By Dr. Felix Liao
Do you suffer from chronic pain in your head, jaws, neck, shoulders, and back? Clinical dentistry is posturally demanding.
Do you snore, grind your teeth, and wake up tired? Keeping your practice going is energy intensive enough without living with a structurally impaired mouth.
Do you have medical symptoms or systemic conditions that baffles you and your doctors and healthcare professionals (HCPs)?
How can you keep up with every demand in the office and at home when you’ve been running on fumes all these years? I know because I’ve been in your shoes as a fellow general dentist.
Hi, this is Dr. Felix Liao, DDS, MAGD, ABGD, MIABDM, Diplomate American Sleep and Breathing Academy, and author of Six-Foot Tiger, Three-Foot Cage (2017), Early Sirens (2017), and Licensed to Thrive (2020). The titles are not meant to snow you, but to support your turn toward thriving personal health.
Welcome to my Dentists’ Wellness Institute, which puts all knowledge and experience therein to take care of Number One — you as the chief producer of your practice and owner of your health.
Im 2017, I began teaching how to become an Airway-centered Mouth Doctor™ (AMD) to general dentists interested in turning from drill and fill dentistry to add airway diagnosis and redevelopment to their clinical practice. Since then, I’ve found that 93% of dentists in my AMD training have issues with airway obstruction, chronic pain, fatigue, and impaired mouth structure issues like TMJ and teeth grinding — just like their patients.
With 3D Jaw Diagnostics™ showing what’s off dentally and skeletally, where, and by how much; WholeHealth Integration to connect the mouth with the whole body; and the principles of epigenetic orthopedic oral appliance therapy, dentists under enormous stress all life long can and do reclaim their health.
A Holistic Mouth is one that is structurally fit to support whole body health. Here are the Holistic Mouth Principles:
- Good health requires good function, which in turn requires good structure. Yet this basic principle is so not in people’s minds, nor doctors’ practices.
- A structurally impaired mouth starts a cascade of medical, dental, and mood symptoms in response, such as chronic pain, fatigue, sleep apnea, and more.
- If you truly want to thrive on the inside and glow on the outside, then you need both Holistic Mouth Structure and Holistic Mouth Style (how to eat). When either is impaired, all other healthcare will fall short.
- An oral appliance by itself cannot heal a patient. An attending mouth doctor with command of oral appliance therapy and WholeHealth Integration can.
Let’s turn to some real-life cases illustrating the Holistic Mouth Principles from Licensed to Thrive:
The Case of Dr. RL
Dr. RL is a general dentist who emailed me her case story:
Dear Dr. Liao, I came to see you about my numb fingers on both hands exactly a year ago. You said I was tongue tied which surprised me but made total sense. You said that you thought that it could be connected to my numb fingers but could not be sure but since I told you that the neurologist told me my numb fingers was coming from stenosis on C6,C7,C8… When I wore a simple mouth piece I didn’t feel numb so I knew it was connected and made an appointment t with you because I knew… neck surgery to fix the stenosis was not the answer either.
A month after meeting you at your office for your gracious consult, I bought a CO2 light scalpel laser, following which I spent a day with Dr. Richard Baxter in Tennessee watching him release lots of kids. Dr Baxter released my tongue late in the day and my numb fingers went away immediately.
I can’t thank you enough for opening my eyes to my tongue tie. My entire life I would get massages twice a month and told them to spend 90 minutes on just my neck and shoulders. Since I was released my neck and shoulders have been 100 % stress free, it amazing no tension at all.
My release has been the greatest gift I received and I owe it all to you so Thank you! I still want to do expansion but have been so swamped with all the airway excitement and am feeling great.
The lower left image in the slide above shows a “Cave Maneuver” by keeping the tip of the tongue on the gum line behind the upper centrals and sucking the tongue to the palatal vault in oral myofunctional therapy (OMT) to reprogram the tongue to stay in touch with the palate, where it belongs instead of the floor of the mouth. OMT trains the tongue to serve as a natural retainer after active oral appliance therapy.
In my experience, patients have felt a loosening of their entire chest after tongue-tie release. One career navy man had tears down his cheeks right after his tongue-tie release because he could breathe without restriction for the first time in his life.
I am so proud of Dr. RL who has evolved from drill and fill dentistry by making the necessary investment and training to help patients with tongue-tie release and more.
It is the most rewarding procedure out of everything I do and I do All my own dentistry so that is saying a lot. I’ve since became certified as an oral myologist (to provide tongue-tied patients with physical therapy of the mouth]. I learned after 27 years of dentistry that the neck and shoulder tension was never a result of my chosen profession but instead it was a result of my tongue tie all along.
The floor of the mouth is connected by fascia (soft skeleton) through the neck vertebrae down the breast bone to the heart and lung sacs, and the nerves to the fingers originate in the neck. Connecting these dots, you can see why Dr. RL’s numb fingers went away with tongue-tie release.
Whether you are a patient or healthcare professional, what is your takeaway from Dr. RL’s case?
Five Keys to Start Thriving: AABCD
To start thriving, you need to be sure to address five basic factors, preferably in this order, AABCD: Alignment, Airway, Breathing, Circulation, and Digestion.
Why Alignment first? Gravity never stops pulling us down toward the grave. The hard and soft skeletons (bones and fascia) provide a durable yet flexible structure. Correct alignment is a prerequisite for nerve and blood supply and everything else that follows, including airway. Narrow and misaligned jaws means a deficient airway.
Airway rules because oxygen isn’t optional. Do you suffer from Impaired Mouth Syndrome? Is your “cage” (your jaws) too small for your “six-foot tiger” (tongue)? Have your airway imaged by a qualified mouth doctor, get a sleep test, and find a treatment that matches your situation and values. Some patients can tolerate CPAP to manage their sleep apnea, while others do better with various forms of appliance therapy.
Breathing is a nasal rather than an oral function. Snoring is mouth breathing during sleep, and nasal obstruction is a huge problem. So is teeth grinding in response to oxygen deficiency. Teeth grinding means your body is confronting death and doing CPR on itself. Remember, sleep is stand-down time for your body so it can repair the daily wear and tear you put it through. Again, a qualified mouth doctor can help you address any troubles that may be stemming from an underdeveloped airway.
Circulation should deliver oxygen and nutrients, not infection and toxins. See a biological dentist to rule out oral infections and a physician to rule out any respiratory, digestive, urinary, or skin infections. Sleep apnea forces your heart to work overtime, and oxygen deficiency grows bad bacteria — two more reasons to first address any airway issues you may have.
Proper Digestion comes without congestion, obesity, or inflammation. So this means training yourself on how to eat right.
Now let’s see why thriving health should start with Alignment.
Case Study of Another Dentist
Dr. RK is a general dentist who took up training with me to become an AMD (airway mouth doctor) way back in 2017. Based on her Liao’s Sign and CT imaging of her airway (one-third of low-comfort), I recommended a sleep test, which came back with an AHI (apnea and hypo-apnea index) of 47. The threshold for severe apnea is 30.
She had sustained a rotator cuff injury while being pulled out of the birth canal. Despite repeated physical therapies and one surgery, she could not raise her dominant hand above her ear, but it did not affect her hand and fingers She went through college, dental school, and 25 years of general dentistry practice that way.
Prior to training with me, Dr. RK had enough training in dental sleep medicine to get herself medically diagnosed with a sleep test score of 68.
I started on CPAP right away and have to say that I have considered myself a CPAP success story… Once I recovered from a lifetime of sleep deprivation, my health hormones started to regulate, meaning cortisol, ghrelin and leptin. The next year I started yet another weight loss health and wellness program but this time I lost 110 lbs. In all the times that I have tried to lose weight, I have never been able to keep it off until now.
Dr. RK’s case also shows why Alignment comes before Airway and Breathing.
I have had orthodontics 3 times in my life, 2 times as an adult, and none of the orthodontists looked at my [airway] anatomy! But Dr. Liao took a CT scan and diagnosed my retruded and deficient maxilla as the structural cause of my impaired mouth and choked airway, which confirmed my obvious Liao’s Sign. Dr Liao then helped design my appliances and I started my journey to WholeHealth Integration and become an Airway-minded Mouth Doctor myself. Thank you Dr Liao!
After her epigenetic oral appliance therapy, Dr. RK’s dropped from AHI of 37 (severe sleep apnea) to 11 (mild) in 14 months. Here’s what her oral appliance did for her injured right shoulder in 3 months:
Could I have predicted this outcome? No way. Now we have precedent.
The jaws and neck and shoulders are connected — a novel idea that should be just common sense. But that’s not taught in medical, dental, chiropractic, or naturopathic schools, nor traditional physical therapy programs, and therefore not in clinical practice. This results in lots of unnecessary cost and suffering.
The point of all the cases mentioned here is this: Reclaiming your health, including losing weight loss and keeping it off, is easier and more sustainable with airway diagnosed and sleep improved.
Airway obstruction is rooted in impaired mouth structure, which should have first-line consideration in WholeHealth Integration — an important point to keep in mind before we get into nasal breathing.
It’s safer to assume there’s an oral contributions to recurring medical, dental, and mental-emotional symptoms than to ignore or dismiss them.
Your choice: You can learn to treat yourself, or you can just come to get yourself evaluated and go home with a treatment to implement, or both.