like, circled up from that particular, like, book club recently when we were sitting around the table with Felix, I was like. I remember because that was also at her kitchen table, which, you know, like, she and I kind of, like, shifted on and off. Who was, like, hosting these. These things at our kitchen table. Um, and. But I remember you. I remember meeting you there. And, you know, and I. It wasn't. It's like, it was a While ago. But it wasn't a while ago. Do you know what I mean? Like you have come like so far and it may feel like a long time.

Yeah.

It's really the amount of information and how you've adapted and changed like your approach and your practice and the way you're seeing things differently and even referring and you know, all the things in addition to everything else you already were doing and that you do in your office as a pediatric dentist. You know, I have to tell you, it's. To me, it's amazing. It's incredible. Like I. Pat yourself. I think you, you know, it's almost like, you know, I think we are the hardest like on ourselves. Like we downplay things. You're like, oh my gosh, two years ago and here we are. But you did it, you know, and you're telling patients are better and I love that. And we love collaborating. Yeah.

Willing, right?

Yeah. Yeah.

Oh, thank you so much. Coming to view. That's enormous compliment.

Oh, well, this has been amazing. Is there. I know we've touched on like so many different things, but is there anything else that we haven't touched on that you want to share before we start to wrap up?

No, I think I'm good. I think it's maybe too much, right? You can keep going and going and going into different facets, but no, I'm satisfied. You know, how can they find you?

If they want to find you in your practice, where are you? Share with them how to find you.

Oh, I'm sorry. Yes, my practice is located In Chevy Chase, Maryland. And yes, it's ChevyChaseKids.delt yeah, I try to put a lot more information there. There's a whole gamut of stuff that's coming. It's just, you know, the behind the scenes work before you launch it onto your webpage. But yeah, I'm, I'm excited, I'm happy. I look forward to the growth and maybe more like minded associate potentials. Um, I think that the more that we grow as a specialty and our kids are going to be better off for it. The community and you know, it resonates with even social media. My friend circle. Back in St. Louis and in Kansas City where I studied, I was like, you gotta get on it, guys. You gotta get on it and be on the same page and we can all meet up and like feel good about what we've taken our careers and created for oral health awareness, you know, I love that.

Well, this has been amazing. I know you and I could like talk all day long. About these things. But thank you so much for joining me today. I love thank you and I hope you, you know, absorb more patients into your practice in the chimney tooth area.

Thank you so much Hallie. Thanks for doing this. You are doing really great things. Hallie.

Thanks for listening to this podcast. If you want to hear more of these Myo Taught, Airway and Feeding related.

Episodes, be sure to leave a review.

On Apple Podcasts or pledge a small amount on patreon.com the Untethered podcast. If you found value, others you know in this space will too. So be sure to share this episode on your social media platforms and join us over on Facebook on my Facebook page @HALLIEBLCAN BIZ on Instagram at Alibulcan, and you can head over to theuntetheredpodcast.com to grab a copy of the Show Notes where you can also subscribe to be kept up to date on the latest podcast episodes.