Episode #358: Can You Help Find Emma?, with Dr. Tracey Nguyễn

Dentists can have a great impact on airway health. And yet, they have been the least active in this field — especially pediatric dentistry. As Jeff Rouse says, adults are roadkill, but kids can be saved! And today’s guest, who is passionate about bringing awareness to the dental community, will tell us how. Kirk Behrendt brings back Dr. Tracey Nguyễn from ASAP Pathway to share intervention strategies in airway and how to identify those she calls the Emmas of the world. To learn about ASAP Pathway and how you can start helping children, listen to Episode 358 of The Best Practices Show!

Main Takeaways:

• Airway is not just a field for orthodontists and pediatric dentists.
• General dentists need to drive the field of airway.
• Look for signs and symptoms of dysfunctional airway before setting teeth.
• Don't oversimplify or overcomplicate things. Just do good dentistry.
• The pediatric medical community wants dentists to get involved.

Quotes:

• “I dabbled in sleep, but I really didn't like all the occlusal changes with sleep. It really didn't jive with my philosophy because I'm sitting here dialing in the occlusion, and then I'm going to put an appliance that just messes it all up.” (2:18—2:33)
• “[Jeff Rouse] talked about the impact of airway in our occlusion, and vice versa. Basically, his philosophy now at Spear is, ‘Is my treatment going to be airway-positive, negative, or neutral?’ And that really made sense with me. I didn't understand why it was okay to have these messed up bites if you had sleep apnea, but not okay if you didn't. So, there's the ethics in what you're supposed to do.” (2:49—3:19)
• “Now, I talk more on the peds side because Jeff [Rouse] will say the adult side — he calls it roadkill. Basically, you're done. There's nothing I can do for you. But kids, you can. And the interesting thing is, I didn't understand why the dental community wasn't as concerned when we had the most impact. So, my journey has been about making the dental community more aware.” (3:46—4:17)
• “I really think general dentists are going to drive this field. We’re the ones that do these comprehensive treatment plans. We’re the ones that understand how to talk to our specialists. We’re the ones that know how to bring everyone together. We’re the ones that have to drive it. It’s not a field strictly for orthodontists, strictly for pediatric dentists. And that's what I'm seeing. I'm seeing more and more general dentists want to do it; they just don't know how, or what they're supposed to do.” (4:53—5:28)
• “[What dentists get wrong about airway is] that we’re not good enough to be involved in it. It’s so weird when I say that, because when we talk about this, I speak to so many dentists that are like, ‘Well, an ENT has to get in first and take the tonsils and adenoids out.’ I was like, ‘Well, you know it’s beyond tonsils and adenoids, right? You know tonsils and adenoids are not a fix.’ And it’s interesting because dentists, they don't realize that they can do so much and guide these kids and direct them in the right treatment, just get to the right care.” (6:16—6:52)
• “Us as general dentists, we understand comprehensive care for adults, but we don't understand comprehensive care for children. And comprehensive care for children deals with growth management and making sure that this child is going to develop the best he or she can be. And I don't think we get that. Our focus is about fixing the problem, not looking at red flags.” (6:56—7:30)
• “I think that people overcomplicate it. Just seeing all these camps, it’s like, ‘Hey, guys. If you're going down these rabbit holes and taking all these classes, the one thing that you're forgetting to do is to diagnose what you're treating.’ It’s just basic dentistry. And Jeff [Rouse] will always say that, ‘Just do dentistry.’” (8:12—8:37)
• “If we just stick to the basics of dentistry and home in on your diagnosis, dentistry actually can impact the child and adults in an amazing, positive way.” (9:16—9:28)
• “Just look at the red flags. And, obviously, understanding the red flags is a big one, and understanding that we can have an impact. Because I feel like most people are like, ‘Well, they need to go to an ENT first.’ And I was like, ‘We've never needed an ENT to bless our dentistry.’ (10:04—10:23)
• “Spear, now, they put airway health as number one. So, basically, you home in on that medical history. You look and see, based on the signs and symptoms, does this person have an airway problem. And from there, then you set the teeth to the optimum airway health, not vice versa.” (11:58—12:21)
• “An example is, setting up dentures or even doing orthodontics, you look first and see that, ‘Okay, does this person have any signs and symptoms of dysfunctional airway?’ And so, you build the anatomy to benefit or to improve that airway space, versus just building the teeth and hoping that you make a positive influence on the airway.” (12:23—12:49)
• “The pediatric medical community wants dentists to get involved. And it’s the dentists that are kind of shutting the door on them.” (14:20—14:28)
• “[Airway] is not just a field for pediatricians. This is a field for all medical and dental professionals. And then, from there, we talk about the treatment modalities and then the importance of dental airway management. I think it’s so important. I think that the way we’re going to help these kids is if the dentists become advocates for these kids.” (15:55—16:21)
• “Most people go to the dentist more often than they go to their primary care. There are so many children and adults that I get that when we start taking their blood pressure, it’s the first time someone talks to them about their health.” (18:44—19:00)
• “We’re really quick to jump to medication. And when you start medication on a seven-year-old, that dependency — it’s done. And I don't know if people get that.” (19:54—20:09)
• “One of the things John Kois taught me is, none of us is smarter than all of us.” (21:40—21:46)

Snippets:

• 0:00 Introduction.
• 1:34 Dr. Nguyễn’s background.
• 5:28 What general dentists get wrong about airway.
• 7:30 Don't overcomplicate it.
• 11:15 The five pillars of diagnosis.
• 13:25 Origin of Can You Help Find Emma?
• 18:06 Dentists are better positioned than ever to change the world.
• 20:19 ASAP online education program and how to get involved.
• 24:18 Dr. Nguyễn’s contact information.
• 26:05 Patients need to know your why.

Reach Out to Dr. Nguyễn:

ASAP Pathway: https://www.asappathway.com/education-upcoming-events/  

Dr. Nguyễn’s Facebook: https://www.facebook.com/tracey.nguyen.9085 

Dr. Nguyễn’s social media: @drtraceynguyen 

Dr. Tracey Nguyễn, DDS, FAGD, AAACD Bio:

Dr. Tracey Nguyễn, a.k.a., “Dr. Tracey,” received her DDS, Magna Cum Laude at the Virginia Commonwealth University, Medical College of Virginia. Dr. Nguyễn pledges to treat each patient with the highest standard of oral health care.

Dr. Nguyễn is very involved in the local, state, and regional organizations, i.e., Loudoun County Dental Study Group, Northern Virginia Dental Association, Virginia Dental Association, and the American Dental Association.

She is a member of the American Academy of Laser Dentistry, the World Clinical Laser Institute, and the International Congress of Implantologists (ICOI). Dr. Nguyễn understands the importance of lasers in dentistry. She was one of the first doctors that introduced the hard tissue laser dentistry in Loudoun County.

Dr. Nguyễn is also a Fellow of the American Academy of General Dentistry. She thus understands that providing great smiles and excellent oral health are the result of going above and beyond basic requirements. Dr. Nguyễn serves as an editor for the AGD peer-reviewed research manuscripts. She also has continued to advance her dental and clinical expertise by completing thousands of hours of advanced training at the most prestigious dental institutions across the country.