Latest / The Word of Mouth Podcast / The Sleep & Airway Wake-Up Call Every Dentist Needs to Hear | WOM 014
Transcript
- Jeffrey Lunt: Welcome to the Word of Mouth Podcast, your weekly rundown of the business, news, and trends shaping modern dentistry. Today I'm joined by Dr. Mark Musso of Musso Family Dentistry in Garland, Texas. Dr. Musso has been practicing dentistry for 32 years, with a special focus the last 16 years on sleep dentistry. He is a clinical advisor and mentor for several other dentists and is passionate about spreading the word about airway and addressing the signs and symptoms of sleep disorders. His second company, Harmonia, educates dentists on sleep dentistry, and he is a diplomat of the American Sleep and Breathing Academy, or ASBA. He's treated over one thousand patients with airway issues, and has learned and practiced many different methods for treating the signs and symptoms of sleep disorders, because there isn't a one size fits all approach for sleep dentistry. Welcome to the podcast, Doctor Mark. So excited to have you here. Thank you, Jeff. Thanks for having me. Super excited to have you. So We're gonna start with our first question. Take us back to the beginning. What was it that inspired you to get into dentistry? So tip just for general dentistry, ⁓ my dad was a dentist, right? So my mom was a hygienist, my brother's a dentist. It's kinda in the blood. And ⁓ you know, we watched my dad growing up as kids and we we enjoyed the life we had and he had the weekends off and it was always, you know, some good family time. So I I've realize how important that is in my life and I'm glad I made this decision 'cause I get Fridays off and I can help the kids, you know, during when they were younger I was teaching and coaching and help having fun with them. But it's been a rewarding career and and so the general dentistry was my love for a long time. I loved extractions and and implants and but then what really got me excited was ⁓ sleep dentistry and that's that started about in two thousand ten. really started to kind of look into why I was having problems and I realized that my my whole family's got issues from my dad had issues and my brothers and my and now my family. So it's been a ⁓ it's it's still the dentistry's my love, but it's altered into this ⁓ different way that we that I treat here at Musso Family Dentistry. ⁓ you know, my brother's doing general dentistry and we have an associate And he does all the crown and bridge stuff that I can can't do any longer because I don't have the time. So that's kind of where I am in my career. I just do ⁓ TMJ issues and orthodontic ⁓ issues and airway issues. Yeah, so talk about kind of the intersection of the TMJ, the orthodontics, and the airway. How do those things all fit together? Absolutely, yeah. A lot of times you'll find out that ⁓ People who have airway issues ⁓ will clinch a lot or have some issues with their joints. And so you gotta look in your patient individually. Everybody has different signs and symptoms. ⁓ But typically TMJ is super related to airway problems. And so also the orthodontics. If your teeth aren't in the right position, the jaw's not in the right position from growth and development, and we're trying to push it in different ways, it affects the joints. And then at night if you're not sleeping, well you're gonna clench and you're grind and you're gonna make your teeth ⁓ and joints, you know, upset. So it's all it's all together. And that's the that's the amazing thing about airway. And you can't really be afraid of TMJ. It's kinda sounded scary 'cause we didn't know much about it. They didn't really teach us that in dental school. They in fact they didn't teach us airway. It's so these are all things that we're having to learn on our own with the collaboration from the medical field. ⁓ But and the orthodontic field, this is all all one thing together that we're working on. That's awesome. So before we dive deeper into the sleep and TMJ and all of those things, ⁓ you're located in Garland, Texas. Right. Tell us what do you love most about serving that community? So my dad started here in nineteen seventy one and I've I've watched Garland literally grow up. There was fields across the way and ⁓ now there's apartments and now they're putting new apartments in over here. ⁓ so it's been my life, right? So I've seen it change and develop and I've seen grandparent grandchildren of of my ⁓ patients that my dad saw, right? So different generations we're still seeing ⁓ It's funny to watch, you know, when they were little kids and I'm fifty eight years old now. Now some of these kids have kids and and I'm still treating their kids. So it's a been a family thing, ⁓ that we've been treating ⁓ all these patients in Garland. It's been a wonderful thing. Yeah, that's something that's super unique about a lot of dentists, but you in particular, with your dad being kind of the founder of the the dental clinic, is through your whole life you've seen patients grow up, get married, have kids. Those kids get grow up, get married, have kids and ⁓ it's it's really you're part of that community and And that's really what makes independent dentists so unique. Yeah, and and we you know, we were my dad's office was in nineteen seventy one, built just a little ways down from ours, and we kind of grew we grew out of it, right? So we moved just a little bit down the way and and Mike and I built our ⁓ this building that we're in right now in two thousand four, started getting it going, and my dad passed away in two thousand five. So he got he actually didn't get to see the whole building being built, but I know He's looking down and and seeing it and w and just really proud of us. So it's been it's been a good ride. Yeah. That is it's su such a special thing for you to have those relationships, both with your family. ⁓ a lot of people say don't go into business with your family, but a lot of dentists have figured it out. So long as my brother does what I tell him to do, then when we're good. That's exactly right. Exactly right. So let's dive a little bit more into sit. You treat the signs and symptoms of sleep disorders, including sleep apnea for both children and adults, as well as the orthodontics and TMJ. ⁓ why do patients specifically seek you out and what makes your approach different than maybe other ⁓ sleep experts in the medical field as well as other dentists? You know, sleep apnea we say sleep apnea, we call it sleep disorders, we call it, you know, airway dentistry. ⁓ but there's it's really hasn't had a specialty by itself. And the more we know about the more we learn about it, it's it's a rabbit hole. We keep learning more and more. So it really wasn't identified or treated or taught in ⁓ in dental school. So we once we got out and kind of realized and we're just, you know, we're treating, you know, decay and and gingivitis and everything, but we're missing the big picture. So once it kind of the light bulb went off and I've learned from some amazing people. And once you learn this, it's amazing. You and you see it in yourself or your family and you can't unsee it and you become almost addicted to trying to figure out more and more and learn more because it's exciting and we have the answers to so much that I didn't even realize we did. And it kinda it hit home because I knew my dad he had ⁓ sleep apnea, undiagnosed, right? And I don't think we were really checking it back then and and ⁓ we didn't really understand. We just thought it was a big heavy person's disease and There's so many sleep or sleep disorders that are not big heavy people. But my dad, I know he was snoring and stopped breathing, and I know he had apnea. And I and I believe he died from complications of sleep apnea. And to to think that, you know, I could have had something to play and to help him, I wish I would have known that kind of thing. So it it kind of hurts that way, but it's also taught me to to learn to look in other patients that I see. So all these patients that come to me. I'm not just looking at teeth and gums. We're looking at the bigger picture. And Jeff, we've we've changed so many lives here. It's crazy because ⁓ their trajectory, they might have been, you know, tr stuck in bed wetting or or other issues and and now we have a way to get them good sleep and and help them understand what the problem is. And we work close. We can't just do this alone. This isn't just dentistry, right? It's gotta be it's gotta be collaboration. You gotta have orthodontists and myofunctional therapists and ENTs and other just professional MDs because and in in ⁓ pediatric physicians, right? They're so busy looking at their stuff that sometimes it's not their fault but they'll miss things that are signs and symptoms that we see daily while we're just checking to see if their teeth have cavities or seeing them in their in the cleaning. So it's something that our eyes have changed. The way we look at things now has changed. And so that's what I believe is different here because what we do now, we're not just cleaning teeth and fixing teeth. We're we're we're advising, we're we're teaching, we're coaching, and we're helping people with sleep dis sleep disorders. Yeah, you mentioned the ⁓ the pediatric and and some of these specialists. I know you work with an E T ⁓ down there in Texas, ⁓ Doctor West, I believe his name is. Doctor Jeff West, yeah. ENT, super nice guy. I've been working with him for, you know, over ten years and w we the ENT and the dentist work in the same field, right? It's it's we we should know what's going on, but we don't know what they do and they don't know what we do. But when we learn it together, he and I have just clicked and we've really become good friends and we were actually born on the exact same day, in the same year, so we're brothers from another. But ⁓ He he understands what he's what we need and I understand what he needs to help our patients get healthy to the point where he and I now ⁓ coach other dentists and coach anybody who's willing to learn because it it's something that it's not really there's not enough education out there and w I believe and I kinda kid about this saying, you know, you can't have an airway dentist without an ENT because you gotta have this together. This is this is the one two punch. And the myofunctional therapy is a big part of what what we're learning who is they they've been underappreciated for years and no one really un still understands how how important their role is, but we're teaching it and showing ⁓ that that's important role in this. So the traditional medical world i is is not looking at this exactly because they don't understand what the dental part is. And we didn't really know what we had. to to offer either. So it's become a a really good collaborative ⁓ effort. Excellent. And you mentioned one of your hygienists is a myofunctional therapist. So actually two well ⁓ I two of my hygienists have been through the program and become myofunctional therapists. And ⁓ they've gone one's gone on to do other things. But I want I'm encouraging my my whole team to be looking for these signs and symptoms so much that that's why ⁓ one of them wanted to become a a myofunctional therapist because she saw how important this is and that cleaning teeth is important but when you're able to find out what you know what's going on here and you teach the tongue, the tongue is God's natural palatal expander. And if it's not working properly, then all these other things go off track. And so that's what's so important about her. And then the nasal like I was talking about Dr. West, the nasal breathing. If you don't have the nasal breathing proper and and the tongue function proper Then we're gonna have some issues. So those two that's ⁓ what's so important about what they too what they do for us. Yeah, that makes a ton of sense. So you talked a lot about signs and symptoms and kind of what to look out for. Explain to me a little bit, especially for a pediatric ⁓ case, what should parents be looking for? A lot of adults, they know if they're not sleeping well, they can tell you they're not they're they're tired. Kids are a little bit Of a different animal. You you got it right. Kids can't articulate that they had a horrible night, right? You if you sleep poorly one night, you can't focus the next day, you you know, you you know how you feel. These kids sometimes are going through this all day, every day, and for weeks and years and months. ⁓ you know, we had some kids that we told parents to go record your child. Just go watch and see. If they're snoring or grinding their teeth, it's not normal. And we think it's you know, it's okay for adults to snore. It's not. So we've be we it's been a problem with normal. Let me give you this. So there's two we've lost the understanding of normal versus common. We think it's normal that you can snore and all these things. It's not normal. It's become common. So we all say, ⁓ it's it's normal because we see it so often, but it's disease, it's it's constriction of the airflow, it's pathology. We we need to be able to understand and see what these signs and symptoms are and they could be subtle or they could be really big. And some people don't connect some things like bed wetting to sleep disorders. A sleep disorder is someone who is not breathing well through their nose and and and if you're mouth breathing, you're not getting good deep sleep. We'll go into that in a second. But for kids who are bedwetters, if once we get them nasal breathing and closing the mouth and tongue position, ⁓ many times that bed wetting goes away. And ADD and ADHD signs and symptoms, those are just like if you didn't sleep well, you feel horrible the next day. You can't learn. You can't sit in a chair and and be ready for that teacher. So there's some mi there's misdiagnosis, I believe. And not everybody, I'm not gonna, you know, overgeneralize this, but if something like this is going on, little tiny signs, it's just get your child to get an airway evaluation. ⁓ we see in the mouth, when we look in the mouth, there are signs that I see. that I can tell you I know that child has not been either breathing through their nose well or tongue position because the teeth change the growth and development when it's not in the proper ⁓ function. So all these things I I know I'm kind of babbling here back and forth, but the two main things, if you don't breathe well through your nose, where the air is warm, humidified, filtered, and sterilized, then your body doesn't get into good deep sleep. And you're not using your diaphragm. When you mouth breathe, You're kinda using the upper chest, you're not filling your full lung up and you're not gonna be getting into that parasympathetic mode where our body rests and digests. And so many people, adults and kids, are living life in this quiet desperation where they're where they don't know what's going on. Their body's in this fight or flight all night long. It's it's literally inflammation and so your body's suffering. So what we do here is we try to we try to figure out There's a lot of different things, but they all a lot of times point to the same thing. And we just gotta see what's going on. It's not the bullet every time. Sometimes I'm just the coach and I'm gonna say, Hey, I can help you here, but go do this first or vice versa. So it's a team approach like I keep saying. Yeah, I mean it makes a ton of sense and while every time I listen to you talk about it, I always am very self conscious about where my tongue is and my mouth. So Maybe let's talk a little bit about the tongue and ⁓ you mentioned kind of getting to that next. Yeah, so our tongue is God's natural palatal expander, like I said, and it it needs to sit in the roof of the mouth, right? And it doesn't just sit in the front, it sits in the whole mouth, the whole roof of the mouth. So and then when you swallow it should come backwards. So many kids ⁓ have a tongue thrust or their tongue's not ⁓ able to do the proper swallow technique. So a lot of the myofunctional therapists are real keen on getting this taken care of and looked and diagnosed. But essentially, if you are mouth breathing, your tongue can't get to the roof of your mouth, right? If your tongue is sitting in the roof of your mouth, you cannot mouth breathe. So these kids who have a low we call it like a low tongue posture where their tongue lays low ⁓ and that means their mouth's probably gonna open up and they're gonna mouth breathe. And it could be a habit. Or it could be a necessity. But if you can't breathe through your nose well, you're gonna start mouth breathing. And when that tongue falls down and it's not sitting in the roof of the mouth, your cheek your cheeks win the war. So your cheeks are pushing in because you're like this. And so it starts causing that upper jaw to get narrow. And when we see that narrowness, we know that there's not tongue space and that the tongue's laying low. There's other reasons, it could be a tongue tie. You've probably heard of being you know, people being tongue tied. There's a lot of people w the when the children are born, they they don't always get checked to see if their tongue is too tight. And there's a lot of people who will teach you how to get it taken care of and released so that you can have full mobility of the tongue. But if your tongue is tied, that's another reason you can't get it to the roof of your mouth. And so it like I said, it comes down to really two things. Sprinkle a little genetics on it, but The two things are the epigenetics of not breathing well through your nose and there could be we'll talk about that in right out here, but in and then ⁓ not ⁓ and then tongue position, not with your lips closed, tongue to the roof of the mouth and breathing through your nose. That's proper that's proper function. So that's and and then the the nose, well the nose is if you can't breathe well through your nose, the there could be other issues like a deviated septum or allergies, or tonsils or adenoids you've heard of, right? So Dallas is one of the worst in allergies in the United States. And so we see a lot of kids just suffering and some in adults too, right? And not even really knowing that that's not normal, right? Or wow, I I wish I could br they don't know what good breathing is until they get good breathing. So it's kinda wild here in Texas we're we're fighting a lot of allergy issues. Yeah, I I mean that all makes a ton of sense. We've talked about a lot of ⁓ things to look for, signs, symptoms, ⁓ some misconceptions and misunderstandings that people have. What would you say is the number one biggest misconception that people have when they come sit in your dental chair? ⁓ I've so you know so many times they come in and they're like what am I doing here at a dental office talking about bed wedding? And so there's just they don't realize some of the things that that we can do to help them. And ⁓ so we we have a We have some amazing technology that can really ⁓ help us get to where we what we can do to help us diagnose better. Right. I have a C B C T ⁓ X-ray machine, it's a 3D view. And without it, I don't know how I would practice now. But it's be it should be standard of care. It's it's the most amazing ⁓ tool I have to be able to really look. And you can't diagnose off of it, but it really helps you put the little pieces of the puzzle together. So ⁓ But as far as misconceptions, ⁓ I don't think they realize what you know, they go to their ⁓ D any time any time they have a problem and a lot of a lot of way we treat stuff now is is give ⁓ a pill or, you know, there's not really or s ⁓ you know, there's other ways to do something like that. But maybe we d we can maybe look a little deeper and say, Let's find the root cause and I don't think they the public kinda realizes that root cause is a dental problem sometimes. And this is like a a medical problem with a dental solution. So we need to teach and get awareness out of ⁓ to what the dentist can actually do. And the dentist needs to start learning this. The we you know, some of the I didn't know what I didn't know before. And there's still ⁓ so much that we're learning. But if you don't go to a dentist and and and try to figure out, you know, what's going on if you're if you're tired all the time, if you're if you can't if you're waking up ⁓ unrested. If you're have ADD issues or bed wetting or anger issues, just think it's all related to when someone doesn't sleep well, think of how you feel that next day. And your body suffers, you get worn down, it affects every organ in your body if you're not getting into deep sleep, where your body regenerates new cells and gets rid of toxins out of your brain, literally. So our deep sleep. Is one of the most important things than medicine and anything else you can take ⁓ to make your body healthy. ⁓ so talking about kind of the interlo ⁓ the overlap rather of medicine, ⁓ pediatricians or general medicine, what what should be people be asking? What signs should parents be talking to the pediatrician about and What should pediatricians be looking for in order to kind of refer them to a dentist? Well, that's a great question. And that's one of our ⁓ issues that we're not having the collaboration that that that our medical world needs. And so when parents parents are in ⁓ you know, they're they know they're moms are innate about find they're they're gonna find a reason. They're gonna they're gonna find the answer. They see the problem and if they get told that something's you know, gonna fix it and it doesn't for all these years, then they're gonna go find their own answers. And ⁓ you know, with the with the web and you know, Google everything, we could find everything in a minute. So sometimes, you know, Googling is good and find out go find out w what your signs and symptoms could be related to and and many times now I see it more and more. Th we are talking about this fifteen years ago and it wasn't out there as much. Now it's starting to see some good literature and some good ⁓ stuff in the in the internet. So i if you're having some issues, ⁓ you know, talk to your pediatrician. They they there could be a lot going on. But unfortunately sometimes the pediatricians aren't looking for what the dental issues are. And once we have that ability to teach the pediatricians and the MDs what what we do in the dental world, it it would really facilitate getting everybody healthier. And and we We're just, you know, we're always trying to put this out there and ⁓ it's a struggle. So I appreciate you doing things like this just so who knows, we might this might come across, you know, someone who's suffering with some things that they've been trying to figure out and it could be a simple, you know, trip to your dentist. ⁓ hopefully that is the case, is that this does get the word out more. ⁓ if people are interested, ⁓ whether they're in Texas and can come visit you in person or ⁓ across the country. If someone wants to get in touch with you, a pediatrician, another dentist, ⁓ whoever, what's the best way for them to to reach out? ⁓ wow. ⁓ you know what, if you could leave all my information on on the end of this, but I I'd be happy to talk to anybody. I'm not weird about leaving my cell phone number out and or my email. I w you know, 'cause I I believe that there's you know, we gotta be able to keep communicating and sharing. I was taught by some amazing people and if they didn't teach me, I couldn't have helped all my patients here. Or my children or my friends, right? So this is this is information I want to give out happily and and openly and whatever. So ⁓ at my office, you can always get a hold of me, you know, at 972-840-8477. ⁓ My email is drumuso at sbcglobal.net. ⁓ but there's so many other things that like Doctor West and I teach or ⁓ you know, we got little collaboration groups that we put together that that we get together quarterly. There's always learning things. So just get a hold of me and I'll and I'll get you to the right people. Awesome. And we'll link all of that ⁓ contact information in the description of the video and the podcast ⁓ wherever you're you're getting this. So ⁓ Really appreciate you coming on, Doctor Mark. ⁓ one final question I wanna leave you with is how do you see the patient experience at Mousso Family Dentistry shifting over the next few years? ⁓ well I've seen it shift so much just in the last in since my dad, right? So I've seen it go w you know, so many different ways and the thing that we pride ourselves on is is service and and being you know, we're real. We're n we're gonna tell ya, you know, if we can't do something, we're gonna get you to the right people. We're gonna ⁓ we're we hire the best and I and I truly believe that that's you know, one of the best things that I that we have. ⁓ we have an associate that's ⁓ that it's a little day it's a little weird when you let someone else come into your office and work on your patients, but we found one that's amazing and he's so good. And ⁓ so I love that anybody we put in this little you know, atmosphere that we're where we we teach our we ⁓ treat our patients so well. Yeah, having been in your practice, I can unequivocally ⁓ recommend going to Musso if you're in the Garland, Texas area. It it it does feel like a family. The patients feel like they're part of the family. The staff is all super happy to be at work and ⁓ you guys have done an excellent job. I appreciate that. That's a nice compliment. Thank you. I I I really appreciate that. And I appreciate what you're doing, Jeff. This is great what you Getting helping getting awareness out for us. Awesome. Well, really appreciate the conversation. and we'll look forward to having you on in the future when there's updates to these kinds of things. and ⁓ hopefully a lot of people can get in touch with you and continue learning about these things. I know for me it's super exciting. I have an eight month eight month old and I know I want her ⁓ her dentist to be looking at these kinds of things. ⁓ I know for me I've been ⁓ looking into them for myself and And so this is really super important. So I really appreciate what you're doing. I love it, man. It keeps going. It's like a ripple effect. It keeps going.