Tongue Ties, Oral Habits & the Future of Airway Health

It was so nice to have a group of people that you trusted that I could reach out to and say, okay, this is going on, and what in the world could this be? Where do I get this person to help me? So there was a patient who came to me and I only saw her once, and she was sent to me because they knew that if they closed her spaces, which was her chief complaint, her tongue was just gonna open up back.

Hi and welcome back to the Untethered Podcast. Today we have Dr. Casey Jones joining us. Dr. Casey Jones is a whole person dentist, a believer in myofunctional therapy and breath retraining. She is an American Academy of Dental Sleep Medicine diplomat, a Dawson-trained dentist, a mom, a wife, a friend, and a person of faith. You are in for a real treat today, so let's dive in.

Welcome to the Untethered Podcast. I am your host, Hallie Bulkin. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner, 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, airway, tethered oral tissue, and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide.

If you've been around since June 2019, thanks for being a loyal listener.

As we jump into today's episode, remember to listen with correct oral rest posture: tongue up, lips closed, teeth apart, breathe through your nose. Let's get started.

Dr. Casey Jones, welcome to the podcast.

Thank you. I'm so excited to be here.

I am excited to have you and to have this. I know we're gonna have an amazing airway conversation. It's, there's so much goodness to come. So before we dive in, everyone just heard your bio, but before we dive in, can you give us just a little bit more of a background on who you are as a provider and your background in airway and all that fun stuff?

Absolutely. So I would call myself a whole person dentist, and I have always believed that oral health is part of your overall health. And more than ever, I believe that breath is at the heart of it all. And probably what started me on that journey initially was just really in the pandemic. I started to give out, or I picked up Close Your Mouth by Patrick McKeown. I had given it out to patients a lot. I picked it up to read and I thought, oh wow, there's a lot of good stuff in here. And I'd been a dysfunctional breather my whole life. I had asthma allergies as a kid. I sucked my finger, which I'm convinced is an airway coping mechanism that brings the jaw forward, brings a place for your tongue to go up to the roof of your mouth so that if you have a high vaulted palate, all this stuff. So there are the bad things, but I also think it's excellent to cope. And so that was a side note. But in addition to that, I picked up the Oxygen Advantage and I read that and I came back from a jog and had written in my journal that I wanted to teach the world to breathe. And really that made no sense because I'm a dentist. There's no codes for that. Okay. Pause. Let's figure that out. But I started anyway. I trained with Patrick McEwen virtually. I trained in Oxygen Advantage, the Buteyko Clinic methods, and I teach people how to breathe functionally. But then the reason I came to you is because I could not take the tongue out of it and the mouth position and all that myofunctional stuff that I knew about. But if I was talking about breathing, I really needed to know enough to be able to at least be competent to merge the two and talk about how they can fit together. How can we do these exercises together? So someone recommended you. I trained with you online, and I'm always saying, I think this originally came from you, up I go, tongue up, lips together, teeth apart, breathe through the nose. My assistant wants me to make shirts that have that on it. So anyway, so then I did American Academy of Dental Sleep Medicine diplomat. I have a huge interest in sleep apnea. It's all connected. That affects your oral health, your overall health, and it's really just trying to meet people where they are and figure out how to help them on their journey towards wellness.

That's incredible. And so just so everyone knows, where are you located? If they're like, ooh, I need to see Dr. Casey Jones.

We're in Lee. So I'm in Lee, Massachusetts, which is a part of the Berkshires. So we're in Western Mass.

Love that. I love that. So I love also that you mentioned the thumb and finger sucking basically being a mandibular advancement tool. Absolutely. It's, it's It's so funny because I, when I was trained in Mayo initially, I was trained that you've got to get that thumb out so that you can work on the Mayo side of things. And so I tried that when it worked with a couple kids and it wasn't working with some others. I was like, we're just gonna go, we're gonna start Mayo because I just feel there's something else going on here. And I started to notice those habits fall by the wayside towards the end of their Mayo program, if you want to call it not program, but intervention. And it was fascinating. I wonder why they don't need that anymore. The purpose of them needing that thumb, and I started to play around with it myself and realize my jaw was advancing forward when I put my own thumb in my mouth. And so that's why I now educate on that too, where it's, this is a helpful tool and we can't take it away until we have effectively replaced it with something else. Or we're just gonna, they're just gonna find something else, another oral habit to put in its place, right? Or it's just gonna continue and you're gonna have a real hard time getting that habit, undoing that habit, if you will. So it's, I love hearing that.

And also I find that it's, I sometimes say, well, why is, why can't an adult do it? Because it's Moving that jaw forward, but also in those grinders where part of it's because of that jaw is falling back. So yes, we look at sleep, all of that. Hi. Sometimes I just wish I could give that thumb back cuz they were that same person who sucked their thumb as a child and it was taken away and now, yeah. So, mm-hmm. Yeah.

And I know I've heard, well, endorphins are also created and so you get that, that feeling of, cuz your tongue's not up there, your tongue's not able to do its job, so the thumb is replacing it and it makes makes so much sense when you actually stop and go, what is the root? Why is this happening? What purpose is it serving? It's not just an annoying habit that we need to just eliminate. It's serving a purpose and there's something more going on. So I appreciate that, that lens through which other providers see thumb sucking and finger sucking and just any oral habit now, because could there be some anxiety?

Sure.

We know that's a symptom of sleep disorder breathing, obstructive sleep apnea, and all the above, but Is that fair? That's not cause necessarily for most people who are kids who are sucking their thumbs. So anyways, so now onto the next thing. So you have developed an oral cancer and airway screening. I wanna hear about this. Will you tell us more?

Absolutely. So at one point in my journey, life's a journey, it's not always a straight line. I was in North Carolina, so I was a dentist in Wilmington and it was a pandemic. So I was let go from the job that allowed me to make that jump. Originally I was here in the Berkshires and I didn't have a plan B. And so with the pandemic, there were so many dentists that were out that needed coverage. And so I became this fill-in dentist and I filled in working in 40 different practices. And in, and in those 40 different practices, I found that very few, even though the ADA recommended that we screen for obstructive sleep apnea, people at risk for sleep disorder breathing years ago. So few people were actually screening for it. And I realized that as I'm screening for it, it's no different than what I'm doing for my oral cancer screening, really. I'm still looking at all the other stuff, but I'm also looking, okay, what's their Mallampati score? What's their Freeman score? Do I see wear on the teeth? Are there mandibular tori? Is the tongue scalloped? Do they, can I see their tonsils? Are they enlarged? All this stuff was at the same time. And so I started to teach it because I really would love it if it became the gold standard. 80 to 90% of people are undiagnosed still with obstructive sleep apnea. And there is this stigma, I guess, if you will, around it, because there's so many females that are struggling with this. You and I were talking a little bit before about children and obstructive sleep apnea can start in childhood. And it's so exciting now that we have all of these ways to help them grow into these healthy adults that won't have these issues. But there's also all of these adults that didn't have the benefit of that knowledge. And so there's hope for them too. There's so many ways that you can help with that. And the first step is really just raising awareness and opening that conversation. So, you know, as we go back, we're looking, I teach people how to open the mouth before they lean them back, look for those things, then you lean them back. Then you're looking at, there's a lot of thyroid issues that go hand in hand with sleep disordered breathing. So palpating the thyroid, looking inside, you're doing the oral cancer screening, but there's just so much more that you're looking at. And as that slowly moving chair gets to go back in the dental chair, you get to say, has anyone ever told you that you snore? And then you never ask them, do you snore? Because they usually say, I don't know, I'm asleep. But they'll usually laugh and say, oh, my wife does, or whatever the case is. And then it starts to open that conversation. Or if they say, well, how did you know? Then say, well, there's really no space between your tongue and the roof of your mouth when you're awake. And oftentimes that closes loses off even more when you fall asleep and everything relaxes. So just from how you're built, you're at high risk for sleep disorder breathing. You have a small airway and then they start to go— because there's nothing that's really wrong with it. And it's wild to me that you can gain weight in your tongue also. And so losing weight not only helps in this area with breathing in the diaphragm, but it is insane that your tongue can actually enlarge as you gain weight. So anyway, I started to develop that, realized I was doing it, and wanted more people to be able to to do it.

So that's, that's something that you still teach. And is that something that people can do? Yep. Yep. Yeah, absolutely. Well, how, and so how would they do that? Do you have a website you can share that? Yeah, absolutely.

So, well, my website is Inspired Dental Wellness. It's two D's in a row, Inspired Dental Wellness. So you can get to me from there. You can also email me at casey@inspireddentalwellness.com. Again, two D's in a row. It's awfully long, but it's all in there. Casey is C-A-S-E-Y, and you can just say interested., and I'll let you know when my next— I train entire offices, people individually, or we can also do, often we'll set up a time where I do a group class and then we can all train together. And there is CE that goes along with that. And I also have oral hygiene coaching for continuing education as well.

So. Amazing. I love that. Cause I created this fast myo screener more with the myo stuff in mind, and I've encouraged RDHs to, hey, when you're cleaning teeth, can you make sure you just look at these quick things? But this sounds like it's even more in depth. And, you know, giving them an easy way to apply a screening very quickly. And that was the whole goal. I'm like, I'm not an RDH, I'm not in the dental chair, I'm not in the dentist's office. So I love this and I think this is really, really important because I know when I still go, I live in South Florida now, but I will still go back up to Maryland when I visit family and go to the dentist who is my friend, who is a biological airway dentist. And I know when they're doing their oral cancer airway screenings that I know what they're looking for and no one has ever said, never explained to me this before. And so it is very different than your typical dentist coming in, just taking a quick peek when the RDHs looked in your mouth while they were cleaning. And that's really that. So it's, it is completely different and it doesn't take that long. It takes me like a minute. It's really fast.

It is fast. And there, there is a, basically a handout that I've developed as well. So it's almost a checklist that shows you what you're looking for so you can remind yourself, cuz it's something to get used to, but once you're used to it, it just takes a few minutes. And then opening that conversation. And sometimes you just, sometimes I'll send them to my YouTube channel and that's where I have more information, things as well. So, yeah.

Amazing. Yeah, I know my dental friend will make little comments to the hygienist to document stuff on the chart and then I'm like, wait, what does that mean? Tell me more. So I'm almost asking for an explanation of what she's seeing. Cause now she's saying things and like, I know, cause I'm in the space, but I think for other people, even when you start to just open that conversation People are like, wait, what does that mean? Well, that's why you're worried about it. What is it?

Oh, so that's great.

I think that's so much more of that is needed. Just screening in general. We talk about this in the pediatric feeding space too. Screening babies for airway and tethered oral tissue and feeding and all the things at birth, not waiting till the problem, because I knew with my second, I was like, well, the chance of her being tongue-tied is pretty high, but I'm just gonna ignore it for the first 24 hours and live in bliss. And the second I latched her, I was, oh no, here we go again. I don't even need to look. I can feel it. Yeah, it's there. This is dysfunctional. And here we are. So interesting existing in this space. And it was very different with my second than my first, cuz I was not working with the infant population. I was really more so working with toddler on up with feeding. And my older one threw me into, I took a myofunctional therapy course. She threw me into the tongue-tie-myo world after I took that course. So I was, oh, you're 24 months old and you already have these things going on, which then led to me teaching my feeding, my pediatric feeding course from like, guys, we gotta be talking about this at birth, not when they're 5. I know that's when traditional myo starts, 4 or 5, but we've got it. And yes, we're gonna address it then, but also can we talk about this earlier? Cuz hi, here from the get-go in a lot of these kids. So it's, it's just a very interesting journey.

It is. And, and I'll add that, yes, I love that. And so in childhood and babies and all that. But sometimes it's just such a habit that people have no idea that that tongue is intended to be up in the roof of their mouth. And so they're adults. And I think I learned it from you that it's not, or maybe it was a book. I don't know. I love books, but it's not a true tongue tie really, unless it's something that's functional that's going on. And sometimes it's not tied. They just don't, they've never done it before. They've never suctioned it up. They don't even know what that is. And it's wild for me to watch them and that tongue will curl back or they, And so then you just have to teach them, but I've been amazed at how many can go away and practice and come back and you'll— that's amazing.

That you don't have to—

so, so it's fun. It's really fun to start to— and people have no idea that neck and back pain can be related to tongue tie, that digestive issues can be related to that, sleep issues. You can't get that tongue out of the airway. There's so much that can be connected. Breathing. If you can't get that tongue up, it's going to change your breathing as well. It's, it's wild. And one time there was a functional medicine doctor that was in part of, I think I mentioned I had this wellness collaborative in Wilmington and I want to develop another one here, but I was teaching some of that stuff with breathing and do, do these. And I would have them do some myofunctional exercises. And she realized at that moment that she could not get her tongue to the roof of her mouth. And she never knew that before. And so we had this conversation after, but not common knowledge.

So, I mean, that is literally every SLP, OT, PT, RDH, dentist sitting in a myofunctional therapy course, all trying to do the exercises for the first time, even us, right? So I think it's, we're all, can we not do this because it's new or can we not do this because we're actually tired or what is happening? And then I think it begs the question of, 'cause you're exactly right. There has to be a functional impact. It's not just a form and what it looks, but is there a functional impact? And sometimes we might see a functional impact, but maybe it's not a functional impact in the eyes of the patient, right? So then there's that whole conversation. But so many of us go through life having no idea that anything is awry. And then all of a sudden someone points out, oh yeah, all of these other symptoms that you were saying are related to what's going on in your mouth. You start to address that and deal with it. And it's— I can't tell you how many adults have gone in for a tongue tie release, come out afterwards and been like, I had no idea what I was missing. I didn't know. I mean, this happened to me with breathing. Here I am, a certified myofunctional therapist, and I go in for my nasal surgery 3 years ago. And I'm, huh, I had no idea I couldn't breathe well outta the left side of my nose. I'm over here, got my mirror.

I'm going right. Yeah. Right.

Yep.

All the time.

Can't breathe equally outta both sides of my nose and that the left side is almost completely obstructed. What? My septum is almost— it was mind-blowing to me. And so it was, as a specialist in this space, to even have that personal experience, it's such a good reminder that we don't know what we don't know. We don't know what we can't really feel, and also we don't realize it sometimes because we've lived with it for so long and that we're compensating so well or, or not compensating so well that that's just our normal. And until something drastic changes, sometimes we go, oh, I get it now. I understand what you're saying. I didn't, I didn't realize that that was the way I was living. Right. Yeah. So that is always so fascinating to me, but I love that you really highlighted the functional impact because yeah, we do see patients that Sometimes they're carrying so much other tension, it mimics a tie. Sometimes they just don't have enough space for their tongue in their mouth. And so it's hard to know, is it really a tie or is it a space issue? Yeah. Is it just, we haven't done this before, we need to learn it and we can actually do it. We have better range of motion than we're demonstrating in the evaluation. Who knows? Right? And so that's why I'm, I'm very pro-release when they're needed, but I'm also very pro, let's do other interventions first and see if we can avoid a procedure because there's no reason to do it if we don't need it.

Right.

So I love that you've touched on that cuz I had, um, there's so many different variables at play here.

There's so many. And I always say it's not magic, right? We can fix structure. So for you, it was magic as far as the nasal breathing and oh my goodness, I had no idea, but you also had this high awareness. So sometimes people will go in thinking it's this magic fix. I'm gonna get my nose, my nasal surgery, and then it's done. And it's the same because no one ever taught them. How to breathe through their nose again. And it's nasal disuse. And so if you don't use it, you can't use it as well. If you breathe through your nose more, it becomes easier to breathe through your nose. If there's a structural reason you can't, then that needs to be fixed, but there can also be inflammation that causes all that congestion. And yeah, so it's fun to look at the non-surgical, and that's the same way I look at dentistry too. It's okay, I can do the filling, I can do the crown, I can fix things, I can place an implant, but Why did that tooth break? Why did that— what's the reason behind so that I don't do something that's gonna have the exact same thing happen? Or, you know, let's address your caries risk. Let's see if we can figure out why this is happening instead of just fix it, which I'm a fixer. That's hard to do too.

But yeah, get the root cause. Well, and sometimes it feels easier if we could just fix it, right? And we get parents who come to us and they're like, can you just fix this? Can you fix what's going on? And we're like, let's have a conversation. I mean, in a sense, I mean, from the kid, I guess, right? In a sense, yes, but that might take 2 years. I mean, it depends what is fixed look to you, because what fixed looks to me might be a very different conversation. This is not going to be a one-and-done situation. Let's do a couple therapy sessions and we're done. Yeah. So yeah, it's always very interesting to see that, but that's, that's the same thing too. I think one of the biggest struggles that a lot of therapists have that I speak with even are we see things knowing what could be the ultimate end goal for this case, right? And what that looks for us versus what that looks for a patient and their end goal and why they're here, what their chief complaint is and what they wanna work on. Sometimes you just gotta meet them where they're at and bite our tongues and just be like, this is what makes them happy and feel they're living their best life. So, we'll help you get there. Yes.

And I've started asking, what does success look for you? Because it's interesting what that answer is sometimes, cuz it's very different. You're saying what success in my mind would be. And sometimes I have to pause, but I just have to go, okay, don't, don't say anything. Let's see how this plays out for them, because what I see, and that's even if I'm doing something aesthetic or whatever, and we've got these dental eyes, so we see fractions of a millimeter or the tiniest little things that I wish I could turn that off sometimes, but I'll have to stop myself and I'll just give the mirror and what do you think? And I, not that I didn't do my best that day, but I see that little tiny thing that I can improve on. But sometimes you get to doing that and then it's not as good. So it's really just trying to, like you said, meet patients where they are and figure out how you can help them get as healthy as they wanna be, right? Because you can't want it more than they do. I've learned that over and over again.

Yeah. Yeah. I mean, I always think back to this one patient I had where it was an adult patient and she was, I don't want expansion. I know I'm very high and narrow. I know my tongue doesn't really fit up there. She's like, can you teach me enough to help me maintain where I'm at so that things don't get worse? And I was like, okay. I was like, we can definitely do that. Definitely give that a go. Let's, let's see what we can do. And that was just so interesting because I don't think that would have ever come up. Even, I don't know if she would have felt comfortable saying that unless I had said, hey, why are you here? How can I help you? What is your end goal? You were saying, what are you hoping to get out of this? What does success— like you said, what does success look to you? And I love that because it's very different. I'm over here, I want it all. I want it all. I want to feel healthy. I don't care what it takes. I want to open my airway. And if We can make straight teeth at the end of that without losing the expansion. I'm here for all of it. Give me all the things, right? Whereas most people are like, I don't have an endless budget or endless timeline. I really just want to feel good now. What can we do in the short term to get me back to— I don't want to be in pain. Okay, great. What is that one thing that's really jumping out for that person? And I'm over here, give me the 5-year plan, give me the 10-year plan. I'm in it. I'm in it to win it. But I know that's not the average.

Right.

Yeah. And that come through our doors, right? Yeah.

Yes, absolutely. And I think that, I think sometimes people forget, patients, whatever, that they're human. And so we can predict a lot of things, but when it comes to this expansion and orthodontics and whatever, to create the room, sometimes you have to stop and then use a different appliance or a different approach, or what are we missing? Do we need to add in the myofunctional therapy now? All along the way. And there's just so many pieces to it. And you're so right that there's these expectations where they wanna know How long? How much is it gonna cost? And you're doing your best to— what is it? Get all the answers, but nobody necessarily has all the answers and we have to give ourselves grace of all. That's every profession, right? I mean, it's even in fixing your house, stuff comes up and you just never know what you're gonna find.

That's a really great comparison. Think to HGTV, all of these fixer-uppers, right? Where they're like, here's our budget and here's our timeline. And then they pull back the floorboards and they're like, oh no, we have to replace all your pipes and you have mold in the walls. And they're like, this is gonna be $100,000. $1,000 more and it's gonna take an extra 6 months. And you're like, and that's not the case, right? For most of our patients. But at the same time, it's, we won't know until we get in there and we start working with you. And I try to give people, look, on average it takes this much time for what your goal is. I, everybody, and I tell people, we're all human. We all have life things come up. We don't know. It could be this, it could be that, it could be longer, it could be shorter. I don't know if you can answer, but it depends. I always laugh when I tell people it depends. I even say that in our courses when we're mentoring clinicians and doctors. And I'm, they're a little, what? And I'm like, you're not gonna know what I'm about to say. They start laughing because they know you're gonna say it depends. I'm like, it depends. And here are all these different possible scenarios and I'm probably missing 35 others. It depends. Yeah. Yeah. Because we're dealing with humans, like you said, and I just, I love that reminder. We are dealing with humans and no two cases are gonna look the same and the timelines are gonna vary and, and, and, and, and, and, and, right? All the things. Yeah. So do you also do, okay, so you, You do oral hygiene coaching instead of oral hygiene instruction. Can you tell us what's the difference? What does that look like?

Yeah.

Yeah.

So essentially oral hygiene coaching is handing someone a mirror and a toothbrush and saying, show me what you do. Right. So instead of saying, do this and describing it or even showing them, sometimes I'm amazed at when I actually just watch what they're doing, that explains to me why things are how they are. So whether that's watching them and they are brushing the teeth super well, but they're not actually angling the toothbrush so that they're getting where the pink joins the white or the gum line, or they flip the toothbrush over in a certain place every time and they're missing an area, or there's so many different things. And if you can just look at what they're doing and then help them improve what they're already doing, you're not really adding something. You're just trying to help them find the right tool. So it's giving them floss and watching them actually floss. And if they don't use floss, there's other alternatives. I'll tie it in a circle so so they don't have to put it on their fingers and then they can use it that way. I'll give them the flosser, watch them do it, teach them how to use that differently if they need it. Prop C brushes, whatever it is, we're just trying to, again, meet you where you are and give you the tools to teach you how to take care of yourself because we get to see you every 3 months, 4 months, 6 months, whatever the right interval is for that person, but they're the ones that are doing it every day, and so we want to give them the tools that they need in order to succeed. And again, to get as healthy as they want to be. Because what I started to realize, I've worked in community health centers and 40 different practices. So I've seen a lot and, and I've realized that I love going into schools and I do that all the time. And I did that as my kids were growing up and now they're a little older, so they're not as excited about it, but it's not taught in schools how to take care of your teeth. And I really wish that it was. Because not every parent knows in order to be able to pass that on to their child. And even as a dentist, I realize that I am always saying that for your kids, you need to help them brush and floss their teeth until, for brushing, usually 6 to 8, or they can tie their own shoes. I'm forgetting what I was saying now, but with flossing, it's even longer. They just don't have the manual dexterity. That one's more writing and cursive. Mm-hmm. But they, I was doing it for my kids and I wasn't even trying to teach them. I was just like, let's do this. And I was brushing and I was flossing. And then I realized, well, how are they ever gonna do that for themselves if I don't actually start to have them do it, coach them on that? And so you can't assume that just because it was the kiddo of a dentist that they actually didn't know how to do it. So it just eliminates all the assumptions so that they feel comfortable. And I do this for everyone. Show me what you do and let's figure it out from there.

That's awesome. That's such a great, it's such a simple but needed approach. Cause I don't know anybody that's really doing that. It's everyone's doing for you in the chair and here's your goodie bag. Take this home with all your fun stuff, your tools. Um, yeah. And it's interesting you're saying this and I'm like, oh, I'll have to tell my husband he's doing something right because he's always, you're always commenting on the things I'm not doing right. But he will stand there and watch my girls brush their teeth and he'll be like, get back there. You didn't go, you didn't go far enough back. Get back teeth. And he watches that and he's like, I think you need to do a Here a little longer, go back up here and I'm, I'm alone and I'm out. Well, they've had really good oral hygiene because of him nagging. That's funny. That's a— yeah. Absolutely love this. And then he will, every night he comes in, did you brush your Invisalign? 'Cause now they're in Invisalign and so for more expansion. And so they're, he's like, did you brush your Invisaligns? Give 'em to me. I'm gonna, I'm gonna brush 'em again. We need to make sure that this is going really clean back into your mouth. And I'm just like, oh my gosh. It's healthy. It's okay.

Yeah. Well, that's cute. Years ago when my now 14-year-old son was 2 or something, I heard him after I put him to bed and I don't know why I didn't do it, but I heard him say to his dad and he's like, did we forget to floss my teeth? Awesome.

Thank you. That's so funny. Kids are awesome. They're so awesome. I know my husband's always like, did you floss? Did you do this? Did you do that? I was like, stop. It's, it just creates those habits. Right. And it's my kids now. Funny, my 7-year-old will not usually do it unless she knows we have somewhere to go on the weekend. She'll wake up, go downstairs, and not brush her teeth. But just wants to get on the iPad or watch a show or something. And my husband will come out and be like, did you brush your teeth? Did you brush your teeth? Go upstairs and brush your teeth right now. And I'm like, we're going to eat. It's whatever. You need to brush your teeth. I'm like, okay, that's fine. It's the weekend. Everyone's a little more relaxed. But my 10-year-old will get up and she'll get dressed and she'll brush her teeth and she'll come down and she'll make sure that she brushed her teeth. She got dressed herself. Like, I'm so funny. The different ages and levels of independence and what they're proud of. And yes, I love that.

I know how different they are too, right? My two kids are so different from each other. When they're old, great. But so different.

And it's funny because my younger one is really the more of the rule follower and the one who's really on the weekends, all rules go out the window. And then my older one is the one who is very lax, but then on the weekend she's, I did all the things. I'm like, I'm like, what is happening here? It's funny. It's, yeah, such different personalities.

So, okay.

I wanna go back to talking about the wellness collaborative because you mentioned that and talked about it very, you talked about it briefly and I wanna circle back on that. Cause I know that so many, when I was living in the DC metro area, I had our, our little roundtable discussions, our little airway health meetings where we would have all these different practitioners come and just sit around my kitchen table. Everything from RDH, SLT, myotherapist. OT, a PT, osteopath, biological dentist. We had oral surgeons, we had, I think PT was also trained in PRI and some maybe, well, we, I really, and then we also had a functional optometrist or optomologist, whatever it was, it was, and we all just, it was so cool 'cause we would have one laptop with a case and many of us were actually seeing this case, not all of us, but many of us. And we would pass this case around the table and all talk about our part. And to see the knowledge and what was shared about the same case from the lens of all these different specialists was just wild. It was so cool. And I was like, I am such a geek. This is the stuff I geek out on. And this is the level of collaborative care that we all aspire to have in our daily lives, but it's so challenging in the real world to actually pull off at the same time. So anyway, so as far as Mayo goes and the Wellness Collaborative, I would just love for you to share with everybody what that looks and how that played into your daily life?

Yes. So it's a lot what you described. When I was in North Carolina in Wilmington, I established, I said, Sleep Wellness Wilmington. So I had gone to all these practices and then I had one of these doctors that I worked for. It was actually funny cuz it was the day I was supposed to fill in for him and he showed up at the office and I was, wait, what's the, why are you here? Why, why am I, what's, what's going on?

He's, no, no, I'm leaving.

He said, I just wanted to talk with you about, you are always talking about breathing and all this other stuff. And so would you have the opportunity to do what you want to do and you can rent my office? And I was like, okay, well, what would that look like? I've never had established something from scratch. So that was sort of the start of that. And then as I started to develop Sleep Wellness Wilmington, then I realized there's so many other pieces to this. And if I'm just going to do this part of it, then I need all these other people that are gonna help me get this person healthy. And there was such a wealth of people to pull from in that area. And when I had the first meeting, I was connected with a couple hygienists who were myofunctional therapists and, and then a therapist. And we all, it was middle of the pandemic. So we met virtually and I said, all right guys, who do we need to bring to the table? And they said, well, I think we need a pelvic floor specialist, which I had never heard of.. And I was, okay, cool. But, and I think I just heard of one today, weirdly, but can you tell me why? And that, so that's when they said, well, everything is connected from the tip of our tongues to the tip of our toes and goes through the pelvic floor and all that. And I was, okay, cool. So then we brought some of those in. We had 3 or 4 members that were just pelvic floor specialists. And so it was just wild for us. My idea was that I didn't want it to be anything about ego. You know, essentially I wanted it to be a conversation. I didn't really want lecture form. I wanted it just to be a group of people that got to meet together to support each other because it's hard in the medical profession or any sort of wellness profession. A lot of times you're this island and you're by yourself and you're trying to figure it out and there's stressful, the hours are long, there's so much to it. And so to have this group of friends essentially going through the same thing, but also from a little different perspective, just to, it was so much fun to meet once a month. We would have this conversation, whatever that might be. And I remember the day when I, it happened to be me that was talking this day, but I was launching the conversation about what does sleep disorder breathing look like in kids. And I go through all the signs and symptoms and I've got the slides and I'm talking about it. And then at the end, one of the functional medicine doctors that was there said, okay, well, I see what you're talking about, but when I look at that list, I think of parasites. And I was like, interesting. People never would have thought of that, but they're just going, well, this is why. And I thought, okay, well, so there can be multiple things that are going on. And so what am I not looking at, thinking about? And, and the other thing that sticks out to me is I miss it and I am gonna establish it. I just had to learn how to be a business owner.

I bought this practice years ago.

You got time. But there was this one, it was so nice to have a group of people that you trusted that I could reach out to you and say, okay, this is going on. And what in the world could this be? Where do I get this person to help me? So there was a patient who came to me and I only saw her once and she was sent to me because her tongue was— okay, I think she said, my tongue is too big for its britches. And at the time I had always done a screening and a, just a phone call or something this beforehand. It had to have been a phone call, cuz I would've known if I saw this. And so I had all these preconceived notions of what I was gonna see. I thought this is an airway issue and it was an orthodontist sending her to me because they didn't, they knew that if they closed her spaces, which was her chief complaint, her tongue was just gonna open up. So she, I start to look and it, none of it made sense. There was, she was not overweight. There was no reason as to why her tongue would be that large. And it had, she was describing how her teeth were all touching. And I thought, yeah, right. But then she got models for me from when she did whitening and all her face spaces were closed. Her tongue had done all this opening. So none of it made sense and ended up for some reason, I started to think, okay, well, what about acromegaly? And so, and we learn about this and where your hands and toes and stuff, everything gets enlarged, including the jaw and the tongue. And so I started to ask her, has your shoe size changed? Has your ring size changed? And this was partly because I was asking this wellness collaborative, what can make the besides gaining weight. And so they're talking about hormone stuff and thyroid issues and acromegaly. And she ended up having the test done. She did have acromegaly. She had a tumor that had been missed for 15 years, was, was then removed. And she felt like a completely different person because they couldn't figure out what was causing all these other symptoms that she had. And so, like I said, I never saw her again. I only saw her that once, but and it was just so cool to have this. I was obviously in touch with her along all of this, all these things happening, but she feels it saved her life and having this collaboration of all these people that could meet together and think about it. I, I don't know what your beliefs are, but I do believe that there are reasons sometimes that we're in the right place at the right time and people will come to me for a reason or come to other people or whatever the case is. So it was, yeah, pretty magical for sure. Yeah. Yeah.

No, I, I believe that too, that we are, we are put here with a purpose and to live out that purpose. And I feel like keep stepping into a grander version of what that purpose is for myself, especially stepping into 2026. And it's wild, scary, crazy, but also so much bigger than me. Right. But it's all these individual lives that you then get to impact as part of that. It's, it's incredible. It's so rewarding. That's the, the self, I always call it the selfish side of me where it's, well, I'm doing what I do because I, it's so gratifying to help people. And, but at the end of the day, I, I've stepped away from a lot of direct patient care because I'm doing more educating. And I see there was sort of at one point it was this, I, I went on sabbatical and it was this dissociation of who I am identity-wise. Well, I'm not the treating therapist now. Now I'm the educating therapist, the person who's helping other people. And, but I also have to realize that seems to be my larger purpose to have gone along this journey so that I can teach other people so that they can then go out and we can incrementally help more people, right? And so it's, it's really come full circle because now we're looking into, we've been talking with hospitals and trying to bring a program in at a hospital level for pediatric feeding specifically. But you know, if you get my program in there, you're gonna be learning about airway and tongue ties and pediatric feeding and everything from conception to birth to NICU to getting that child out of the NICU. And hopefully they don't come back into the NICU. And if we're in a pediatric rehab hospital or inpatient outpatient with outlets, and so, but more from a holistic drastic. Let's talk to everybody who touches any of these cases, not just the feeding therapists anymore. I still have that course and we've trained thousands of therapists through that Feed the Feeds course, but I just— it just came to me. I was in this mastermind in August and it just hit me a ton of bricks and I was like, oh, there's this other thing. Okay, this is why my goal— and I started to feel my goal when I started all this back in 2019 was get kids off of pediatric feeding waitlists. Therapists, and then I was like, I can't do that fast enough if I'm just training the therapist. Like even having trained thousands of therapists, I'm like, I feel this needs to go faster in order to truly impact more. And so how do we do that? Right. And it's sort of, and everyone was like, well, now we need the myo course. The myo course was born. Okay. Now we need to be certified. So the certification was born. Well, we can't do certification here. There's no feed feeding certification. So that was born.

Right.

And now that all of those things have existed for a number of years, I'm now, I feel like all of a sudden the universe was like, here you go, here is your next project. And I was like, okay. And it was, it was wild because I don't know what 2026 will bring. I joke, I am a, I'm an online personality. People meet me in person and they're like, oh my gosh, you're so tiny. Because I'm like 5'2". I'm an introverted extrovert, right? So if I'm around the right people who fuel me, I'm good energetically. But if I'm in a big room and I have to be in a convention or something for several days, it's going to take me 2 weeks to recover from that energetically. Exactly. So I live in this world where I'm what fuels me and what sucks the energy out of me, right? One of those energy vampires. And someone said to me, they're like, you gotta go on your local news and Good Morning America and talk about this. And I was like, what? Is that, is that the next thing? Is that how we get this out there? Is that how we continue to grow this? And do I have to overcome my story of what this looks and the pathway in order to actually bring this to fruition? I don't know. But it's interesting because I do believe exactly what you said. It is a journey and I do believe that we are all individually here to serve different purposes. And so my most highest, my most aligned self, like, who am I being in that process and where am I functioning from right now? And is that, is that— here we are in the next version, the higher version of this self, I guess.

So, yeah. And I sometimes I refer to it as God incidences, just, oh, it's an interesting coincidence. But, and again, I don't know what your faith is, but yeah, I think that sometimes I have a plan and then those times when I see you where you have the inkling and you're, okay, I've That doesn't make any sense, but I really feel I'm supposed to do it anyway. I mean, it's really true, right? It's so surprising where it leads. And it's just those times when I can let go and just have faith, let go and let God. But it's easier said than done sometimes because we all like to have a plan. We, and our plan, we think it's good, but it may not be. It could possibly be even better than we ever imagined. 100%.

Yeah, I mean, my poor leadership team, because I came back from a different business mastermind earlier this year and was, okay guys, this is what we're doing in 2026. This is what we're doing internally. This is what we're doing externally. We're gonna go into this market and this market and do this. How we're gonna expand. And then I joined another mastermind and somebody was put in front of me who then delivered this other thought that then I had this whole download and I was, no, clearly God wants me to do this. This is what we're doing. And. We're gonna blow all that up. Table all that. That's no longer happening. Apparently this is the pathway for 2026. And it's something more loud than I was. And I'm gonna venture to say that we're also gonna change this. And they were like, yeah. And they were excited about it, but they were like, we never thought we would hear those words out of your mouth. This has been the thing that you've been doing for so long. And I'm like, well, we'll keep doing it, but it's just gonna look different. Right? Because stepping into a higher version of what we're offering. And in order for us to do this, something else has to give.

Right?

So yeah. It's been, it's 2026. And it's interesting too, because I feel the way that 2025 has played out has been very interesting. And a lot of changes and things and challenges happened that we were just coasting the past 5 years. And then 2025 came around and said, okay, hey, this thing that you've been doing, it still works, but also we're going to make it more challenging for you. And we're going to stretch the green a little bit. And all of these, I'm not, I don't really follow all the astrological things necessarily super closely, but I've been seeing all of these different things on my Instagram and about 2025 and 2026. And I'm like, oh my gosh, that's exactly what happened. And that's exactly where we're headed. Apparently a year of renewal and rebirthing things and all of this. And I'm like, well, without knowing, here we are.

Yep.

I love that.

Yeah.

So into, yeah, into 2026 we are. And by the time this airs, we will be into 2026. But yeah, I don't know. It's, life is definitely a journey and it's funny how things just continue to, it's if you are open to the opportunity and open to that level of expansion, it's amazing what just seems to fall into your lap and the downloads that you have, right? Yeah, absolutely. Yes.

Amazing. So getting to, getting to be around people with the energy of yours, it's just so exciting. And I have, I have a wonderful team and I, it's funny because they, I have to temper myself a lot of times because there's so much, I, I have so many ideas all the time and I have multiple coaches that help me with the business side of things. And so we have a meeting every month. With our team, and last time it was all about everyone talking about what we could do to improve, what are our goals. And I've tried so hard to be quiet and everyone else got to talk, and then I was like, okay, so let me start by saying that I know I have a million different ideas. And so then I started spouting out, and my coach was like, yes, so we know that you could have a million different ideas. And it's just funny because you can't do what you're saying, but It's what's the right thing right now? What's the next right thing?

And then see where it goes. I recently heard a mentor in one of my circles say, I have a journal and I know people do this. They write all their ideas down. That's how we go to sleep at night. Um, ADHD, your brain just doesn't stop. But they were like, I have a journal where I will put it down and it seems like the best idea right now. If it's still a good idea in 3 months, I will explore it. And I was like, oh, oh. I'm not, I was like, solid amount of time. And there were, and she was like, 99% of those ideas, 3 months later, don't seem like good ideas anymore. And I was like, huh. Yeah. Okay. And it was, it was interesting that she said that because there are some ideas that I will act on quickly. Cause I just know in my knowing this, this has to happen. This is where we are headed, but that's rare. It's usually I have this idea and I have that idea and I'll sit on some of these ideas for years and talk about them and finally be like, oh, and that actually is what happened with what we were supposed to do next year. I was like, maybe it's the time. We have a marketing director now. I have more bandwidth. Okay, we can do that. And then all of a sudden this other thing appeared and I was like, nope, we're not. I was like, see, the universe doesn't want me to do that.

That's why it hasn't happened.

Yep.

And that is a little redirecting.

I have to make sure. Yeah. That is not the pathway. So yeah, it's, it's, but it's, yeah, the, the business mind, the mind of a business owner, right? It's we don't stop. The ideas just keep flowing. So write it down and then 3 months from now, I don't, I don't remember who said that cause I wish I could credit them, but it was And it was fascinating because I was just, that is, that is really a very peaceful way to approach all of these ideas. My team knows when I'm at a mastermind event, they're, we carved out 3 hours in the week just to, just to get the, you're going to send us 10-minute-long voice memos at the end of every day. And then there may be some things we have to act on immediately regarding whatever we're currently launching, because you're going to have ideas that need to be implemented now, but also then some of them we know we can table for later. That's really smart. I'm glad that operationally you're anticipating what's going to happen when I'm away the week of the fall. Yeah, absolutely.

Yeah.

So, but yeah, strong team is everything. So our teams are incredible and it's, it's so nice to be supported in the work that we do and to have passionate people behind, behind us and walking alongside of us, carrying these forward. So I would be nothing without my team. Absolutely. Same. For sure. Well, this has been amazing. I thank you for spending your time with me. Is there anything else you wanna share before we wrap up today?

I feel complete. I mean, I think this has been so much fun to talk with you and it's just some stuff came up when you think and you're like, what am I gonna say? And this time, honestly, I had so much going on and I was like, I have no idea what I'm gonna say. And I think I'm okay with that. So we'll just see how it plays out. So hopefully something good happened along the way of value to someone that was there, but I feel we covered a lot and it was so much fun. So thank you for having me. I really just enjoyed it.

Quick disclaimer: all information, content, and material of this podcast are the opinions of the speakers and is for informational purposes only and not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified healthcare provider. Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots, airway, and feeding-related episodes, be sure to leave a review on Apple Podcasts and share this episode on your social media platforms. You can access free resources and all I offer at halliebulkin.com or pop over to @halliebulkin on Instagram to get all the latest updates.