{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"The DOC Podcast","title":"The Good, Bad, & Ugly of the AAO White Paper Update on SDB and Orthodontics [Ep.156]","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/717ba2d9\"></iframe>","width":"100%","height":180,"duration":5381,"description":"In this episode, Dr. Mike breaks down the 2024 update to the 2019 AAO White Paper on obstructive sleep apnea and orthodontics, published in the AJODO in April. After presenting to hundreds of medical, dental, and myofunctional therapy colleagues across the country, he recorded his full presentation for listeners worldwide.\nTimestamps0:00 – Introduction, episode overview & why Dr. Mike recorded this presentation1:17 – Context: Presenting across the U.S. (Houston, Bronx, Long Island) — the near-universal reaction was shock at the document's flaws3:07 – THE GOOD begins3:07 – Good #1: Acknowledges the full spectrum of sleep-disordered breathing (SDB), not just OSA3:55 – Good #2 & #3: Calls on orthodontists to screen all pediatric patients for SDB, emphasizes early detection, and acknowledges multifactorial etiology requiring interdisciplinary care5:07 – THE BAD begins5:07 – Bad #1–2: Author panel was 8 orthodontists + 1 librarian (no physicians, no myofunctional therapists); document inconsistently uses \"OSA\" vs. \"SDB\" throughout8:03 – Bad #3–5: Minimal screening guidance (32 signs & symptoms largely ignored); only briefly mentions comorbidities; never discusses the importance of nasal breathing13:00 – Bad #6: Overall focus is on what not to do rather than guiding orthodontists on how to help patients14:00 – THE UGLY begins15:01 – Ugly #1: Reliance on PSG-confirmed OSA to justify intervention — challenges with pediatric sleep studies (access, sensitivity, first-night effect, lack of standardization); what Reference 34 actually says vs. how it was cited22:40 – Patient case study: Child with AHI of zero but severe signs of airway disease — the ENT said \"what does the orthodontist know about sleep medicine?\"26:34 – Ugly #2: \"No way to determine if a patient is a mouth breather\" — justified by a study of 9 adults on a cycle ergometer; Dr. Kandasamy's 2025 AJODO editorial; what the actual research shows (European OJ, AHA, ADHD literature, microbiome)36:51 – Ugly #3: \"No...","thumbnail_url":"https://img.transistorcdn.com/Wf6VIMhB_ulpfJzsJlix0BOF0i4W9yk8xxJ6-5X1Y6E/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9zaG93/LzQxOTI3LzE2OTg2/MzExNDktYXJ0d29y/ay5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}