Do Kids Outgrow Their Airway Issues? An ENT's Perspective (w/Dr. David McIntosh) [Ep.155]
The DOC PodcastShow Notes
In this episode, I sit down again with Dr. David McIntosh, an ENT surgeon from Australia and one of the sharpest medical minds I know when it comes to pediatric airway and sleep-disordered breathing. We dig deep into the recently updated AAO white paper, including what it got right, what it got dangerously wrong, and why publishing a document about interdisciplinary care without a single interdisciplinary author is a problem we can't ignore. Dr. McIntosh also walks me through one of the most eye-opening breakdowns I've ever heard about Scammon's curve, and what orthodontists were never actually taught about what that data really shows. This episode is a must-listen for any dental or medical professional who works with children and cares about more than just straight teeth. Timestamps: 0:02:40 — Welcome & introducing Dr. David McIntosh back to the show 0:04:35 — The AAO white paper update: eight orthodontists, one librarian, and zero medical or myofunctional colleagues 0:09:51 — The quote that stopped Dr. McIntosh cold: "Pre-pubertal OSA tends to resolve naturally" 0:11:34 — Dissecting the flaws in reference #17: small sample sizes, changing scoring rules & selection bias 0:13:01 — Reference #18 from a 2010 Journal of Pediatrics paper that actually contradicts the white paper's own conclusion 0:22:59 — Why the CHAT study should have been their starting point 0:23:09 — The Karen Bonuck study: 12,000 children, 7 years of data, and what early SDB really does to development 0:27:54 — Christian Guilleminault and why he wished he'd never invented the AHI 0:38:16 — Breaking down Scammon's curve: what it actually measures (and what it doesn't) 0:40:25 — The original data came from the spleen and thymus — not tonsils or adenoids 0:53:30 — "I don't care about teeth" — Dr. McIntosh on why craniofacial outcomes are the wrong finish line 0:55:34 — Straight teeth bias: why orthodontists need to think like dentofacial orthopedists 1:04:08 — Mouth breathing and craniofacial growth: why the debate doesn't even matter anymore 1:20:41 — Dr. McIntosh and Bill Harrell's upcoming Airway Breathing Academy — what it is and who it's for I hope this episode challenges the way you think about what we're really treating when we treat children's airways, because it's never just about the teeth. If you found this valuable, please follow me on Instagram at @theorthocoach, join our community at The DOC Community on Facebook (link below), and subscribe on YouTube at @theorthocoach. Your support helps keep these important conversations going. See you next episode.
LINKS Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/ Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/ Guillimenault & Huang article in Sleep Medicine Reviews, 2018: Guilleminault C, Huang YS. From oral facial dysfunction to dysmorphism and the onset of pediatric OSA. Sleep Med Rev. 2018 Aug;40:203-214. Connect with Dr. McIntosh: Facebook: https://www.facebook.com/david.mcintosh.180 Instagram: https://www.instagram.com/dr.mcintosh.ent/?hl=en
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