Mouth Breathing, Tongue Ties & Picky Eating: What Moms Need to Know with Misty Bridges [S1, E7]

Transcript

Grace Gerke, PA-C: Hi, Misty. Welcome to the Skills for Moms podcast.

mistybridges: Hi, I'm so glad to be here.

Grace Gerke, PA-C: We're so glad to hear you. thank you for coming on the show.

mistybridges: Yes, it's very exciting to be able to speak about all of the things myofunctional therapy.

Grace Gerke, PA-C: yeah well, I just want to give our audience a little introduction to you. Misty, who is personal therapist for two of our children. She has 30 years of experience in the dental field and also a background in dental hygiene.

Grace Gerke, PA-C: You're passionate about helping your patients live healthier lives. You're the only therapist in East Texas who is certified by the International Association for Oral Facial Myology, and you treat a variety of dysfunctions, including tongue and lip ties,

Grace Gerke, PA-C: thumb sucking, nail biting, tongue thrust, TMJ, open mouth issues, you name it.

mistybridges: Thank you.

Grace Gerke, PA-C: You also help people with breathing issues, also functional nutrition. Misty also has her certified functional nutritional counselor certification and then her functional nutrition lifestyle practitioner certification. So you are so well qualified.

Grace Gerke, PA-C: You also have your own business, East Texas Orofacial Myology, where you see patients in person and virtually. um And you came highly recommended by pretty much every top dentist and orthodontist we consulted in the DFW Metroplex. So we're so glad to be connected with you personally, Misty.

mistybridges: well likewise um very flattering that you know that you have you you trust me i appreciate that to take a part in your children's growth and development so it means a lot to me that you place your trust in me so thank you

Grace Gerke, PA-C: Oh, yeah, I would love to hear more just a little bit about your background beyond the professional side. Like what gave you this passion for this area and why do you care about it? Something that many of us don't even know exists.

mistybridges: Exactly. Well, like most of us, if we fall into something, we have a personal experience. And I look back on my journey and being adopted, never having the opportunity to breastfeed, really kind of set the stage for my oral development.

Grace Gerke, PA-C: Mm hmm.

mistybridges: And from what I can recall, I was on the bottle too long. So that kind of set me up for some malocclusion and And so I have ah a pretty long journey of just a personal history with orthodontics and jaw surgery and then a second round of orthodontics and and and also with my child.

Grace Gerke, PA-C: Yeah. Mm-hmm. Wow.

mistybridges: So he, looking back, I didn't know the things that I know now.

Grace Gerke, PA-C: Mm-hmm. Mm-hmm. Mm-hmm.

mistybridges: I mean, he's grown now, so I can put all of the pieces together to understand why we struggled. so much.

Grace Gerke, PA-C: yeah

mistybridges: So yes, it's very personal. And when I took my first course in understanding what these disorders were, i was still working in the dental office.

Grace Gerke, PA-C: Yeah.

mistybridges: there is a reason behind the dysfunction.

Grace Gerke, PA-C: Yeah.

mistybridges: And so that's how my journey began.

Grace Gerke, PA-C: Wow. Wow. Well, I can really relate, you know, personally, I went through jaw surgery, I had two rounds of braces, I was told I always mouth breathed. And, you know, no one knew what to do with that, you know, and now looking back of seeing the full picture and seeing it in my kids of like, wow, I just needed some help and retraining that back then in the nineties, I don't think was out there Very few people knew what was lacking, I guess.

mistybridges: Yes,

Grace Gerke, PA-C: I've heard so many of these big words recently that I'm trying to dive into myself, myofunctional craniosacral,

Grace Gerke, PA-C: myofascial and sometimes they all just blend together. so could you just define in a simple way, what is myofunctional therapy?

mistybridges: Yes, and that is so common because they do overlap. So I would say Defining myofunctional therapy is working with all of the muscles that we use to breathe, eat, speak, chew, and swallow with in the oral phase of the swallow, which also includes oral habit elimination.

mistybridges: So that's where thumb sucking, long-term pacifier use, and nail biting, and all of those habits come into play.

Grace Gerke, PA-C: Thank you.

mistybridges: So it's retraining a neuromuscular pathway um Because a lot of times these children are adults. They have an an incorrect swallow pattern. So we need to correct that. And so we have to find the reason why the dysfunction is there to begin with.

Grace Gerke, PA-C: Mm-hmm. Mm-hmm. Mm-hmm.

mistybridges: And craniosacral therapy is wonderful if we can incorporate that. I don't do that personally. But it is more of a very gentle, light touch to really reset the nervous system.

mistybridges: And that can be very beneficial when, especially with babies, when they are having some oral dysfunction and feeding issues. But also it is beneficial for adults too.

mistybridges: So the myofunctional therapy is more hands-on, um you know, exercise-based, active, and whereas the cranial sacral therapy is very gentle, non-exercise approach.

Grace Gerke, PA-C: the

Grace Gerke, PA-C: Yeah, that makes a lot of sense. I mean, makes me think of, you know, in the traditional medical world, you have, you know, physical therapy, you need to maybe strengthen or retrain something after an injury or surgery, but then you also might need massage or something to support the the training that you're doing.

mistybridges: Exactly.

Grace Gerke, PA-C: Yeah. Yeah. That makes a lot of sense. And you take care of both children and adults. Is that right?

mistybridges: Yes. Usually when a child is ready for myofunctional therapy, I like for them to be able to do an exercise, you know, if I ask them to do something to really kind of understand and, and have, you know, they be able to volitionally do what, or mock what I'm doing or what mom is doing and just really kind of set them up. And then the older that they get, we can build on that and become a little bit more advanced.

mistybridges: But sometimes we start in stages, you know, A three or four year old is not going to have the same program that a six or seven year old may.

Grace Gerke, PA-C: Yeah. That makes a lot of sense.

mistybridges: Yeah. Mm-hmm.

Grace Gerke, PA-C: I know as a mom, you know, if you start seeing an issue with a young child, maybe even a toddler where, you I'm thinking about like the white diet, you know, where i don't know what happened, but now we're dealing with this with one of my children.

Grace Gerke, PA-C: You know, he's two of like, he was eating more food and now he just wants chicken nuggets and pasta. What happened or what, what did we do wrong? What would be your advice for a mom? Who's maybe in between, you know, she, there's the baby stage, but then there's the, you know, three plus where you could benefit from therapy.

Grace Gerke, PA-C: what is a mom kind of in the mid, in the middle time do. Yeah.

mistybridges: I think if we can find a way to make sure that they are able to chew correctly and try to get away from any of the pouched foods are softer foods, because sometimes those children, when they become picky, they're gravitating towards more processed softer foods.

Grace Gerke, PA-C: finish

Grace Gerke, PA-C: yes

mistybridges: And if we can encourage more chewing, that's really going to help to develop

Grace Gerke, PA-C: Mm-hmm. Mm-hmm. Mm-hmm.

mistybridges: the jaws, because muscle always influences bone growth. And, but sometimes, you know, kids, they just kind of go through a little phase and maybe they're out of it. But we have so many different avenues. If it's true feeding, you know, we can refer to a feeding specialist.

mistybridges: If it is a functional problem with maybe the tongue just can't gather and lateralize the food appropriately. Maybe they come a little aversive to certain textures.

Grace Gerke, PA-C: Yeah.

mistybridges: So it's sometimes it's maybe a phase and then sometimes it needs to be looked into a little bit further.

Grace Gerke, PA-C: Yeah. So it sounds like some things a young mom could do really thinking about chewing with the kid, not having pacifiers.

Grace Gerke, PA-C: Do you have certain limits on where, you know, I know even pediatricians will say after one, you know, don't, do a bottle anymore and things like that. But then it's almost like as long as you don't do those two things or you don't suck the thumb, you can kind of think, oh, I guess my kid's fine.

mistybridges: Thank

Grace Gerke, PA-C: But I guess for me and with my kids on our journey, it feels like just doing those things alone, no bottle at one, no passy or no thumb sucking, you could still have, you know, dysfunctions.

Grace Gerke, PA-C: So do you have any good takeaways or things a mom could do right now, you know, who has a young, maybe toddler?

mistybridges: Yes, I would say the most important thing is getting the tongue in the palate, because that is going to guide the jaw to grow forward and out, which is also going to support the airway and increase the nasal space.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: So if you're noticing that your child is mouth breathing, and I don't mean necessarily really wide open mouth, like we would think mouth breathing, like

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: Yeah.

mistybridges: Napoleon dynamite type mouth breathing, but even just a very slight open posture in the lips can signify that the tongue is low.

Grace Gerke, PA-C: Yeah. Yeah.

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: Yeah.

mistybridges: And, you know, it's hard because we're watching, we're looking at our children every day and what we sometimes see as normal, it may be a dysfunction and we're not recognizing it because they've always done that.

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: yeah

mistybridges: and Who's teaching us these things? Nobody, you know, I never learned. all of these things to look for.

Grace Gerke, PA-C: Yeah. Mm-hmm.

mistybridges: So I would say if the tongue is not able to lift in the palate and that that's kind of complicated too, because you know, some kids, they just need a few exercises. They need a few weeks to really work on getting the tongue to the palate.

mistybridges: Um, so if we just really focus on looking at kind of the red flags and How is their sleep? Are they restless? um One early clue for um ah toddlers and babies is recurrent ear infections.

Grace Gerke, PA-C: Hmm.

mistybridges: So in looking at the early feeding history, because if maybe they struggled with a latch or maybe mom was told, oh, here, so here's a ah nipple shield.

Grace Gerke, PA-C: Yeah.

Grace Gerke, PA-C: Mm-hmm. Mm-hmm.

mistybridges: And okay, well,

Grace Gerke, PA-C: Mm-hmm.

mistybridges: Why does she need that? You know, there's there's a problem. There's a dysfunction or breakdown there. So having a good suck-swallow dyad is so beneficial for the eustachian tubes.

mistybridges: And so those are a lot of the red flags that I look for when I'm doing the medical history and, you know, maybe having tubes placed and just chronic upper respiratory infections because they're not able to use the nose.

Grace Gerke, PA-C: Yeah.

mistybridges: and warm and humidifying filter. And, you know, all of that is like a domino effect with the adenoids flaring up.

Grace Gerke, PA-C: Yeah. Mm-hmm.

mistybridges: And, you know, I know you're aware that with your, your background and seeing that in working with the ENTs and, you know, the tonsillar tissue.

Grace Gerke, PA-C: Yeah.

mistybridges: And we, we really need the lip closure for so many things in creating the nitric oxide that's so healing to our body.

Grace Gerke, PA-C: Yeah. Yeah. That reminds me of, I think you have it in your office, James Nestor, his book breathe as a good starting book of if you've never even considered why, you know, mouth breathing may not be beneficial or like you're saying, maybe it's not a super obvious mouth breathing, like a full dynamite, but it's just a subtle thing.

mistybridges: Yes. yes

Grace Gerke, PA-C: And then all of a sudden, you know, the whole, you if you're not using it, you lose it. Like we learned in my ENT training, when a patient has a tracheostomy, you know, a hole to breathe for a medical reason in their neck after, i think it's only a few weeks, their nose completely occludes, not because it's nothing's wrong with it, but just that's the body. The body can only breathe through here.

Grace Gerke, PA-C: And so there's no reason for the body to keep the nose patent, you know, um, So yeah, that's a really good, i don't know, feels like an aha that we don't talk about enough, the nasal breathing.

mistybridges: Right.

Grace Gerke, PA-C: Yeah.

mistybridges: And i I try to tell my kids, you know, I try to make everything fun and, and, you know, it's like, okay, let's think about what our nose is used for.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And I have them tell me, you know, smelling, breathing, and it's okay, well, so what do we do with our mouth? And then, you know, try to get them to talk about, you know, all the things.

Grace Gerke, PA-C: yes

mistybridges: And then'm like, okay, so let's think about this. We breathe through our nose and we eat with our mouth. We don't eat with our nose and breathe.

Grace Gerke, PA-C: yeah yeah

mistybridges: So trying to get on their level to have them more aware.

Grace Gerke, PA-C: yeah

Grace Gerke, PA-C: hand

mistybridges: Um, and so that's, that's a little tricky too. So I think moms can just start observing their child when they're unaware, when they are asleep, um,

Grace Gerke, PA-C: you

mistybridges: at night, but also in the car seat or when they're on the couch watching a movie or when you're reading with them, just really taking a look at their jaw posture.

Grace Gerke, PA-C: the

mistybridges: And if it's low, their tongue is most likely low. Yeah.

Grace Gerke, PA-C: And then for a mom who she realizes that, what does she do from there? you know what How does a mom know, okay, I just need to kind of try to do nasal saline, try to help my child you know, keep their tongue on the top of their mouth versus I need some extra help from someone like you.

mistybridges: Right. but One of the things that i I love is just making sure that the child knows how to blow their nose.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: We do a lot of nasal hygiene in here. And I'm kind of surprised at some of the kids that are a little bit older that actually really cannot clean their nose well.

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And maybe they're fearful of nasal sprays. So I always say if they don't like

Grace Gerke, PA-C: Yeah. Uh-huh. Yeah.

mistybridges: the spray, then use the infant drop and drop that in their nose, even if they're older, you know, and I really love the eggs clear the X that X L E A R brand.

mistybridges: And that is so helpful in resolving inflammatory issues and all of the things. So if, if that is not working and mom has been to, you know, her primary care physician or ENT, someone, an airway specialist to take a look and they've ruled out, you know, airway obstruction, then I would say I like to work with just having them think about their food choices and maybe incorporate something that they really have to chew a little bit more.

Grace Gerke, PA-C: Yeah.

mistybridges: And if a child is still aversive to trying in new food, then maybe we do more chewy tubes or, you know, and those are pretty easy to come by, you know, around $10. And, you know, just have the child really chewing and, and really working those muscles of mastication.

mistybridges: And then hopefully that will encourage them to, you know, feel better about grabbing for something like a raw carrot or an apple, but you know, just working

Grace Gerke, PA-C: Yeah.

mistybridges: having all of the muscles working together, the facial muscles, the lips and the tongue. But if if it's prolonging for an extended period of time, then I would say it would be important to have someone do an oral evaluation and look for tongue range of look Look at the airway. A lot of times it is the airway. These kids are afraid to swallow because they're afraid they're going to choke.

mistybridges: Um, so just making sure their palate is wide and it's being supportive for the swallowing phase.

Grace Gerke, PA-C: Okay. Yeah, that makes a lot of sense. And I mean, it's something I feel like right now, personally, we're working through in our home of, you know,

Grace Gerke, PA-C: we mentioned when we were seeing you last, I think one of our kids was kind of chewing on his shirt, you know, and you had recommended, well, if he could get a, you know, safe silicone, kind of like a chew toy that he could use temporarily to kind of nix that habit. And then you're chewing on something hard that gives that, you know, stimulation that he needs.

Grace Gerke, PA-C: So then we're not doing this bad habit. And I think I've just seen how quickly these bad habits can develop and it's hard to kind of catch it early on.

mistybridges: Hmm.

Grace Gerke, PA-C: Like with one of my kids, he had two bouts of adenoiditis and it basically blocked his nose. But because of that, you know, it caused even more inflammation, then his tonsils swelled up, and then he ended up leaving his tonsils out because he really couldn't breathe at night.

Grace Gerke, PA-C: And, you know, it was kind of past the point of just doing therapy to get better. But, you know, I still look back on that and like, man, you know, i just felt like a big snowball of like, one thing's happening and then picky eating and Sometimes it could be hard to just notice it when it's small, I guess, it you know, or with babies, like, you know, how can we, besides not doing the pouches, how can we with a baby help develop that strong jaw so they want to eat harder foods when they're able to?

Grace Gerke, PA-C: My baby's about to turn six months tomorrow, so that's on my mind as well. Anything to speak into on that?

mistybridges: Well, I, you know, I'm, ah don't really work with the babies, but I will, you know, kind of help advise and and guide moms.

Grace Gerke, PA-C: Yeah. Yeah.

mistybridges: So, you know, in our culture, we may be a little quick sometimes, and it may not be by choice. It may be out of necessity to not breastfeed for longer.

mistybridges: um You know, it's something that that is very helpful and supportive. And And then maybe getting into, like you were saying, the little chewy tubes. I really love, um, utilizing the mile munchie.

Grace Gerke, PA-C: Yeah.

mistybridges: Um, but you know, it, I also have another little tool that, um, if moms can't afford a mile munchie right off the bat, there's a little tool. It's the, well, I have it here.

mistybridges: It's this, and they keep changing the name, but this little brilliant, uh, looks like a half little munchie.

Grace Gerke, PA-C: Yeah. Yes. Yeah.

mistybridges: And it's five bucks. And, you know, that's really a great tool for the toddler age that is supportive for chewing, because a lot of times they're there're sensory seeking.

Grace Gerke, PA-C: Yes.

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: Yes. Yeah.

mistybridges: And if the tongue isn't reaching on the palate right behind the front teeth, where we need it to rest, a lot of times they they start to chew on things or become very you know oral.

mistybridges: And and we early on, you know that's great for the oral development and the the child needs that. But then when it's chronic, like if you see infants or toddlers that just are and hand to the mouth all the time and their lip stays rolled out and their lips are apart, you know as they age, they may continue with that oral posture

Grace Gerke, PA-C: yeah

Grace Gerke, PA-C: good

mistybridges: And at four, they still have the same mouth shape and jaw shape as they did when they were a baby with their hand in their mouth.

Grace Gerke, PA-C: yeah

Grace Gerke, PA-C: yeah so like when we get to that age where i think because we have myo munchies for our family and have really been trying to implement those doing time where they're It's just a little kind of retainer that you chew on and then you can keep in your mouth to keep your lips closed and nasal breathe.

mistybridges: Yeah.

Grace Gerke, PA-C: But being like, okay, instead of giving my six month old this pacifier, we took that away. Now you can chew on this little safe chew toy. I mean, that's kind of a small thing we've done different than with our last child of like, let's get rid of the pacifier sooner and give them kind of a better alternative that's going to help cure our baby for chewing food as he's getting older.

Grace Gerke, PA-C: um So yeah, I love that there's like a continuum because like you said, it feels like it can be expensive. You know, if you have a lot of kids and you haven't bought in, why would I buy a $90, you know, shoe thing, you know, but maybe starting small and working up.

mistybridges: Yes. And another thing too is, you know, i want to point out that there there is a time and place for a pacifier.

Grace Gerke, PA-C: Yeah.

mistybridges: You know, we know that there's research that is supportive for SIDS.

Grace Gerke, PA-C: Yes. Wow. Wow.

mistybridges: And I always want to ask if there's a continued pacifier habit I mean, a lot of times we think continued pacifier habit might be, you know, one, two.

mistybridges: I've had children that are, I mean, preteen that still have the pacifier. I mean, 12 year olds. And as soon as they, you know, leave school, they have to have the pacifier. And so my goal is to let's find out why, why is the need is the need.

mistybridges: They can't get the tongue to the palate for that sensory input that they need.

Grace Gerke, PA-C: Mm-hmm. Mm-hmm.

mistybridges: Is it trying to move the tongue out of the airway space? Is it trying to open the airway? So I, you know, i think I don't want moms to think, oh, I should never have given my child a pacifier. But um we just know that long term, it creates a lot more sucking in the front part and we really need to work more chewing posteriorly and working our muscles and you know that that is going to help with the oral phase of the swallow.

Grace Gerke, PA-C: Yeah.

Grace Gerke, PA-C: Um, yeah, that makes a lot of sense too. And it kind of ties right in with tongue ties. I wanted to touch on that as well. Um, cause my understanding is if a person can't naturally keep their entire tongue on their palate, you're going to have a sensitive gag reflex. You're going to, um,

Grace Gerke, PA-C: you know, not be tolerant to foods and things touching the back of your mouth because you haven't been used to that sensation from the tongue. And so I know tongue tie can be kind of a big topic of a lot, you know, if you, you know, mommy blogs or Facebook, it's, you know, so much talk about both in infancy, but I think also as kids are getting older, you know, do I need to get some sort of release to help my child speak better? Or like you're saying, eat better. so I don't know, could you just start to touch a little bit more on where to go with that?

mistybridges: Yes, it it is such a hot topic. And You know, thankfully, we have more and more research to support recognizing and how to treat tongue ties.

mistybridges: I would say where a lot of misconception can come from a tongue tie is there, you know, moms will say, I think my child has a tongue tie.

mistybridges: Maybe we just get that corrected and that's going to fix everything art

Grace Gerke, PA-C: Yeah. Yeah.

mistybridges: I even have that same issue with adults. They just want to correct the tongue tie, but it really affects the whole body from head to toe.

Grace Gerke, PA-C: yeah

mistybridges: And i would say if some of the warning signs that I always are red flags, I should say, that I look for in my evaluation would be a lot of the picky eating. And then we're very specific on how we can measure function.

mistybridges: and range of motion of the tongue now from the tip of the tongue to the middle part of the tongue.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And so thankfully we can look at that and then we can look at the compensatory patterns um during movement, whether it's jaw movement, speaking, chewing and swallowing, because a lot of times if there's any tethering, then there's definitely compensations, either a forward,

mistybridges: what we used to call a tongue thrust lisping, things like that that that, that you could maybe visibly see the tongue being forward, but maybe these are the kids that struggle. Maybe they're messy eating.

mistybridges: Maybe they swallow a lot of air. Maybe they, you know, they just are selective on certain food groups, but looking at how they can

Grace Gerke, PA-C: Mm-hmm. Mm-hmm.

mistybridges: do all of the shapes with their tongue is important to to dive to really dive into the function and then we can send to a tongue tie release provider that understands the function and you know then we can proceed from there.

mistybridges: But it's just having a release is not correcting the problem because if you've been tethered for however many years, you've created

Grace Gerke, PA-C: Yeah. Mm-hmm.

mistybridges: one pattern that you could only do. And then having the release, we have to learn a whole new pattern. So really after the release, then we go through, you know, just making sure that it doesn't, you know, get tight and we go through the aftercare management.

mistybridges: But after that is healed, then we really need to start working on forming new patterns and habituating those. So it it can be a little bit overwhelming because it's not just a quick fix, but having the right team that understands the function, it's easier to go through that and and not have to do that again later.

Grace Gerke, PA-C: Yeah. So really it has to be, I mean, similar to, I would say other people, if you get a surgery, people think, Oh, I got my ACL repaired or something. And then they just think, Oh, everything's great.

Grace Gerke, PA-C: But the reality is a surgery doesn't just, or you get your gallbladder out for gallstones, but that doesn't deal with the reason you got gallstones to begin with or why the ACL got tick torn. And so you have to have that therapy and support to really learn how to keep your tongue in a whole new place and learn those new patterns.

Grace Gerke, PA-C: Yeah, that makes sense. Yeah, I know when my mom, it was kind of a fringe thing, but when I was getting ready to possibly get jaw surgery in high school, there was this tongue therapist in town.

Grace Gerke, PA-C: And so I started going to this tongue therapist, you know, here I'm like a teenager to like learn the tongue on the spot and doing all these different tongue exercises.

mistybridges: Mm-hmm. Mm-hmm.

Grace Gerke, PA-C: And I think the hope was like, well, maybe that will just, you know, make her jaw be the right size and not have an open bite now. And I think at that point it was probably a little bit too late, but the things I learned have still,

Grace Gerke, PA-C: stuck with me, you know, of like waking up in the middle of the night and being like, is my tongue up, you know, and, um, I have gotten in the habit personally of, because my mouth, if I don't mouth tape it at night, my mouth will just kind of drop open. And so something like a little piece of silk tape has helped me to just keep my tongue in the right position for sleep, at least. Um,

mistybridges: Right. Yes. So the tongue, you know, I always tell, especially the kids, it's like, I want your swallow pattern to be your built-in myofunctional therapy forever.

Grace Gerke, PA-C: Wow.

mistybridges: Because if you are swallowing roughly 2000 times a day, we need it working to our advantage and not working against us because there again, form and function and muscle always outweighs

Grace Gerke, PA-C: Yes.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: the bone. So if we're hitting it correctly, we're going to be supportive.

Grace Gerke, PA-C: Yes.

mistybridges: And that's very, very true for orthodontic therapy, you know, orthodontic treatment that they've had because your tongue and your lips really are your built in retainers because we, there are so many times that you can, or you probably know somebody that has relapsed or have an open bite after braces.

Grace Gerke, PA-C: Mm-hmm. Yes. Mm-hmm. Yes.

Grace Gerke, PA-C: Yeah.

Grace Gerke, PA-C: Yes.

mistybridges: Well, the function most likely wasn't corrected prior to that and you know just there again the swallow pattern but equally the resting posture so if the tongue continues to stay low that's not supporting the upper jaw and the lips

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: Yeah.

Grace Gerke, PA-C: Mm-hmm. Mm-hmm.

Grace Gerke, PA-C: Yeah, because it's basically our tongue. I was taught by Dr. Capps, our son's orthodontist that you work with. you know The tongue's really what's expanding your top jaw, right?

Grace Gerke, PA-C: The maxillade.

mistybridges: exactly

Grace Gerke, PA-C: So it doesn't matter genetics as much. It's it's up to your tongue to give that maxillade expansion. Our lower jaw has some genetic component. you know There's people that just naturally have a big bigger lower jaw, but At the same time, when our tongue is up, it helps, is that correct, to bring the jaw out in a good form?

mistybridges: Yes. Yes, because if you think about, you know, your tongue is the guide for forward development and then the lateral expansion.

Grace Gerke, PA-C: Mm-hmm.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And our teeth, they always want to come together. So when they they want that occlusion, they they're looking for one another. So if we are expanding and growing and guiding the jaw in an appropriate manner for airway support, then the lower jaw is going to come up too, and it's going to meet.

mistybridges: So if we... If we really had good function and chewing patterns and nasal breathing, we could really offset a lot of the myofunctional disorders in the dental crowding and the need for a lot of orthodontic treatment later.

Grace Gerke, PA-C: I've been joking with my kids recently. We try to get them to eat an apple a day. It doesn't always happen. You know, the whole old saying an apple a day keeps the doctor away but I'm like I wonder if it's more about the whole apple like is it because of the nutritional value of the apple or is it like the biting you know is that saying but I don't know the more I've looked into this I'm like maybe it's not just you know the micronutrients and macronutrients that we're taking in but how we consume it you know if it's all smoothies which ah smoothies healthy but

mistybridges: yes

Grace Gerke, PA-C: We can't get all our nutrients through a smoothie like in Wall-E know, where they're going around with their like smoothie hamburgers.

mistybridges: Yes. Yes.

Grace Gerke, PA-C: of It's like we want to do that.

mistybridges: Yes. honey to No, i the I think you're right.

Grace Gerke, PA-C: Let's say that again.

mistybridges: I think it's all, I think it's all the above because i we want them to be able to, to chew, you know, a good 20 times, maybe 30 times before they're ready to swallow.

Grace Gerke, PA-C: Yeah.

mistybridges: But also if you think about, like you were saying that the micronutrients in an apple, the, all of the polyphenols and the antioxidants,

mistybridges: In an apple, I think there's like over 400 versus if you were to take you know an isolated vitamin, you're not getting all of the synergy with all of those vital nutrients working together.

Grace Gerke, PA-C: Wow.

Grace Gerke, PA-C: the

mistybridges: You're getting bits and pieces of that in a laboratory made.

Grace Gerke, PA-C: Yeah.

mistybridges: So I think there was just it's underrated what an apple can do for you.

Grace Gerke, PA-C: Yeah. Yes. yes Do you want to just shift gears a little bit to share a little bit more about your nutritional piece and what you can, um, offer with your, is it called food first approach?

mistybridges: Yes, yes.

Grace Gerke, PA-C: Yeah.

mistybridges: Thank you for asking. um You know, I realized that so much of what we do as myofunctional therapists is talking about the chewing and the swallowing because that that is so important.

Grace Gerke, PA-C: Okay.

mistybridges: And when we have a dysfunction with mouth breathing, we also have a ah disruption with the oral microbiome.

Grace Gerke, PA-C: Wow. Wow.

mistybridges: Well, also that nasal microbiome and everything, you know, is one track. So we have the, the gut microbiome and there's so much information now.

Grace Gerke, PA-C: Wow.

mistybridges: People are hearing about all the time, probiotics, probiotics for your gut, but we also need probiotics for the upper track too. And if we have, um, anybody, no matter what age, if you are mouth breathing a lot,

Grace Gerke, PA-C: think about that.

mistybridges: Maybe you're more susceptible to decay because of the pH challenges.

Grace Gerke, PA-C: Mm-hmm. Mm-hmm. Mm-hmm.

mistybridges: Maybe there's a little nocturnal reflux and you know, it's not because you made a greasy piece of pizza.

Grace Gerke, PA-C: the

mistybridges: It's more of that airway and that vacuum that, that kind of pulls. And so I actually, when I was in hygiene school, i I really, really loved the nutrition piece of that.

mistybridges: And I realized just through my own health journey, being a cancer survivor, you know, for a long time now, I really wanted to support my body with what I, you know, what I put in and on my body anyway.

Grace Gerke, PA-C: Yeah. Yeah.

Grace Gerke, PA-C: yeah

mistybridges: But it just really coincided with what I'm doing here with no matter if it's a child or an adult. And looking at the body as a whole and and looking at the whole timeline from prenatal history to birth to childhood diseases, all of the things that um can be triggers or traumas that we've had that may lead to if we've been diagnosed.

Grace Gerke, PA-C: Yeah.

mistybridges: So I'm not looking at the diagnosis. I'm looking at the terrain or the soil and trying to support that. So we can use food as medicine to help heal our bodies or to support our healing process. and And a lot of the the children that I see you know they they don't like to eat raw fruits and vegetables.

mistybridges: And so that's when I can help guide them to alternative methods to do that, but also helping to support their oral microbiome and their gut microbiome.

Grace Gerke, PA-C: yeah

mistybridges: Because if you if you have a child that's sick all of the time and they're constantly on antibiotics, we need to constantly rebuild that. And, you know, we need to be supportive. So I've just kind of taken that piece, the nutrition piece, and folded it into what I do.

mistybridges: But I also can separate it out. And I do work with clients for functional nutrition, that we're not doing anything malfunctional.

Grace Gerke, PA-C: Yeah. Yeah. And you even can offer supplements like I took them growing up juice plus or things where if maybe you're not all the way to the kids eating the raw fruits and veggies, you could have something in a pill or gummy form that could help kind of be a bridge, if you will.

mistybridges: Yes, it just bridges the gap between what we can or don't eat And the thing about Juice Plus that I love so much is that it's food. It's 100% food.

mistybridges: It has over 50 gold standard research studies. So it's not an isolated vitamin. It's very, very thoroughly tested.

mistybridges: um The research institutions are just amazing at top of the line institutions that have done their own research and you know i've had I've had a lot of breakthroughs with some children that have been on the white diet or very bland diet.

mistybridges: and it and Even my own son, we started him, he you know he got to that phase where he wasn't allergic to anything that I know of, but you know he would hear his friends talk about, oh, I'm allergic to that and I don't want to eat that.

Grace Gerke, PA-C: Yeah. Yeah. Yeah.

mistybridges: and you know He only wanted to eat what his friends were eating. I'm like, well, So it became a challenge and you know, you kind of have to pick your battles sometimes. And so I introduced the children's health study where he could get the juice plus for free.

mistybridges: It's probably what you did too. i don't know if if you did it when you were younger and, um and I just didn't say anything, you know, sometimes he would be good about taking them and sometimes not so good, but over time, the compound effect.

Grace Gerke, PA-C: ah yeah

mistybridges: you know, I remember the days like, I think I want to take a salad to lunch.

Grace Gerke, PA-C: More that, yeah.

mistybridges: I don't care what my friends think, you know, and it just really, when you're, when you're giving your body, what, whatever you're giving it, whether it's sugar or whole foods, it's going to crave more of what you're, you're getting.

Grace Gerke, PA-C: Yeah.

Grace Gerke, PA-C: more of that yeah

mistybridges: So, and now they have a a powder form where it's not necessarily a a chewable gummy or a capsule, which most kids can't swallow, but Yeah, it's just been really great to be able to offer that.

Grace Gerke, PA-C: Yeah, it's kind of the same principle. I know they've done studies. If a woman eats really nourishing, nutritious foods when she's pregnant, the chances of a cho you know a baby like being open to more diverse foods is greater. Or same with if babies get diverse foods when they're a baby, then they're going to not have as much trouble probably as a toddler, right?

Grace Gerke, PA-C: Because it's like their palate has experienced, like you're saying, like when you taste authentic foods, you don't like, you know, Pop-Tarts or, you know, something like that.

mistybridges: Right.

Grace Gerke, PA-C: But then if all you've grown up on is McDonald's and Pop-Tarts, then it's hard to enjoy a fancy Italian, you know, made from scratch meal or something like that.

mistybridges: Right. That's true. Yes. I know. And I don't know. You've probably seen in my office where I have The happy meal from 2008, still sitting on my shelf, the same, it looks the same as the day I bought it.

Grace Gerke, PA-C: That's crazy.

mistybridges: It's just, it's crazy. little, little petrified, but no mold.

Grace Gerke, PA-C: It literally can't can't go bad. It's that fake.

mistybridges: Right.

Grace Gerke, PA-C: Yeah.

mistybridges: Yes.

Grace Gerke, PA-C: And that's, I feel like a whole nother topic of just food and, you know, There's so many, I know we touched on it when we were in person last of just with all these issues, there can be a lot of mom guilt, you know, oh my goodness, I'm the lights are shining. I realized my kid might have a tongue tire. Oh my goodness.

Grace Gerke, PA-C: We have some oral dysfunction. You know, what kind of encouragement can you give to a mom who's starting to feel overwhelmed? Like, I didn't know that chicken nuggets and French fries were every meal where it wasn't ideal, you know, like,

Grace Gerke, PA-C: What encouragement could you give to us?

mistybridges: Yes. Well, first of all, I want to tell everybody there's no mom guilt because i would be first in line with the big neon sign, mom guilt, because I look back and just think that only you know we did the best we could with what we knew.

Grace Gerke, PA-C: Yes. Yeah.

Grace Gerke, PA-C: Yeah.

mistybridges: okay But when you know better, you do better. i mean, I remember early in the in the dental office cleaning kids' teeth and I would give them a free...

mistybridges: you know, happy meal coupon.

Grace Gerke, PA-C: Yeah. Yeah. Mm-hmm.

mistybridges: I mean, you know, but um there's no mom guilt because in some mom, I want to meet you where you are.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: Okay. Because maybe that's the only thing that your child is eating is chicken nuggets. Well, okay. We can, we can start slow. We can make one simple change and let's, let's find out what works. And maybe, you know, it,

mistybridges: but maybe different therapies. Maybe a lot of times I may need to so to kind of say, maybe you need to see this person first and then come back to me.

Grace Gerke, PA-C: Yeah. Yeah. Yeah.

Grace Gerke, PA-C: yeah

mistybridges: are you know So i don't I don't want anybody to think it's too late for your child. I have adults that are in their 70s that I'm seeing, and it's never too late to breathe better, right? or to improve our oral health or our nutrition or our sleep and breathing.

Grace Gerke, PA-C: Yeah. And that's, yeah. So encouraging to hear that you even have elderly patients who are like wanting to make improvements in their life. And so it's kind of just like maybe doing the next thing, like maybe it's buying that chewy tube, like you said, or just being more aware, having that awareness.

Grace Gerke, PA-C: Do my kids have their tongues down in their mouth? You know, are they breathing through their nose with their tongue up most of the day? Um, would you, um, let's see, just want to share as we're closing, just how people can reach you.

mistybridges: Thank you.

Grace Gerke, PA-C: We'll definitely include it in the show notes as far as people getting scheduled for myofunctional therapy. I know we live in East Texas and you were kind of like, well, you're like the best, one of the first in Texas.

Grace Gerke, PA-C: But you were kind of like our only option, you know, and we didn't want to have to drive to Dallas, you know, to do therapy. And so we were so thankful for your help, but maybe even how you could reach women who are more rural or don't have all those options that a big Metroplex has.

mistybridges: Absolutely. So i I do like to give options because, you know, we have, like i like we talked about good, better and best.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And if maybe all you can do is come see, you know, me for just a consultation and get a little bit of guidance of what you can do at home to help.

Grace Gerke, PA-C: Yeah. Yeah.

mistybridges: Maybe your child is thumb sucker, but you just really can't make, you know, the the little habit program work. I can help direct you in and things that you can do.

mistybridges: Maybe adding on to that would be, you know, adding the myomanchu or a little therapy tool. And then from there is helping you find maybe a pediatric dentist or an orthodontist focused on airway or tongue ties, one of the specific providers that you need.

Grace Gerke, PA-C: Yes. Yes.

mistybridges: And you know, allowing you to have the knowledge of what's out there. So you're better equipped to make a decision of what you can do and what you can afford and your time.

mistybridges: um i you know, am certified through the international, of the IOM. And if you go to the IOM.com and we'll put that in the, in the show notes, I know you'll have that in there.

mistybridges: There's a list of all of our therapists and,

Grace Gerke, PA-C: Okay.

mistybridges: Um, I just think it's important because being certified just adds another layer because it, it really took me a good year and a half to become certified because we're doing ah a written evaluation with all different phases of, of.

mistybridges: Cases and in therapy and, and then we are, you know, doing an onsite with clinical observation and really learning how to use our critical thinking skills.

mistybridges: So every child that I see is not a cookie cutter approach.

Grace Gerke, PA-C: Yeah.

mistybridges: There basics that everybody needs to know, yes, but I really try to individualize that. So my website is the East Texas Oral Facial Myology and I'm on Instagram and m and Facebook. ah And then just going to the main IAOM website, if you

Grace Gerke, PA-C: yeah

mistybridges: aren't close that can help guide you.

Grace Gerke, PA-C: Yes, you're

mistybridges: And, ah you know, or you can call me and and I can help maybe I know somebody in your area. Since I've been around for a long time, I i know a lot of a lot of the therapists, so I can help direct.

Grace Gerke, PA-C: a great resource. Yes.

Grace Gerke, PA-C: Yes.

mistybridges: But yes, I can do teletherapy and, you know, maybe you live

Grace Gerke, PA-C: Mm-hmm.

mistybridges: not too far away, but far enough that it's kind of complicated to drive all of the time. Maybe we just do every now and then in the office.

Grace Gerke, PA-C: council

mistybridges: So, you know, as long as, you know, the internet is good and, you know, we can, COVID really made that happen.

Grace Gerke, PA-C: Yeah.

mistybridges: So we got really good.

Grace Gerke, PA-C: And it feels like yeah with an older kid, it's not as critical. Maybe a three-year-old would be more challenging on the computer, but more training for the parent to do it with the child.

mistybridges: Yes.

Grace Gerke, PA-C: Okay.

mistybridges: Yes.

Grace Gerke, PA-C: Yeah. And then... I don't know. Is there anything? Thank you so much for your time today, Misty. Anything we haven't talked about or that you would want to just share more about in closing?

Grace Gerke, PA-C: We're going to include all of your information in the show notes as well as, like I believe, a discount code for people who are interested.

mistybridges: Yes.

Grace Gerke, PA-C: yeah

mistybridges: um I don't know. Maybe I got a little sidetracked while ago, but we were talking about, did we talk about when I gathered my habit cases and was...

Grace Gerke, PA-C: No, I wanted to talk about that. Yes. Yeah. Could you share with us more about the tongue-tie research you did?

mistybridges: Okay. Sure.

Grace Gerke, PA-C: Yes.

mistybridges: Yes. ah Actually, it was, I gathered a group of 300 of my previous and non-nutritive sucking habit cases.

Grace Gerke, PA-C: Wow. Yes.

mistybridges: So pacifiers, thumbs, fingers, all of the things. And I really wanted to know what was the dominating factor driving that? Was it tongue tie? Was it airway? Because generally, if the tongue isn't in the palate correctly, and then in their mouth breathing, it's usually tongue tie or airway related. So was i was really curious and I was doing a presentation so I wanted to gather that information and over 88% of those non-nutritive sucking cases were airway related.

mistybridges: Now there there was a big overlap with airway and tongue tie over you know 50% but just the tongue tie alone it was still under the airway the tongue tie alone was about 67% so so

Grace Gerke, PA-C: Mm-hmm. Mm-hmm. Yes.

mistybridges: You know, airway is a big, you know, it's a really big issue in our craniofacial jaw growth and development. So I think the most supportive thing that mom can do is in ensure nasal breathing, whether you need to see an allergist or take more of a homeopathic or, you know, natural remedy, find some way that you can mitigate.

mistybridges: Maybe it's looking into mold.

Grace Gerke, PA-C: Yeah. Yeah. Yeah.

mistybridges: But don't be overwhelmed, you know, because I feel like it can be very um overwhelming. You know, you may, mom comes in here thinking their child has one thing, and then we're discussing a whole a long list, and it can be very um overwhelming.

Grace Gerke, PA-C: yeah

mistybridges: So one step at a time, okay?

Grace Gerke, PA-C: yeah

mistybridges: And if you're, if you, as a mom, you're your child's best advocate, And I love the fact that we are in a season, in a culture now that moms are doing the research.

mistybridges: I never asked a question.

Grace Gerke, PA-C: Just do what the doctor says. That's it. Yeah.

mistybridges: Never. And looking back at that, you know, i i can see some gaps. But now moms are really driving that ship.

mistybridges: So if you're dismissed, if you're told they're going to grow out of it,

Grace Gerke, PA-C: Mm-hmm.

mistybridges: maybe Maybe that's because the provider doesn't have the answer.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And the default is they will grow out of it.

mistybridges: Maybe it's time to dig a little bit deeper and continue because if you know your child isn't sleeping well, they're mouth breathing, they're crowded tea, the tide is shifting with early orthodontic intervention.

mistybridges: you know i have a lot of kids that are being treated with early orthodontic intervention by great pediatric dentists and orthodontists, you know, in the, before the age of seven.

Grace Gerke, PA-C: Yeah. Mm-hmm.

mistybridges: And so I would say just keep researching and don't feel like you're made like, you know, I, I don't know why I was thinking that, you know, like my doctor just dismissed me, but if you really feel it, you know something's not right with your child. Just keep asking questions and maybe, you know, not to find the one that you want to hear, but just do a little bit more investigating to make sure that you can find the right provider to help support you because it's never normal to snore. Okay.

mistybridges: And a lot of times that's dismissed.

Grace Gerke, PA-C: Yeah.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And we want to make sure that cognitive function and all of the things are supported.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: And the other thing, you know, big thing that I have, not that I'm treating it, but it's bedwetting.

Grace Gerke, PA-C: Yeah.

mistybridges: And, oh, well, you know, that they'll grow out of it. Well, when they're 12, that really is affecting their social life and their self-esteem and

Grace Gerke, PA-C: It's a sign with something, yeah.

Grace Gerke, PA-C: Yeah.

mistybridges: No, they're not growing out of it.

Grace Gerke, PA-C: Yeah.

mistybridges: So dig a little bit deeper.

Grace Gerke, PA-C: Yeah. Yeah. That's, I mean, been a lot, our story because I had jaw surgery. dream I had ah another family member who had jaw surgery. So it's like, I do not want my kids to follow in my tracks in that way.

Grace Gerke, PA-C: So with one of my children, we did an early consult for orthodont or early orthodontics and the orthodontist more traditional, just kind of laughed at me. I mean, he,

Grace Gerke, PA-C: I brought up some of these words, you know, myofunctional or this or that. And, you know, it's like he had never, never even heard of it, you know? And so he just, oh, you're he'll be fine. Just wait till he's 12, you know? And I, you know, I'm thankful that we had some friends and people like you who I was able to ask some more questions to, you know, not necessarily that he's doing a bad job, but just, okay, I think in my case with my child, we're going to do something differently.

Grace Gerke, PA-C: And, you know, it I feel like it's similar in the medical field, you know, something's kind of frowned upon or people don't care like smoking in the past or aspartame, you know, and now it's kind of, Oh, common knowledge, you know, smoking's not that great for you or, Oh, don't, don't be doing that sweet and low, you know, but for so many years, people would just say, Oh, there's no big deal.

mistybridges: Mm-hmm. Mm-hmm.

Grace Gerke, PA-C: You know? Um, I mean, that was kind of in the ENT world. you know, we do sleep studies, we try to make sure someone doesn't have sleep apnea, but if they mouth breathe and don't have sleep apnea, and you know, it's like, well, I think they're fine. Everything's good, you know, and that that's just kind of, you know, the traditional Western approach versus more of a functional medicine, like, okay, this issue isn't as big as sleep apnea, but there's still something there, like you're talking about the airway.

Grace Gerke, PA-C: And it seems like that is becoming just an increasing area of, as a society, we need to like wake up and like look into it, right? For adults and children.

mistybridges: Absolutely. And especially when you're taking your child in for their cleaning, they should be doing an airway exam, just like we do a cancer screening.

Grace Gerke, PA-C: Wow.

Grace Gerke, PA-C: Yeah.

mistybridges: You're looking at the same tissue. You just maybe need to ask a few more questions.

Grace Gerke, PA-C: Mm-hmm.

mistybridges: So, you know, and a lot of people, it's true, you know, they, professionals, medical, dental, they never heard of myofunctional therapy.

Grace Gerke, PA-C: Yeah.

mistybridges: So maybe they think Oh, would this is just some new fad.

Grace Gerke, PA-C: yeah

mistybridges: But it actually started in the early 1900s with an orthodontist recognizing form and function. Like something's not right here with the tongue and the the mouth breathing. So it has been around a very long time.

mistybridges: Well, the IOM has been around. i mean, we've celebrated 50 years of training therapists.

Grace Gerke, PA-C: Wow. That's amazing.

mistybridges: It's just very...

Grace Gerke, PA-C: Public awareness.

mistybridges: small group, but now we have many, many more that are being trained.

Grace Gerke, PA-C: Yeah.

mistybridges: And hopefully now with the way social media is, you know, there's so much out there now that it's more accessible to learn these things. But yeah, we just still need to keep talking about it and going back and always tell my families, it's like, go back and share with your primary care or your pediatrician And let them know the things that we found, because I would love to have a conversation with them.

Grace Gerke, PA-C: Yeah. Yeah. Yeah. Again, that bridging the doctors or specialists aren't the enemy and the natural alternative therapists aren't either. It's like, we need that bridge of connection. And I know you are doing that so beautifully in your practice. You know, you take care of medically complex children and you're able to really, um,

Grace Gerke, PA-C: navigate that nuanced care where you're giving that individualized specific approach that is different. It's not just a copy paste. And I really appreciate that about you, Misty, for our own personal experience.

mistybridges: Thank you.

Grace Gerke, PA-C: And I hope our audience has enjoyed hearing from you as much as I have. And we will include all of that information so that people can reach out and connect with you coming up.

Grace Gerke, PA-C: So thank you so much.

mistybridges: Yes, and, and maybe I have ah a little checklist that I will give you that you can ah kind of like an awareness checklist for moms to look.

Grace Gerke, PA-C: Oh, thank you.

mistybridges: Yeah.

Grace Gerke, PA-C: That's yeah. Having something quick to look at is a big part.

mistybridges: Yes.

Grace Gerke, PA-C: So yeah.

mistybridges: Well, I'm honored that you had me on your show. i appreciate that. It's always pleasure.

Grace Gerke, PA-C: Yeah. Thank you. Oh, thank you so much, Misty. Well, have a great rest of your day today. Bye.

mistybridges: Same to you. bye