The DOC Podcast

Overview
In this episode, I sit down with Dr. Peter Catalano - an otolaryngologist, rhinology fellowship director, and pioneer of minimally invasive nasal surgery. Dr. Catalano has held appointments at Mount Sinai School of Medicine, the Lahey Clinic, and Tufts University, and has spent over three decades developing and publishing on targeted nasal airway surgery. I've had the privilege of working with Dr. Catalano on a major article addressing mouth breathing, and our conversation here is one of the most important I've had on this platform.
We go deep into the science of nasal airflow, the structural and institutional barriers preventing children from getting the care they need, and the very real consequences (neurological, behavioral, cardiovascular, and craniofacial) of untreated mouth breathing and sleep-disordered breathing. We also address the myths and dogmas that continue to persist in both the ENT and orthodontic worlds, and what it's going to take to break them down.
If you've ever wondered why the two worlds of dentistry and medicine remain so siloed on this issue, or what it means for patients when they fall through the crack, this episode is for you.
Timestamps
0:00 – Introduction and Dr. Catalano's background: ENT, skull base surgery, academic appointments at Mount Sinai, Lahey Clinic, and Tufts University
4:10 – How Dr. Catalano's career trajectory led him from engineering to medicine to rhinology — and the philosophy of fate and the "hidden angel" guiding his path
9:12 – The MicroShaver revolution: meeting Dr. Setliff in South Dakota and the aha moment that changed everything about minimally invasive sinus surgery
11:13 – The unexpected discovery: patients reporting they stopped snoring after sinus surgery, and how that led to a focus on nasal airway and sleep-disordered breathing
13:18 – [Ad] Early Orthodontic Treatment Comprehensive — a two-day hands-on immersive course with Dr. Daniel Camacho, Fort Lauderdale, FL, November 13–14. Click the link in the show notes to register.
14:27 – The 2009 Singapore breakthrough: Dr. Deyun Wang and computational flow dynamics — why no one actually knew how air moved through the nose until then
19:32 – Why previous nasal surgeries failed for OSA, and what "follow the airflow" means for surgical targets between the eyes
20:30 – Why making big holes in sinuses made things worse — and why the sinuses don't actually ventilate during breathing
23:58 – How the superior airway and structures like the uncinate process and concha bullosa became key surgical targets, producing a 15–20% improvement in airflow
26:08 – The insurance dilemma and medical-legal risks that prevent ENTs from performing airway surgery — even when the data is clear
30:03 – The ferret studies and the "never operate under 16" dogma: how flawed 1980s animal models became entrenched standard of care for pediatric ENT surgery
35:48 – Parallels to hormone replacement therapy and the rampant hypocrisy in academic medicine — how good studies get buried and bad ones persist
40:55 – How Dr. Catalano fought back against an insurance company, changed their pediatric sinus surgery policy, and survived multiple attempts to have his medical license revoked
47:12 – The Harvold monkey studies: why the obligate nasal breather argument is wrong, why the studies are foundational, and what it means that no one could repeat them today
58:07 – Children don't just "outgrow" airway obstruction: why the lymphoid involution argument is true but dangerously misleading when 90% of craniofacial growth is complete by age 8
1:13:57 – CBCT in ENT and orthodontic practice: why orthodontists need to learn to read the full image, how Dr. Catalano and Dr. John Walker found hidden tumors, and why rhinology-focused ENTs already use equivalent imaging
1:17:33 – Nocturnal enuresis and airway: the pituitary/ADH connection, why these children ask about bedwetting the moment they wake from surgery, and the anecdotal but compelling clinical evidence
1:27:15 – Swell body reduction: how a novel procedure Dr. Catalano pioneered in 2015 went from being met with rotten tomatoes at conferences to becoming standard of care
Closing
If this conversation resonated with you, I want to encourage you to share it with your colleagues, your dental and medical partners, and anyone who works with young patients who struggle to breathe. This is exactly the kind of interdisciplinary dialogue that can change outcomes for kids who are being told to wait it out.
LINKS
Dr. Peter Catalano: Email: catalanop9@gmail.com
AJODO Article on Mouth Breathing: https://pubmed.ncbi.nlm.nih.gov/40057896/
Join The DOC Community on Facebook for more great content and discussions (https://www.facebook.com/share/g/1Cb9rkQVde/)
Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ 
Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/
Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/
Website: theorthocoach.com
YouTube: @theorthocoach
Email: drmike@theorthocoach.com
Instagram: @theorthocoach

In this episode, I sit down with a truly inspiring father-daughter team - Dr. Victor Avis, a recently retired general dentist and orthodontist of 38 years, and his daughter Sydney Avis, co-founders of the Airway Revolution Foundation. What begins as a deeply personal story about Sydney's lifelong, undiagnosed struggle with airway and sleep disorders quickly evolves into a powerful conversation about the systemic gaps in how medicine and dentistry recognize and treat airway-related health issues. From Sydney's childhood as a chronic mouth breather to her life-changing double jaw surgery in 2020, and from Dr. Avis' discovery of the Mews and orthotropics to the launch of a nonprofit digital learning platform, this episode is packed with insight, honesty, and a whole lot of heart.
Timestamps
0:00 — Introduction & welcome
0:23 — About today's guests: Dr. Victor Avis & Sydney Avis, co-founders of the Airway Revolution Foundation
3:16 — Dr. Avis frames the conversation: what it's like to see patients transform through airway treatment, and why he didn't see it in his own daughter
7:19 — Sydney begins her story: growing up without knowing something was wrong
8:21 — Dr. Avis reflects: he didn't know mouth breathing wasn't normal, even watching home videos; the missed opportunity at age 6
10:43 — School struggles begin: from A student to C student despite extraordinary effort; asthma, inhalers, and cavities nobody connected to airway
15:25 — Sydney's growing anxiety: first panic attack at prom; daily panic attacks escalating through her gap year
15:57 — The breaking point: a 3 AM call from Thailand - Sydney in the hospital getting a brain scan
20:29 — Dr. Avis discovers John Mew on YouTube; two weeks later he's in England studying orthotropics
22:19 — Presenting Sydney's case to Bill Hang's study group: the recommendation for double jaw surgery, and Sydney's immediate answer: "Okay, let's do it"
24:13 — The pre-surgery journey: sleep studies, DICE with Dr. Soroush Zaghi, MADs, CPAP, nothing helps; surgery delayed by COVID
31:11 — Sydney shares life after surgery: REM rebound, finally feeling rested, and the lifting of the "fog"
52:37 — Why they founded the Airway Revolution Foundation and built a free digital learning platform for parents, educators, and adults
1:12:28 — Lessons from trying to change doctoral education and lobbying Capitol Hill and why they ultimately decided to go directly to the public
1:22:51 — The danger of anti-airway commentary; 50–60% of kids on ADHD medications may have an undiagnosed sleep disorder; how to connect with the Foundation
Closing
Dr. Victor and Sydney Avis are doing something rare - turning personal pain into a movement that has the potential to change millions of lives. If their story resonates with you, visit airwayrevolution.org and follow @theairwayrevolution on social media to stay connected as their digital learning platform launches this fall.
LINKS
Airwayrevolution.org
Connect w/the Avis' on Social Media: @theairwayrevolution   
Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ 
Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/
Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/
Website: theorthocoach.com
YouTube: @theorthocoach
Email: drmike@theorthocoach.com
Instagram: @theorthocoach

In this episode, I'm joined for the second time by Dr. Shereen Lim, an internationally recognized dentist whose work is reshaping how we think about oral tethered tissues and their role in craniofacial growth, airway health, and orthodontic outcomes. Since her first appearance on the show (Episode 34 - link below), Dr. Lim has pushed even further beyond tongue ties, focusing her clinical lens on lip ties, buccal frenum ties, and their profound influence on facial development, maxillary arch constriction, dental crowding, and orthodontic relapse. 
This conversation is a masterclass in staying intellectually curious, remaining open to what the evidence in your own practice is telling you, and constantly reassessing your diagnosis and treatment approach as new information emerges.
Timestamps
0:00 – Introduction & episode overview
3:12 – Welcome back: Dr. Lim returns to The DOC Podcast
4:43 – Beyond tongue ties: Dr. Lim's evolving focus on lip and cheek (buccal) ties and their impact on latch, facial tension, and development
8:46 – The lower lip tie discovery: how chin strain and mentalis tension led to a clinical breakthrough
9:55 – Buccal ties, orthodontic relapse, and how cheek tension shapes the dental arch
14:45 – Interdisciplinary collaboration: working with osteopaths, chiropractors, and lactation consultants
15:59 – The emotional weight of realizing what we've missed — and why blinders happen
19:01 – Case study: the patient with severe malocclusion and the tightest cheek ties Dr. Lim has ever seen
22:03 – My talk on why orthodontists resist airway-focused care — and granting colleagues grace
25:44 – Tongue ties without transverse deficiency: how cheek ties may explain the variation
27:36 – V-shaped arches, orthodontic relapse, and the role of perioral restrictions
29:39 – Historical perspective: the Frenkel appliance, lip bumpers, and treating the etiology
33:03 – How to assess what's normal vs. abnormal: signs to look for across infancy, childhood, and adulthood
36:41 – The procedure: CO2 laser technique, team-based approach, and what to expect after releases
39:10 – When outcomes fall short — and why proper pre/post care changes everything
41:34 – A remarkable case: releasing ties in an infant with Down syndrome against specialist advice
44:19 – Challenging the 2020 AAO-HNS consensus statement and the misuse of evidence-based medicine
46:53 – The real value of clinical observation and patient-reported outcomes
50:19 – Pushback on social media vs. trust within the clinical community
52:10 – Functional trainer appliances (Myobrace, Vivos, 2Pill): where they help and where they fall short
56:18 – Post-release comfort: why oral releases may make functional appliances easier to tolerate
57:54 – The journey approach: doing one thing at a time and building confidence incrementally
1:00:46 – Vestibuloplasty technique: releasing multiple sites together for better outcomes
1:03:46 – A message to overwhelmed clinicians: you don't have to do it all at once
1:06:32 – Evidence-based practice in action: what Dr. Lim is actually doing in her clinic
1:07:09 – Where to find Dr. Lim & closing thoughts
This conversation reminded me of why I do this work. Dr. Lim's willingness to look critically at her own outcomes, stay open to what her patients are showing her, and continuously evolve her clinical approach is a model for all of us. Whether you're brand new to airway-focused dentistry or have been in this space for years, I hope this episode leaves you a little more curious, a little more humble, and motivated to ask whether there's a better way to serve the children and families we care for.
LINKS
Episode 34 w/Dr. Lim: LINK
Dr Lim’s Book: Breathe, Sleep, Thrive
Dr. Lim’s Website: https://www.drshereenlim.com.au/
Dr. Lim’s IG: @dr.shereenlim
Dr. Lim on FB: LINK
Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ 
Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/
Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/
Website: theorthocoach.com
YouTube: @theorthocoach
Instagram: @theorthocoach
Email: drmike@theorthocoach.com

In this episode, I sit down with Dr. Dave McCarty - board-certified in internal medicine and sleep medicine, Chief Medical Officer of Rebis, and the visionary behind the Empowered Sleep Apnea Project - for one of the richest conversations I've had on this show.
We go deep on why the AHI is far more limited than most providers and patients realize, trace the history of sleep apnea from Dickens' "Fat Joe" to the invention of CPAP, and unpack a landmark trial now questioning whether high-pressure CPAP may cause harm. Dave draws a compelling parallel between today's resistance to airway-focused thinking in dentistry and the tragic story of Ignaz Semmelweis, the physician who discovered handwashing saves lives and was institutionalized for it.
We also make the case for nasal breathing, tackle the real limits of evidence-based medicine, and Dave shares his vision for Rebis: an integrated sleep medicine ecosystem that puts the patient, not the algorithm, at the center.

Timestamps
0:00 – Introduction & Dr. Dave McCarty bio
2:40 – Dave's origin story: from primary care to sleep medicine ("I'm a recovering primary care doc")
12:32 – Cold-calling Tom Colquitt & the dental-airway connection
15:59 – Enthusiasm as a guiding force: Ralph Waldo Emerson, cold calls, and following fear
18:20 – Why insurance-driven medicine creates silos — and what the dental community can teach physicians about patient-centered care
21:37 – Unpacking the complexity of sleep apnea: obstructive vs. central, the "vanilla chocolate swirl," and why the AHI is a code that needs decoding
26:12 – The history of sleep apnea: from Osler and Dickens' "Fat Joe" to Pickwickian syndrome
29:21 – 1966: Henri Gastaut studies a Pickwickian patient and discovers sleep apnea as we know it
30:38 – Colin Sullivan and the invention of CPAP in 1981
40:40 – The five reasons to treat sleep apnea: risk, snoring, sleep experience, wake experience, and comorbidities
50:00 – Why nasal breathing matters: autonomic nervous system, nitric oxide, craniofacial development, and immune defense
56:07 – The Semmelweis parallel: dangerous truths, resistance to change, and the human cost of orthodontic practices we may need to revisit
1:12:43 – No randomized controlled trial proves CPAP prevents mortality — and new data suggests over-pressurization may cause harm
1:18:22 – Rebis: building an integrated, multidisciplinary sleep medicine ecosystem that democratizes complexity
1:27:40 – Closing thoughts & how to connect with Dr. McCarty
LINKS:
Rebis: https://www.rebishealth.org/ 
Contact Dr. McCarty:  https://www.empoweredsleepapnea.com/
Beyond OSA: https://www.nxtbook.com/farran/orthotown/orthotown-march-2025/index.php?startpage=36#/p/34; 
Articles Referenced by Dr. McCarty: email Dr. DeLuke (drmike@theorthocoach.com) 
Phase I CE Courses: https://theorthocoach.com/courses/phase-i-arch-development/?portfolioCats=99
Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ 
Join The DOC Community on Facebook for more great content and discussions: https://www.facebook.com/share/g/1Cb9rkQVde/
Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/
Website: theorthocoach.com
YouTube: @theorthocoach
Email: drmike@theorthocoach.com
Instagram: @theorthocoach
If this episode opened your eyes to how much more there is to sleep-disordered breathing than a number on a sleep study report, I encourage you to share it with a colleague in medicine, dentistry, or orthodontics who needs to hear this conversation. The siloes between our disciplines are costing patients, and it's going to take all of us working together to tear them down.

Summary:
In this episode, I sat down with one of the most respected voices in dentistry, Dr. Witt Wilkerson - Director of Dental Medicine at the Dawson Academy and a true pioneer in the intersection of occlusion, TMD, airway, and integrative dental medicine. We had an incredibly rich conversation about the paradigm shift that I believe is transforming our profession: moving away from reactive, tooth-focused treatment and toward a whole-health, root-cause approach.
Dr. Wilkerson shares his 44-year journey from treating bruxism purely as a bite problem to recognizing airway and sleep-disordered breathing as primary drivers of dysfunction. We challenged the siloing of dental specialties, made the case for dentistry as oral medicine, and explored the enormous opportunity we all have, dentists and hygienists alike, to screen for and address systemic health issues, including inflammation, blood sugar dysregulation, and sleep disorders. This is a conversation you do not want to miss.
Timestamps:
0:00 - Welcome
0:23 — I introduce Dr. Witt Wilkerson and what we'll cover in today's episode
4:46 — Dr. Wilkerson shares his background: joining Dr. Pete Dawson's practice in 1982 and a career built on the question, "Is there a better way?"
6:07 — We discuss the segmentalized state of dentistry and medicine, and why the younger generation is finally starting to change that
8:33 — The 2009 Baylor article that changed everything for Dr. Wilkerson: the link between sleep apnea, bruxism, and airway
12:51 — I ask Dr. Wilkerson about the courage and humility it takes to admit you were wrong, and to update what you've been teaching for decades
28:23 — Dr. Wilkerson walks us through the three pillars of Integrative Dental Medicine: inflammation/infection, airway/sleep, and TMD/occlusion
29:26 — Why salivary testing should be part of every new patient exam, and what it can tell us about systemic health
30:06 — The diabetes-periodontal link we've known about since dental school, and why almost none of us are acting on it
30:52 — How continuous glucose monitoring is being used as both a periodontal and whole-health tool in Dr. Wilkerson's practice
45:41 — We get into orthodontics and TMD, including the defensive reaction from the ortho community that held the profession back, and what I think the specialty should do instead
50:05 — A critical clinical protocol: why you should always study sleep before placing any occlusal appliance on a bruxer
54:43 — The adult complex restorative patient: how I believe we should be approaching these cases from a truly interdisciplinary standpoint
1:14:16 — The future of treatment sequencing: why airway therapy may need to come first, before any restorative or orthodontic work
1:18:15 — How to connect with Dr. Wilkerson, the IDM Scholar Society, and the S3 Workshops
Call to Action:
If this conversation lit a fire in you the way it did for me, here's what I'd encourage you to do next:
Connect with Dr. Witt Wilkerson and learn more about the IDM Scholar Society and his S3 (Sleep, Saliva & Sugar) Workshops at IDMScholarSociety.com, or reach out to him directly at WittWilkersonDMD@gmail.com
Join me and Dr. Daniel Camacho at the Early Orthodontic Treatment Comprehensive Course - a two-day hands-on event, November 13–14 in Fort Lauderdale, FL. We'll cover early airway-focused interceptive treatment, CBCT reading, live patient observation, and so much more. Includes 41 CE hours. Space is limited, so grab your spot at https://www.earlyorthotreatment.com/ 
Share this episode - If this conversation shifted your perspective on dentistry's role in whole-body health, please pass it along to a colleague. The more dental professionals hear this message, the more patients we can help and the stronger our profession becomes.
Join The DOC Community on Facebook for ongoing discussions, resources, and more content like this.  https://www.facebook.com/share/g/1Cb9rkQVde/
Work with me directly - Head to  theorthocoach.com to access my CE courses or schedule a private one-on-one coaching session.
LINKS
AAO White Paper Review: https://youtu.be/pKSD_PVO4G0
YouTube: @theorthocoach
Email: drmike@theorthocoach.com
Instagram: @theorthocoach