NBS #134: The Hidden Link Between Teeth, Sleep & Whole-Body Health

Straight teeth do not always mean healthy teeth.

In this episode of Never Been Sicker, Michael Rubino sits down with Dr. Azadeh Afzali to discuss functional orthodontics, sleep dentistry, TMJ, gum disease, root canals, implants, airway health, and the deeper connection between oral health and the entire body.

Dr. Afzali explains why traditional orthodontics often focuses too heavily on appearance, while functional orthodontics looks at the root causes behind misalignment, bite dysfunction, airway restriction, sleep apnea, jaw pain, and long-term oral health problems.

In this episode, they discuss:
✔️ Why straight teeth are not always healthy teeth
✔️ How your bite can impact headaches, TMJ, grinding, and pain
✔️ The connection between oral health and whole-body health
✔️ Why airway and sleep matter in dentistry
✔️ How narrow palates can affect breathing
✔️ Root canals, implants, gum disease, and bone loss
✔️ Why some orthodontic extractions may contribute to future problems
✔️ How functional orthodontics can help address root causes
✔️ The personal story that led Dr. Afzali to develop her approach

If you have struggled with TMJ, sleep apnea, clenching, grinding, headaches, gum issues, or have been told your only option is surgery, this episode offers a new way to look at oral health.

Chapters
00:00 – Meet Dr. Azadeh Afzali
02:06 – What Is Functional Orthodontics?
03:10 – Are Teeth Connected To The Whole Body?
05:48 – Root Canals & Missed Root Causes
07:45 – The Mouth-Body Connection
09:37 – Why Implants Aren’t Always The First Answer
12:20 – What Dr. Afzali Looks For In Patients
13:46 – Gum Disease, Bone Loss & Bite Dysfunction
17:30 – What Causes Traumatic Bite Problems?
20:48 – Myofunctional Education & Jaw Development
21:16 – The Story Behind Vital Ortho
23:06 – Avoiding Double Jaw Surgery
25:24 – How Her Son’s Bite Changed In 11 Months
26:19 – TMJ Pain, Sleep Apnea & Complex Cases
29:41 – The Body As An Ecosystem
30:42 – Air Quality, Sleep & Teeth Grinding
33:47 – Bone Cavitations & Healing
37:50 – The Biggest Lie In Orthodontics
40:14 – Why Straight Teeth Are Not Always Healthy
41:39 – Sleep Apnea & Old Orthodontic Practices
44:37 – What Is TMJ?
47:40 – How Bite Dysfunction Affects The Jaw Joint
49:14 – Sleep Apnea, Clenching & TMJ
52:00 – Where To Find Dr. Afzali

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As a dentist, a mother, and a lifelong learner, I've always believed that true beauty beings with balance - inside and out. Over the years, I've met countless patients who were told that jaw surgery or tooth extractions were their only options. I knew there had to be a better, more compassionate way. That's why I developed VitalOrtho TM. A holistic, non-surgical orthodontic protocol that restores natural bite function, support TMJ health, and improves airway flow through gentle, guided expansion of the palate. By helping the face develop as it was meant to, VitalOrtho brings together function, beauty, and breath in a way that feels as natural as it looks. As a mother who faced these same challenges with my own child this method is deeply personal. It's not just about straightening teeth - it's about protecting confidence, health and long-term well-being without compromising facial structure or resorting to invasive procedures. 

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Transcript

SPEAKER_01 0:04

My name is Michael Rabino. I'm on a personal mission to make sure you don't get sick inside your own home.

SPEAKER_00 0:09

I knew there was something wrong. I'm just so believed there's something that you can do about it.

SPEAKER_01 0:15

Hello and welcome to another episode of Never Been Sicker. I'm your host, indoor air quality expert, Michael Rabino. And today's very special guest, Dr. Azadeh Avzali.

unknown 0:26

Dr.

SPEAKER_01 0:26

Azadeh, thank you so much for taking time out of your busy day to be here with us. Can you share a little bit about yourself and let everyone know why you're here?

SPEAKER_00 0:34

Michael, thank you so much for the invitation. It is really, I'm very excited to be on your podcast and talking to your audience. Yeah, uh I like to I'm really excited about the opportunity to share some of my life experience, some professional experience, and with the hope that uh can benefit people.

SPEAKER_01 1:02

Well, I'm really excited too, and I know for sure we're gonna get some benefit out of listening to you speak. So so really thank you for the time here. Yeah, can you explain a little bit about what you do with your life's work and your mission?

SPEAKER_00 1:16

Absolutely. Uh currently, basically, my focus is on functional orthodontics and sleep dentistry, which is uh geared toward a root cause uh approach to both orthodontics and sleep disordered breedings and temporandibular joint disorders known as TMD. That's my focus, and my patients uh are both uh young adults, even children uh at the preventative level. I start uh working with patients as young as five, six years old, and then go to young adults and then to adults. Uh, and patients I have patients that are uh in their 60s, in their 70s, and it's still you know, there are ways that I can assist them and support them.

SPEAKER_01 2:10

Wow. And you know, for those that don't know, because obviously I think a lot of people know what functional medicine is. Can you explain a little bit about the field of uh functional orthodontics?

SPEAKER_00 2:20

Absolutely. Basically, the traditional orthodontics function is on the alignment of the teeth, and uh the end result is uh aesthetic and beautiful smile. The aesthetic and beauty is the main focus. In functional orthodontics, although we do achieve the aesthetic results and the beautiful smile, even in some senses, since we address the functional issues, it is long-lasting and even more enhanced. But the main focus is the root cause approach, finding out what are the dysfunctions, what are the root cause of the misalignment of the teeth or the spaces between the teeth. You know, we go deeper to the root cause, and then by addressing those, we fundamentally resolve the issue, which is permanently and also with amazing results, both at the aesthetic level and at functional level.

SPEAKER_01 3:24

Now, I've recently heard that you know you have to almost look at each tooth as its own organ, which if you do that, that would really concentrate a ton of organs in one centralized area of the body. Do you have that same philosophy where each tooth is its own organ and making sure that each tooth gets the care it needs?

SPEAKER_00 3:46

That's a very uh interesting concept. And in fact, I've been working with this concept for years. It's based on the meridian pathways and the connection between each tooth and the uh different organs of the body. And when you look at the mouth and the teeth from that perspective, your viewpoint changes. Then extraction of a tooth or allowing a tooth to decay or to crack or be traumatized, be under constant uh uh trauma of the bite, resulting into fracture, root canals, and eventually loss of the teeth becomes a very obsolete viewpoint. Uh, and um, in my own practice, I have had um situations that the patient would come for a second opinion to me, and you wouldn't find uh any decay on the tooth, and the um because the tooth was hurting, uh, the patient was recommended to have a root canal, and the patient you know came to my office for a second opinion. And when I uh examined the tooth and I did the x-ray, I didn't find anything to the tooth. But by having this viewpoint and understanding that the canine tooth is also connected to the organ of the body, the liver became a concern for me. I started asking the question about any type of symptoms that would translate to liver toxicity, liver overload, or something that has to do with the internal organs. And as a result, not only the patient was able to say the tooth and a beautiful, I remember that vividly, a beautiful healthy tooth that um would be heartbreaking for me to see that patient to get a root canal. Not only the tooth was safe, but honestly the patient's life was safe because you know, just going into a root canal situation which would not resolve the solution, the root cause of the problem would be remain hidden, which could uh build up into a much more severe situation.

SPEAKER_01 6:02

That's so interesting. And and I've commonly heard that traditional dentistry they they typically go to that root canal as a as a you know as a solution uh to pain, and obviously root canals as a result have been sort of increasing and on the rise, um, but yet people are still experiencing pains and symptoms because they're not actually addressing the root cause. Why do you think that is? Why do you think um you know traditional dentistry is always providing root canals as a solution, even though it doesn't always uh handle the problem?

SPEAKER_00 6:35

Yeah, you know, it's the traditional um schooling and traditional education that are provided in our dental schools and the curriculums are very um geared toward um the traditional uh treatments and the modern uh findings and understanding about the connection between the oral cavity and the whole body, I think is lagging way behind. And we have a long way to go that route. And that's one of the reasons that I have really taken upon myself to educate the consumers, you know, at the level of consumers, at least bring the awareness that when people are looking about their oral health, they search for uh dentists that have a better understanding about these systemic connections. And um as long as we are uh continuing to uh stick with those uh traditional solutions and traditional curriculums, uh it is going to be a very slow process to really understand the connection between oral uh cavity and the rest of the mouth. Of course, we are slowly moving to a very slow degree, like the connection of the gum infection to the heart problems and you know, the systemic issues, this is becoming more popular than like let's say 20 years ago, 30 years ago, but still I think the rate is very, very slow compared to the necessity of it, the importance of it. And unfortunately, what happens is that when we are going with that viewpoint, when we look at the truth as an isolated concept uh and completely disconnected to the rest of the body, and we just go and hammer it down. Okay, we fill it, we do the root canal, and then the root canal fails, and then we pull it, and then we do an implant, and then what would be next? You know, and the more we go with that path, uh, I think we will be on the path of a duendling spiral going down. Like the concept of um uh uh uh extraction of natural teeth uh and replacing them by the concept of all on four or all on six, which are dental implants. Uh I am very cautious about that. And in fact, I try to do a lot of education uh to patients, and when people come, I have had patients coming to my office for second opinion, that I was able through orthodontics remove the root cause of their problem, which was causing the mobility, which was causing the bone loss, by addressing their bite, by bringing harmony into their bite and restoring their function, saving all of their teeth, and the teeth become nice and solid, you know. And um, that's what I like to um really spread, you know, the word that I like to um get across to as many people as possible is that look at the root cause. If you are losing your teeth, if your teeth are becoming loose, if you're having bone loss, don't think that getting rid of the teeth and replacing them with titanium implants in your jaw is the solution. Because what would be next after those implants given when the function, when the structure is compromised, what are you gonna where are you gonna go next? And unfortunately, all of these um invasive procedures are very traumatic, not only emotionally, but also structurally and functionally, it takes a toll on the body. And I have uh witnessed some people that really didn't do very well with this type of procedures. They do have their place, you know, and it is I believe implants are one of the greatest uh adventures in dentistry, but it has to be used sensibly.

SPEAKER_01 11:15

Yeah, I can see that. You know, I I really appreciate you spreading the awareness about that, you know, and I think that functional medicine as a whole is something that I really enjoy and agree with just because it does focus on that root cause, you know, and I think we should be looking at it at that advancement across all industries of medicine because, like you said, we seem to be on this dwindling spiral. And uh, you know, it's not just happening in dentistry, it's just happening in overall health. I mean, our global health is declining, right? Uh autoimmune disease and autoimmune conditions are on the rise. There's a reason we call this podcast Never Been Sicker, it's because we have never been sicker. And so we got to get off this dwindling spiral as quickly as possible. And I think looking at root cause is how we do that. So I really appreciate you spreading that awareness because I think it's so needed. You know, you mentioned uh gum disease and how that can be tied to the heart. You mentioned obviously a tooth and how that can be tied to the liver. What are some of the what are some of the things that you can actually help a person identify by uh really addressing things in your practice? Like if somebody's coming in for certain pains or certain things, what are some of the questions you're asking? What are you helping people uncover through this root cause approach?

SPEAKER_00 12:34

Yes. Uh I go by the viewpoint of the holistic viewpoint about the connection between the mouth and teeth uh as a unit. Like I look at the tongue, I look at the structure of the jaw, I look at the structure of the palate, I look at the airway. My exam is very comprehensive. I um look at the tempomandibular joint, which is the jaw joint that we have. This is the temporal bone, this is the condyle and the uh the uh the head of the condyle, and this is the mandible, and that's called tempomandibular joint, which is the very active jaw joint that is responsible for our articulation, chewing, uh, breeding, you know, it's all of our a lot of our functions that uh are connected to this joint. So when I do my exam, I look at the foundation. I want to make sure that I have a good grasp of where the foundation is, and if there are any uh deficiencies in the foundation, I like to identify those because I just give you an example. We can look at a gum disease. Uh in fact, prior to this approach, even in my own practice, like years ago, when we were looking at um treating the infection of the gums individually and not connecting it to the alignment of the teeth, to the crooked teeth, and also to the traumatic bite, we had to exhaust our energies on doing uh deep cleanings and uh irrigations and laser treatment and uh you know uh antibiotic treatments at the uh like arresting placement of the antibiotic around the pockets to really go by the defensive mechanism to try to arrest the infection and give the tooth a chance of recovery. And honestly, um with all the efforts still the condition would just stay under control. You know, those days when um these concepts of functional orthodontics was not part of um uh our knowledge, we would even tell patients that uh, you know, once you get the gum disease, this is something that there is no cure for it. You just need to maintain it so the infection uh doesn't uh get to a point, you know, the infection is absent, and also uh you be able to avoid uh a spread of infection to your uh internal organs. That was what we uh the not the degree of expertise that we were able to deliver to our patients. But then as I started taking the path of functional orthodontics and really putting all the pieces of puzzles together, and I started treating these plum disease patients, you know, which I have the cases, these people with excessive bone loss, with persistent periodonal disease, that we were doing deep cleaning and everything, and we were not having a major, I would say, arrest of the disease. Not only we started seeing that the disease is disappearing, but we also started seeing bone growth and gum growth. And that really has been uh emerald uh in our practice that we bring the patients with gum disease and with um periodonal disease, and we help them not only to completely overcome their periodonal problems um but also recover, uh go through the recovery and regeneration process. That is our regenerative orthodontics section. So within my practice, uh our practice, I have divided the functional uh orthodontics, the regenerative orthodontics, and then the sleep uh dentistry.

SPEAKER_01 17:19

Wow, that's incredible. So you said about 50% of the patients you're seeing, they're dealing with some sort of gum disease or bone loss.

SPEAKER_00 17:27

Absolutely. I think in some, depending on the demographic, in some uh demographic, it's even higher than that. Yes.

SPEAKER_01 17:37

What do you think the cause of that typically is? Or obviously, what are the some of the patterns that you're seeing with some of the causes of those?

SPEAKER_00 17:44

The pattern is the basically the uh dysfunction of the bite. When the bite becomes traumatic, and we can take it one step further that uh the modern living has really uh introduced our bodies um to uh a structural changes. You know, I strongly believe that function monitors a structure, uh, and I just give you some examples. Uh by uh breastfeeding um become um uh out of fashion and bottle feeding replaces breastfeeding, and then the past the popularity of the pacifiers. Just these two points, if we look at only these two things and nothing else, which I'm gonna get to the other aspect, these uh really have a direct impact in the structure of the jaw and really setting up our children's oral system and structure for future failures and airway issues. And when we have a child that is bottle fat, and then further uh has been given pacifiers, especially some pacifiers, the shape is even more uh controversial than others, and they end up with a high palate, narrow palate, and a restriction of the uh airway due to the structural deficiencies, then the lower arch start to deform, and the relationship between upper and lower arch goes out of balance. The teeth are not occluding means touching each other properly, where they're supposed to come like hand and glove, and as a result, the bite changes. And the a bite that is supposed to be complementary to the whole mastication system become a traumatic bite because of those structural changes. And in the presence of uh traumatic bite, you start getting quite a bit of trauma to the not only T structure but also underlying bone and periodontium, which is the gum tissue and basically the vascular tissue that is around the bone and the tooth, and is called the periodontium. And by deterioration of the periodontium around the tooth, we get bone loss, we get inflamed gum, deep pockets, and not correcting the root cause, which is the traumatic bite, and the this amount that is in dysfunction, we get exasperation of the problem, and then one thing leads to the other. So the whole concept is how our functions are affecting our structure. That's why myofunctional um education is a big part of my vital ord that I have uh created.

SPEAKER_01 21:23

Yeah, and can you explain a little bit about the vital ordo that you have created? Because it seems amazing.

SPEAKER_00 21:31

Oh, thank you. Yeah, basically that was uh true and necessity and a very um, I would say um to a degree a heartbreaking, a personal struggle. Uh my son uh was um on braces and headgear since he was 11 years old, and then for 11 years he was going. Through different orthodontic treatments. He was, I think, three or four different orthodontic treatments. And then at the end, what we were given was a severe underbite and open bite, and the only option that he was given was double jaw surgery. And this was during the period that I had started at the functional orthodontics. Throughout my career, I had always studied orthodontics, but it was not my main um focus. You know, I was for a long time I dedicated my practice to format reconstructions and TMJ therapies, and I had not got into that part. I have seen these type of surgeries, and really I just feel sick into my stomach when I look at what happens in this surgical room. So he told me that you know this is definitely a surgical case, and he hasn't seen anyone that be able to do this type of approaches without the surgery, and it is not something that he would recommend me to even think about. And of course, you know, I always have this instinct that um I cannot give up. I never give up in life, and if I believe in something, and there must be a way to do it. That was my desire. And especially my son told me something that really ignited my emotions. My motherhood was really coming to a different level. He told me he was 22 years old, and one day he told me, you know, uh, it's not fair that in my best years I look like this. And when I heard that, I just took it upon myself. I said, I don't care what it takes, I am going to figure this out. So I started it. I was seeing patients and I started it seeing cases that were milder than him. It was not as impossible. And this, and I saw that, wow, with what I have figured out, this is responding successfully. Then I worked a little bit in, you know, I pretty much I would say I started identifying the techniques that would give me expansion of the upper palate and bone growth at the level that would not be uh conceivable, you know, without surgery. So I started just working on that, and then one day I told him, you know, I'm ready to go, let's get it started. And I'm so grateful that he trusted me and he let me work on him. And in 11 months, he be his mouth became a functional, beautiful bite, no more underbite, no more overbite. Uh, it just became an amazing bite, and that was really the beginning of this journey for me, because you know, it just became I um I feel so grateful about this opportunity that uh I have, and still, you know, on a daily basis, I keep enhancing my knowledge and technique so I can overcome more challenging cases, because with each one of these cases, I dive into another area and I open another path to solutions. And he also had severe TMJ pain. Unfortunately, the the TMJ, the popping of the joint, the pain, the discomfort, he had sharp pains that when it would hit him, he would just like hold his face. All disappeared, all just went away. And then after his case, I started even taking on more complicated cases. Then I took cases that had tinais. And I I took cases that had sleep apnea. You know, just each one of them, and with each step, uh I got into a new territory of being able to solve a problem that otherwise looked unsolvable without surgery.

SPEAKER_01 27:40

That's incredible. Well, thank thank goodness for your motherly instinct, because it all started there. I mean, it if you didn't have that instinct, you might not have developed some of the processes that you've developed and have been able to help as many people as you've helped now.

SPEAKER_00 27:55

Exactly. And uh, you know, Michael, this has been the greatest gift that I have been given, the greatest opportunity. Because what is life without being able to solve other people's problems? What is life without being able to give someone a beautiful smile that gives them joy, to take away their pain, to give them relief, to give them a life that they're happy with. And honestly, the transformation that I saw in my son has been just incredible. And not only my son, I've seen it in many of my patients. Their life changes, their career takes on. And you know, they they just um go into a different level of existence.

SPEAKER_01 28:47

That's so incredible. Yeah, no, I I really appreciate that because obviously, as you said, you know, people need transformations, and there's not a better life living than helping people solve their problems and being in service to others. That for sure I can agree with.

SPEAKER_00 29:02

Absolutely.

SPEAKER_01 29:03

I saw so many parallels in sort of the work we do because obviously in my field, a lot of people are getting sick from their homes from really bad indoor air quality, and obviously that affects different parts of their body, you know, just from the from the detox pathways, but also some of the neurological impacts it has, of course. I am curious if there's a connection between the toxins that people experience environmentally and how that impacts their mouth, of course. Um, that's something that I I've never been able to research, but I bet you there's always some connection, especially since you found that you're seeing a lot of connection with the mouth in general and other parts of the body. So, but it's you know, to really see people transform their environment and then feel better, um, that's that's that's what this is all about.

SPEAKER_00 29:56

Yes, absolutely. My concept is that um uh our body is uh ecosystem and that uh not only within itself but also with the environment is in exchange. And um, when the our environment becomes too hostile uh and um becomes too toxic, then the body experiences an overload. And this overload, you know, as it relates to what I do, you know, when an environment uh is toxic and there or the breeding is interrupted by that, the uh regenerative sleep is uh interrupted by that, then you start uh going into the again, doing the linear spiral, and you start manifesting, like for example, in an environment that the air quality is poor and it impacts the regenerative sleep, then the body starts to manifest different symptoms, which they can be a wide variety of symptoms, but as it relates to my work, people can start uh manifesting uh deprived uh deprivation from oxygen by teeth grinding and by clenching, and then that leads to muscle tension. Then the muscle tension has a neuromuscular impact and also destructive um uh effect on their teeth and the bite, and then as they start chipping away their teeth, then the bite goes uh out of harmony, and then they further impact the tempomandibular joint, and then they start getting headaches. You know, it's just like we cannot disconnect from this. In fact, one of the things that in my practice I identify uh with all my patients, I check uh their nostrils for a cold breathing for any congestion. When I see their x-ray, I check their sinuses and see if um they are structurally they are in a position that they can copy the environment. And then I think from a standpoint of knowledge and information about um you know the environment of the house and their workplace, uh, it's so crucial that looking at it as an ecosystem. In fact, I have um the entire uh mold control system and you know, even nasal irrigation that I do myself with uh with salt and distilled water, and I do have uh some uh citrus, you know. Uh I I worked with uh I get my products from a company and they that I use, the candles that I use at home for um cleaning up the air. I have air purifiers, three of them in my house. Uh I have about 30 to I think about 35 house plans throughout my indoor, and not talking about the outdoor that are filled with huge land escape and trees for air filtration. I'm a strong believer in that.

SPEAKER_01 33:40

No, that's perfect. I'm I'm really glad that you are a strong believer in that because I think it it really helps make a difference. You know, you mentioned sleep quite a few times. Obviously, we've seen a lot of studies of indoor air quality and how that impacts sleep, and of course, if it impacts sleep, it impacts so many things. You know, our bodies do need sleep. So I wanted to ask your opinion. Um, I've been hearing more rumblings about bone cavitations from some of the older dentistry practices that maybe haven't been done correctly or things of that nature. Do you see that um in some x-rays that that you've taken? Is bone cavitations really something that that is happening quite a bit, or is it more uh something we're still learning about?

SPEAKER_00 34:27

Um you know, through my experience, uh through uh taking panoramic x-ray and even on CTS can it's not something that I see it often. Um honestly, it's not frequent at all. Uh however, I strongly believe that when you are removing uh tutor structure, you need to have a very friendly and suitable environment, including a strong blood clot and the supportive um procedure that uh activates the bone formation and not causing a delay. You know, and this is part of it, is also overall health of the patient. Then, you know, when we lose a truth, what is happening in the bone? The bone starts, the blood clot goes through, forms, and which is very uh fundamental to the formation of the bone, and then it goes through the transformation and remodeling um to calcification and becoming um you know um the bone structure. When we look at our diets these days, you know, we have to look at putting all these things in the perspective of our modern lives. Is our um uh you know, are we having enough nutrients or uh nutrient-dense food that supports the healing process of our body? So um these are the questions that I would ask, and then in our practice, then uh my periodonist does the visdom feet extractions. We do protect the site by bone graft and membrane to allow that healing process and to maximize the you know the healing uh of the bone. Uh also PRP, it's very uh popular and I do recommend it, especially you can either do it by itself or you can mix it with the bone graft. And those are all measures that can help uh the regrowth of the bone. But I would always go with the power, healing power of the body, uh, you know, with the good nutrition, with good rest, and um trying to reduce the stress during the healing process as much as possible.

SPEAKER_01 37:13

No, thank you for clearing that up because you know it's it's obviously been I've I've seen people being talking about it, and you know, uh supposedly it's an upcoming issue from uh years of I guess the old way of dentistry that that is apparently getting corrected. So I loved your opinion on that, and I appreciated that. Um I wanted I wanted to ask that what you know, you've obviously really transitioned into more of a holistic approach, um, more of a functional medicine approach. So as you've as you've really seen both sides of this coin, what's the biggest lie that you've encountered in traditional dentistry and traditional orthodontics that you've really realized is not true as you as you started to practice more of a holistic and functional approach?

SPEAKER_00 38:04

Yes, uh the concept that straight teeth are healthy, and the ultimate goal is to have a straight teeth. In my opinion, this is the greatest misconception in the field of orthodontics, and not only in the field of orthodontics, in the field of oral health. Because you can have beautiful teeth, you can have a straight teeth, but you can have a traumatic bite. You can have a bite that is traumatizing your teeth, your bone, your gum, your tempomandibular joint, and is giving you headache. It happens all the time. I have patients that when they come to me, you know, when you look at the teeth, you cannot really see anything that from the standpoint of the look and aesthetics and straight teeth, you know, they're good. But they're having chronic migrant headaches, they're having teeth grinding, they are clenching, their jaw is hurting, they have ear pain. And when I when we start to harmonize the relationship between the teeth, those beautiful straight teeth need to be in harmony and correct relationship and functional relationship with each other. When we start establishing that, when we start giving restoring functions in the bite, when we start to align the upper arch with the lower arch, and then further align the both arches with the temporomandibular joint and its function and restore a healthy uh apparatus for eating, for chewing, for speaking, for breathing, for functioning, then the magics happen and they are even stunned. Like I have it all the time that my patients come and say, Oh, you know, I no longer uh have a headache. Uh and they forget. I'm I'm so thrilled that it becomes a history and a memory that they don't even want to talk about it, or they don't want to even, you know, think about it. It's something is an event of the past. And it happens because of not buying into that misconception and honestly a very limited view that you have a straight teeth. And then the other side of this is for a straightening teeth, still, unfortunately, even in United States and even in progressive countries, they are still extracting bicuspid teeth to make room to a straight teeth, and that needs to become a function and operation of past, because it is an iarthrogenic um practice, means when uh treatment hurts patient, and imagine the size of each bicuspid is about 10 millimeters, about centimeters. So by extracting four bicuspid, you are reducing the size of the upper arch and lower arch, and as a result, aura cavity by four centimeters, which is huge. The tongue that has a reduced space does not have enough room and is pushed back and blocking the airway. Unfortunately, um sleep apnea is an epidemic because of um this miscon this misconception about uh orthodontics and about a straight tooth.

SPEAKER_01 42:13

That's so interesting. Yeah, I was you know, I was about to ask you next, because you've brought up sleep apnea a few times and obviously sleep deprivation, and you know, I was curious from your perspective, how related is sleep apnea with some of the old ways of orthodontics and how we've um you know sort of created this philosophy. And how do you think that functional orthodontics can help um you know with sleep apnea?

SPEAKER_00 42:38

Um yes, that's a great question. And thank you for asking that because I really want to give hope to everyone. I have experienced it in my practice, even patients that have had bicuspid extracted and they had severe sleep disorder issue to the point that you know their health was in danger, you know, like falling asleep while driving. Uh it's a pretty severe type of situation. I've been even able to expand their jaw and to help them um to um function better and to create more space for time, but it is uh uh a direct side effect of uh this old-fashioned orthodontic philosophy that uh instead of creating room by enhancing the sizes of the arches and making room for the teeth to move into, forcing teeth to become straight by extraction of the adjacent teeth and trying to create um a space by elimination of teeth. And as I said, when you go with that practice, you are reducing the volume of the oral cavity and That's something that has a negative impact in the floor of the nose because our nostrils are sitting on our palate and the shape of the palate, the size of the palate supports the nostrils. You know, in my patients, I have been increasing the palatal structure by centimeters. We're talking about like uh two, three, in some cases four centimeters palatal expansion that you can imagine how it impacts the nasal performance, uh the nostril performance, and a more uh suitable and friendly environment uh for breeding and for um uh upper airway function.

SPEAKER_01 44:51

Can you explain a little bit about TMJ? I know we talked about it briefly earlier on, but you know, can you explain a little bit about what it is and why it's so important?

SPEAKER_00 45:02

Sure. Basically, uh T stands for tempo, which is this bone right in here. M stands for mandible, which is the lower jaw, lower arch. J stands for joint. So it's a tempo mandibular joint where two bones, one from connected to the skull, part of the skull, one from the jaw mandible, they are coming together as something like this, like a socket and ball. And between this ball and socket, there is um soft tissue structure disc which is vascular. Uh it has um it is made of soft tissue and facilitates the movement of this ball in this socket, and that happens that you know, this ball goes up, it comes down, it goes forward, it goes backwards based on the motions that we do, and that's what the flexibility of the joint is. Now, the what we need to really understand is that this joint is directly guided and connected by our upper arch and lower arch. We have a healthy arch in the upper, which is called a curve, a curve of the bite, curve of Wilson. I don't want to go into the technical details, but if we look at it, like the upper arch goes like a smile. It goes up, the back teeth go up, the lower arch goes, the lower teeth are lower and then the back teeth are higher, just like a nice smile. So when we have dysfunction of the relationship between upper and lower arch, these arches unfortunately often change their form. And instead of going this way, a smiley face, it becomes a sad face arch. And that hangs and acts as an interfer for the joint. The first thing that I look at my TMJ patients when they are having severe pain, I look at the shape of the arch. What is the shape of the arch and how teeth are connecting? When I see, you know, that this is like there, then there might be 10 other indicators, but even if there is this indicator by itself, the reverse uh of the curve of the bike, um, we found the culprit, and you know, we know that we can definitely have a positive impact. So, my whole point is that this joint is sensitive and is connected to the form of the upper arch and lower arch and also to the harmony of the smile and the bite, the way that teeth come together, hand and gloves. If there is trauma on one side, let's say there is hyperactivity on one side compared to the other, we are overloading the joint. The joint becomes overloaded in one side compared to the other, and then the results, the body tries to compensate for that by uh neuromuscular method and causes tension in the muscles. Uh, it would be constant uh tightness of the muscles, discomfort and uh you know pain. So uh it is a very sensitive joint, one of the most active joints in the body because uh it is in charge of mastication, swallowing, um, or um speech, and um showing impressions, facial impressions is connected to important structural issues. And another aspect of connection between a sleep disorder breathing and tempomandibular joint is that when the body is deprived from oxygen, then the compensation process goes toward movement of the jaw, grinding of the teeth, or clenching of the teeth, which cause the overload of the joint, and then we can have TMJ issue. That's why majority uh of sleep apnea patients do have um uh symptoms and to some degree TMJ uh problems.

SPEAKER_01 50:22

That's so interesting. And traditional orthodontics and dentistry doesn't really cover uh the TMJ or look at the TMJ for issues?

SPEAKER_00 50:30

Uh you know, it's all depending on um what is the end goal. Uh yes, if the end goal is to bring a harmonious spike and the awareness is in that direction, it definitely is capable of doing it. Um but it does it's not fully adequate um to, in my opinion, you know, I like the expansion of the palate to be in a more holistic and natural way instead of forcing uh through upper expanders. Uh, you know, there are limitations, uh, in my opinion, with upper expanders, and then when you start going through that path and is not in the harmonious way with the whole system, you can actually end up with the TMJ problem. So there are some uh accessibilities and definitely possibilities, um, but um uh in my belief uh there are some issues that are lacking. And um the myofunctional aspect, I think it's the one that probably is mostly pronounced um missing.

SPEAKER_01 51:58

Yeah, I really I really appreciate all you share with us today. Uh, before we go, I do want people to be able to find you, to learn more about all the amazing work you're doing, um, you know, where your practice is. Do you mind giving us some info?

SPEAKER_00 52:14

Absolutely. First of all, thank you for having me. And it's really a pleasure uh to have a platform that I'll be able to share um what I've learned throughout you know 35 years of being in practice and actively um having the goal of being an advocate for my patients, and so that's a great opportunity. Uh yes, I have three dental practices in Southern California, and um I have um the my Instagram account is dr uh dotseli, uh my YouTube is dr.apseli, and also Facebook, I think, is also drapseli. I can provide with those addresses, and I do see patients virtually uh if they do have uh a particular concern and they are out of state and they want a second opinion. Um, you know, I definitely uh have my uh you know uh team reaching out to them uh once uh you know they want to connect with us uh and get uh proper information and see how we can support them and help them.

SPEAKER_01 53:35

That's amazing. Well, we'll definitely have all your social medias in the show notes as well so people can check it out and be able to click right in and find you. So I really appreciate that. Thank you so much for taking time out of your busy day to be here with us and share all of your amazing wisdom. It was so helpful and so needed and wanted.

SPEAKER_00 53:54

You're most welcome and thank you for the opportunity in the India Global.

SPEAKER_01 54:00

Well, I can't wait to have you on again. I'm sure this won't be the last time. And thank you so much, and we'll see you soon.

SPEAKER_00 54:06

Thank you.