The DOC Podcast

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

What is The DOC Podcast?

The DOC Podcast brings you unique educational content taught by Dr. Mike DeLuke, a Board Certified Orthodontist with over 20 years of clinical and academic experience. Dr. DeLuke built his orthodontic practice from scratch in the early 2000s and grew it into a multimillion-dollar enterprise in less than 10 years. He was able to retire from his private practice at the age of 46 years old, and now devotes his energy to teaching his colleagues how to succeed both personally and professionally. He also provides locum tenens coverage for colleagues in South Florida.

Dr. DeLuke has served as a faculty member at numerous hospitals and orthodontic residency programs around the country, including as the cleft craniofacial orthodontist at Albany Medical Center in New York, and as a clinical professor at The University of Connecticut in the Department of Orthodontics. He is presently an adjunct professor in the Department of Pediatric Dentistry at Healthcare Network and a Visiting Professor in the Department of Orthodontics at Montefiore Einstein Hospital in the Bronx.

The DOC Podcast will bring you in-depth discussions and interviews with industry leaders and experts on a variety of topics, including clinical excellence, practice management, finance and wealth creation, health and wellness, taxes and accounting, fitness, and much more!