Speaker 1: 0:43

We are live. Welcome everybody to the Beauty of Breathing podcast. Look who I have with me today Miss Katrina Sanders. Thank you so much for being here.

Speaker 2: 0:55

Oh, thank you so much for having me. I'm so excited to talk about this. This is going to be wonderful. I just I can't wait. It's going to be fabulous.

Speaker 1: 1:02

So Katrina recently spoke for us on Aerie Circle and we didn't have time to do a Q&A and I said why don't you come over on the podcast and we can ask you some questions? You guys know that we love anybody who knows about Airway and they are in the dental field. But first of all, I'm going to start by introducing our guests to you guys and then we're going to be able to ask some questions. We are live on Instagram right now, so if you're watching this live, please just post on the comments some questions that we can ask Katrina and if you have not checked out her talk on Airway Circle, run over there. It is so, so good.

Speaker 1: 1:42

So Katrina is passionate about elevating the dental profession by creating a movement that educates, encourages and empowers the industry. Known as a dental wine genus, which I love that, she combines her love for dental excellence with her passion for wine. As clinical liaison for AZ Perio, she collaborates with leading periodontists in surgical care. Founder of Sanders Board Preparatory, katrina is a published author and recipient of multiple awards, including the Denobi Award and RDH Magazine Award of Distinction. Her philanthropy includes humanitarian dental work, supporting animals and advocating for organ donation. What else, my goodness? Check all the boxes, you go, girl. You know that's what they call living the dream. When you check all the boxes, you go girl.

Speaker 2: 2:28

You know, that's what they call living the dream, when you can check all those boxes right. So here I am, living the dream 100%.

Speaker 1: 2:37

So whenever you spoke for us on Airway Circle, you went through a very personal journey on Airway. So let's go back even further right now. How did you even get into dental hygiene?

Speaker 2: 2:52

Oh my gosh, you know what I loved dentistry from the moment I had teeth. I hear these amazing stories of clinicians who are like when I was a child, I had a really bad experience at the dentist and I wanted to make a better experience for my patients and I love those stories. Like, love them. I had the exact opposite. I had the best experience at the dental office.

Speaker 2: 3:16

Like to me, going to the dentist was equated with skipping school because my mom was like you know, yeah, she'd take me out of class and then I would go and I'd get my teeth cleaned and I'd get my fluoride treatment and I'd get my sealants. You know I had the opposite impact where I was in a relatively affluent community of receiving preventive dentistry, and so I I don't, I mean I had my first premolars extracted for ortho, which you know I we're talking about it already, right. So we know how. Concerning that, right, you know that that at the time that was how we did things, right. But so I had extractions and space maintainers and those things, but I didn't have these traumatic, catastrophic experiences in dentistry.

Speaker 2: 4:05

And I implore the people listening to consider you're creating that experience for your patients now, right Like now that we're spending so much time focusing on the provision of prevention and what prevention can do to be non-invasive and to educate and empower and instill values of oral hygiene and airway management. All of these things, generation by generation, we're getting better. Generation by generation, we're seeing less oh, my parents were indentures by the time they were 40, blah, blah, blah. We're seeing this amazing movement which shows it's so hard in the day to day for us to see that in dentistry, but when we see that as a collective movement of our profession, in going yeah, now we have people that come in. I mean, I don't think people love going to the dentist. Every once in a while you get a person who's like I love being here and you're like that's so awesome. That's not common, but at least we aren't getting the same level of disdain I think that we used to get.

Speaker 2: 5:11

So I I had a great experience going to the dentist as a child and loved my hygienist, linda. She had an amazing relationship with my dentist, dr Don, and so I I I loved it when I was, you know, learning about what I wanted to be when I grow up. You take one of those quizzes like you know, what would you be really good at? And I had two things at the top of the list librarian and dental hygienist. And I'm a pretty loud person so I figured the librarians maybe not the way to go, um, but you know, let's check out this dentistry thing. So you know, I I had the opportunity to shadow and see the other side of it and it's such a it really is a very cool profession to be a part of.

Speaker 2: 5:57

Right. You get it's new. Every every hour, on the hour. You get a new patient. You get to connect with them, have their own unique needs. They are a part of your like an extended part of your family in a way. You get to collaborate with doctors, other hygienists. It is a respected profession. We are seen as healthcare practitioners. We are seen as inflammatory specialists. I mean hygienists are very well positioned in healthcare today and as the focus around prevention gets stronger, I mean I can't scroll on Instagram without seeing a new supplement that's out there to help prevent whatever you know. I mean there's so much education around prevention, exactly, yes, probiotic Go take your probiotic right now. Girl Talking about that is so funny.

Speaker 1: 6:47

I did a story the other day and I'm like taking two of them and then I turn around. I'm like take one, sorry, sorry One.

Speaker 2: 6:55

You're all good. Yeah, I mean you only need one if you're healthy, two if you've got a little bit of disease going on, right. But I mean all of this, this concept around how can we take a step back and allow Mother Nature to do what she does best and heal ourselves from the inside out? I mean, that's really where hygienists are so focused and where we want to spend our time. So it's exciting that hygienists are so active in the airway conversation because it just it makes sense when you really think about it. It makes sense when you think about how well positioned hygiene practitioners are in being able to take that now to the next level. So it's an exciting time to be in dentistry, I think.

Speaker 1: 7:39

Yeah, yes, I'm not going to lie. I decided to go into the dental field because I liked the boy. Gonna lie, I decided to go into the dental field because I liked the boy what you who was going to dental school. His father was a dentist, his brother was a dentist and he's a dentist so now so I was in love with him and I'm like I totally want to be a dentist too.

Speaker 1: 8:00

So but I lived in brazil and in brazil it's a little bit different. We don't have dental hygienists. The dentist does everything. It does all the cleanings, and then we have several specializations. And it's kind of crazy. If you speak to a Brazilian dentist, they don't have like only one specialization, have like two or three, because in Brazil you stay home whenever you're going to school and you leave a high school straight into college and you leave high school straight into college. You don't have to do the four-year program before you go to dental school or medical school, you go straight into the program. So you save a lot of time. So people graduate super early. They're still home, they don't have any bills, parents are still taking care of them most of the time, not every time, so they have time and the funds to go and take so many other specializations.

Speaker 1: 8:52

Um, so I wanted to be a dentist because of that cute boy. And when I moved to the united states, same thing. I'm like, well, I want to be a dentist. So I picked up the school's program and I saw I was going to a small community college in Brunswick, georgia, and I looked and he said dental hygiene. I was like, well, there's dental in the name, I guess I can start there. I had no idea what it was. However, I've always been in love with dentistry. Same way I love my dentist. Growing up she's a family dentist, you know, took care of my whole, whole family. I'm really good friends with her daughter and we grew up together and I just love going to see her and the smells of the dental office, like all of that I loved. However, I hate getting my teeth cleaned y'all what.

Speaker 2: 9:41

I know really wait, so what?

Speaker 1: 9:43

do you love about going to?

Speaker 2: 9:45

the dentist. Are you like give me a filling over here Like what do you love about it?

Speaker 1: 9:50

Well, I guess it's just different nowadays. Whenever you're a kid, you know it doesn't really bother you because pretty much you're just polishing your teeth. But as an adult, and I'm just so fearful of things and needles in my mouth I'm like ah. However, just getting it at cleaning it freaks me out and I feel like it's a little bit different after you do the job. You kind of know what they're about to do. You know and you like anticipate. So I have that anxiety, you know anxiety, anticipation, and anyways, I'm like I'll floss myself. It's okay, they hate me, they hate me. My last hygienist was like no, renata.

Speaker 2: 10:28

They hate me. They hate me. My last hygienist was like no, renata, my hygienist hates me too. There's no. So I have some recession in a few areas and it's very sensitive. So when my I'm always like just a reminder, number three and 14, don't put your ultrasonic she's like oh my God, calm down, like. And then, of course, afterwards she's like would you like the fluoride varnish? And I'm like I have like a zillion packets of fluoride varnish at home, like I'm just going to put it, on it, you know she's like just just let me do my job.

Speaker 2: 10:51

So.

Speaker 1: 10:52

I get it.

Speaker 2: 10:53

We're oftentimes the worst patients, aren't we? Yes?

Speaker 1: 10:56

Yes, and I hate it and I'm so sorry to my hygienist. I love you, Um, but it's tough being my hygienist. However, I loved being one and I miss it dearly. The interaction with patients. They're always looking for new research out there and what else is in the market. How else can we help our patients? Not only oral health, guys. This is the entrance of the body. If you have something going on in here, I mean, think about the amount of bacteria that you have in your mouth. It's more than anywhere else and it connects to your whole body. If this is not healthy, it's going to affect the rest of the body, your gut health. Everybody talks about gut health all the time. Guess what? They're connected? There's a tube there.

Speaker 2: 11:43

It's connected and it turns out the entryway of that tube. We're working in all the time.

Speaker 1: 11:49

Yeah right, I interviewed a functional medicine doctor not long ago, because we all talk about gut health and how we have to take care of our gut and we take probiotics. Um, however, he was saying, I do believe that the oral flora is even more important, because we're always like, well, which one is going to affect? Is the oral flora going to affect your oral flora is even more important because we're always like, well, which one is going to affect? Is the oral flora going to affect your gut flora or vice versa? I think it's a little bit of both.

Speaker 2: 12:15

Yeah, I absolutely agree and you know this is um. This is such an important conversation to have because to me I think this changes the essence of what we do from being a technician who just scrapes the teeth into a true career clinician who recognizes that what we're doing is in fact augmenting so many bodily processes. So the oral gut access, we've been studying quite a bit and, to your point, we've studied things like the gut and the bacteria inside of the gut drive a lot of the presence of health or disease in the body and we've seen that in like. There are these amazing mouse studies, like lab mice studies, where you take these sterile lab mice that don't have their own commensal microbiota and they get injected or they get a fecal transfer of individuals with various levels of disease. And the gut microbiome we have seen drives so much of systemic disease or systemic health. But, to your point, the fact that the mouth is the portal or the entryway for that becomes really critical or the entryway for that becomes really critical. And that study of the oral gut axis has opened up the door for looking at things like the oral lung axis, the oral brain barriers. We're starting to see bacteria of oral origin colonizing the placenta of pregnant women. I mean, it is really incredible when you study what happens. Oh yes, the bacteria from the mouth can translocate or transmigrate to all of these different areas and it doesn't belong in those areas. So what happens when bacteria, particularly bacteria that have processes to them, have enzymes, have byproducts, toxins, all these things? What happens when these bacteria are able to go to areas where they're protected and because they're very good at creating plaques? What happens when they create plaques in, I don't know, the lining of our blood vessels? What happens when they create plaques in our brain? That's Alzheimer's disease, is having an amyloid plaque, right? So when we start studying these processes and we think about the fact that the mouth is I mean the teeth are the skeleton that we're interacting with on the outside, I mean, when you really think about it, right, so we have the ability to do so much, right? That's really what it is Like. We're interacting with a skeleton and it's amazing to see how we interact with so many aspects of that and how well educated we are on those things. And for a long time, I think hygienists weren't brought into that conversation, despite how often we are sitting at that table listening to that conversation.

Speaker 2: 15:13

So now we start talking about the oral systemic link, and I don't just mean the periosystemic link, right Like, the periosystemic link is very specific Periodontal pathogens and periodontal inflammation contribute to systemic disease. But we're talking about the oral systemic link. We're talking about the fact that in the oral cavity we're also looking at pathologies. We're looking at decay and the fact that bacteria that cause decay CNN positive, strep mutans, et cetera have the ability to cause atherosclerotic disease. And now we're even looking at some of the complications of, of course, how airway, the positions of the jaws, the tethered oral tissues that have been left untreated in our patients have now created major airway issues. And we're creating that line going if we don't address these airway issues, here are the systemic complications that come into play. Now that's a long string to create, right For those of us who have read, you know, james Nestor's book, you know, or any of the books that discuss the role of airway, breathing, the importance of airway and breathing on systemic health.

Speaker 2: 16:23

You have to be able to create that line to say, well, we need to go back further and look at the fact that the orientation of the jaw, the position of the tongue, the ability for the tongue to have total range of motion or not. All of these things are going to dictate the shape, size, condition of the airway. That, I think, is a piece that dentistry is excited to participate in, but we're just not mainstream in it, particularly in hygiene education and in dental education. Today, I just don't find that we're getting that level of education because, unfortunately, when I took my boards as a dental hygienist, my skills were adjudicated simply on my ability to scrape off 12 clickable pieces of calculus.

Speaker 2: 17:17

That is how I was adjudicated in my skillset. So the reality is, if we are looking at the teaching to the test model of education, we're deficient or we're creating deficiencies in our profession. So now we're starting to see dental hygiene programs creating educational opportunities for hygienists, hygiene students now saying, okay, you may not be tested on this on your boards and sadly, you may enter into a clinical practice where you're not looking at any of this. Because I mean, let's face it right, there are school programs that are going to teach this Hygiene students who will graduate with this knowledge. They're going to get out into clinical practice and it's not mainstream for dental practices to be doing airway sleep work of any kind. So there's a reality that they'll get out into the world and not be doing this. But it's important that we have these conversations to talk about it, to normalize it, and I do believe that we have a population of patients now who also are curious about their health. They want prevention, they're asking for those things. We just have to do a better job of listening.

Speaker 1: 18:36

Oh, my goodness, Thank you for saying that 100%. And and you just mentioned that you know, in order for us to get our state license for dental hygiene, we have to prove that we can clean teeth really well. So we have to pick the sites, we have to pick our patient, and then we have to go to this, the setting where we clean the teeth, and then they come to check after us. That is what gives us the dental hygiene license. And I'm only going to mention this briefly. The education that a dental hygienist gets head and neck, anatomy, pharmacology, all of this microbiology, all of this intensive, you know medical classes that we take, plus our experience of working inside the mouth, touching these structures and looking at these structures every single day is what allows us to go into myofunctional therapy. So if there is a dental hygienist there that's interested in learning more and becoming a myofunctional therapist, it's not necessarily your license that allows you to go into this. Your license allows you to go into this. Your license allows you to clean teeth. Your education allows you to get extra training, so then you can practice myofunctional therapy. It is so important for us to start recognizing these things. I believe that there's a personal with everybody a personal thing, for example either your child was born with a tongue tie and couldn't breastfeed and you had pain that was mine but also I was an ARA patient. Growing up I had all the issues. So I believe that in order for you to go into this field and want to learn more and want to help other patients, there's always that link that you have to have something personal, because it is way more education. You're paying for all these classes on your own most of the time. It takes time for you to grow that. That field and that side and I'm thinking as a business in a dental office it's more time that you're gonna have to spend with your patients. So not every dental office is going to want to embrace all of this, and it's okay. It's not for everybody, but, taking the stance of, at least let's learn how to screen these patients. Because what was it? October 2017?

Speaker 1: 20:55

I think it was the ADA put this new statement out that dental practices are supposed to now be screening for sleep disorder, breathing, and we don't have to treat. However, we have to know when to refer to a different professional. These kids come to us and they're healthy. These patients come to us and they're, you know, otherwise healthy. They don't go to a doctor unless they're sick. They don't go to a speech pathologist unless they have a speech issue, but they come to see us all the time and you see these kids walking around with runny noses and extremely hyper and mouth breathing and crooked teeth, and that's enough for you to be like, have a little screener for them to fill out the five seconds.

Speaker 1: 21:39

It doesn't take a long time for you to ask a few questions and just plant seeds, just give them a flyer. By the way, area circle has some, some flyers available that you guys can can get. You don't have to make your own, um, and it's all research based. But give them a flyer, give some information. It might take a year before these patients are going. You know what? I have noticed that maybe this is something I want to explore. So be that little seed in everybody's lives.

Speaker 2: 22:06

You know, I love what you just said and I want to do like a little bit of a way back playback on this, if that's okay. So my sister is a physician. She was just in town for the Thanksgiving holiday and this is just like how things go she and I are having coffee one morning out on the patio and we start talking about, you know, some of the challenges that we're seeing in healthcare today where, in my opinion, it is not healthcare, it is sick care. People are going to see physicians when the problem has gotten so bad that somebody else has noticed or they've noticed, and it's inconveniencing them, whatever that may be. So my sister is a foot and ankle surgeon so she does a lot, you know, in the diabetic foot ulcer, toe amputation, foot amputation.

Speaker 2: 22:51

She's seeing advanced, pretty diseased patients. So by the time the patient comes in to see her with a really bad diabetic foot ulcer, like it's bad, the diabetes is uncontrolled. Oftentimes the patient does not know that they're diabetic when they come in right. So she's seeing all of these individuals who are going through major, catastrophic issues and she's got to go back to square one. She has to debride the diabetic foot ulcer, get the patient on metformin glyburide, whatever, try to control their diabetes and kind of reverse engineer this. When patients come in to see her, it is often she works in a hospital setting. It is oftentimes a catastrophic issue and she is just getting the patient out of pain, getting them into a state of control, sending them out the door. She does not have the time to sit and talk to her patients about diet and exercise. She's managed by a hospital setting where she has to see X number of patients every hour in order to make sure that she hits her numbers.

Speaker 2: 23:52

Now, I don't mean to say that dentistry doesn't have production goals and things like that. Of course we do, but there's a difference. Hygienists, particularly to your point, are oftentimes seeing individuals who are in a perceived state of health, so it's oftentimes not catastrophic. Now we ask a chief complaint, anything bothering you, and they might say like no, no, no, this tooth is like a little sensitive over here, obviously not enough to have our patient banging down our door, you know, on Black Friday going, you know, but it was a little bit so again, like the body's amazing how it can shut off these pain perceptions, or the way that we can convince ourselves the number of women who are experiencing cardiovascular issues but don't know they are until they have a cardiovascular event, which is why cardiovascular disease is the number one killer of women. So we see this right. The challenge is it takes so much to get the patient to a medical provider today and it doesn't take as much.

Speaker 2: 24:53

In the 1950s. We did a really good job of creating this campaign of educating to the general public to go and see your dentist twice a year and I think most hygienists will say like oh my gosh. Yeah, my patients think like, oh, you go in every six months for your cleaning. Like we did a nice job. Dentistry, we did it. We educated the general public. You got to come in twice a year. Now not everybody follows that, but at least we did a good job of educating them on that.

Speaker 2: 25:18

The challenge along the way is that we're seeing these opportunities for advocacy. You know, doing oral myofunctional therapy here in the state of Arizona, hygienists having the ability to deliver Botox. You know we're starting to see this stretch or expansion of our work in other areas. So I was talking to my sister and I said you know, hey, I asked her what do you think about dental hygienists doing Botox? She's a physician and she's like you know, what's so weird is she's like I could do Botox if I wanted to. She doesn't right. She doesn't do Botox on her patients, is what I mean to say.

Speaker 2: 25:54

I'm sure she you know, she's in her thirties, you'm sure she's doing her own Botox, but she's like I could do Botox if I wanted to. I don't, but she's like I could, she's like. What's so weird is that you, as a person who knows the anatomy of the head and neck, you're still fighting for states to believe that it's safe for you to do Botox. So I said I was like this is so crazy. I asked her I was like how much training do you get on head and neck anatomy? And she said none. So I did a little bit of a research study on this.

Speaker 2: 26:29

My sister had to take anatomy and physiology. Right, the average nursing student, the average medical student has to take anatomy and physiology. They have to take eight credit hours of A&P. Then they specialize in their area of expertise. So my sister's a foot and ankle surgeon. Did she take a bunch of like metatarsals 101? Like I'm sure of course she did right, but she's at the other end of the body, so that's what she understands. Dental hygiene students take eight credit hours of human anatomy and physiology. Then we take four additional credit hours of head and neck anatomy, dental anatomy and histology, which is supremely higher than our nursing colleagues and certainly supremely higher than our medical specialties. So the reality is we have received the training and I do believe somehow we got into a whole discussion.

Speaker 2: 27:21

We were talking about pain management. We were talking again. This is what we were talking about. I want to come over for Thanksgiving next year. Come on over, girl, you'd love these conversations. We're sitting there with our coffee, like you know, blowing it. We're like what do you think about pain management? Because we were talking about the opioid crisis and the fact that, like what my sister was taught to just write scripts for opioids and it's getting really bad, and States that have legalized cannabis, that we're seeing patients self-medicating with cannabis, and I'm of the camp of hey, if it's non-addictive and it helps to control their pain, like great, we have to start advocating for our patients.

Speaker 2: 27:57

So I start going down the rabbit hole. I'm like, well, we learned about ibuprofen and the arachidonic acid pathway, right, the fact that when body experiences trauma, that the body generates or creates arachidonic acid, and so the aspect of ibuprofen is that. And I'm going on this whole thing, my sister's looking at me like how do you know this? And I'm like I learned that in pharmacology, in hygiene school, did you not learn? And my sister was like no, we didn't learn any of that. I'm like so what kind of nutrition training did you get? And she's like we didn't have to take nutrition. So it's like she had to take biochem. So all I mean to say is it's incredible. I in hygiene school was trained on all these things, but I was also trained that if there's a problem with the patient, that I should probably just send it to the primary care physician. I should probably send it to my patient's doctor.

Speaker 2: 28:47

Let them take care of it, let the big boys take care of it, cause I don't know. I'm I'm just a dental hygienist and the reality is it shows up in what we do. When a patient has ridiculously high blood pressure and we do this thing where we take the blood pressure cuff and we're like so your blood pressure today, and the patient's like, I have white coat syndrome. It doesn't even listen to us and we're like well, but this isn't right. I mean, at what point do you just say when's the last time you had anybody in the healthcare space check your blood pressure at all? Because if you don't go in to see your primary care physician at all, it's been 10 years since somebody's taken a blood pressure on you then, respectfully, this may not be white coat syndrome. How do you know, patient? How do you know? Right, you know right. So we in dentistry we know. We know what this looks like. We know what the change in the tissues look like. We know what that patient's tissues have looked like over time. All of a sudden they come in. They're super duper, stressed out, they're going through divorce, whatever's going on in their lives. Things look different physiologically, like we know what those things look like and I believe that we are very well positioned to participate inside of those conversations.

Speaker 2: 30:00

The challenge is, I think we've been silenced for a really long time. We were just excited to have the opportunity to just like kick a seat up to the table. We're not allowed to talk, we're not allowed to pour the wine for anybody, we're just supposed to sit back and like sip our water cup in the corner. But the reality is we we are. We are counseling our patients. We are seeing these patients multiple times a year. In a decent portion of these cases, we are watching our patients progress over time in complexities of their health history. Look at patients who've been in your practice for a very long time and watch their health histories evolve. When you first came in, you weren't on these hormones, you weren't freezing your embryos, you weren't doing all of it. Now all of these things have changed and I'm seeing that showing up in your oral health and subsequent systemic health. Who else is going to advocate for these patients?

Speaker 1: 30:52

Oh my gosh, can we have a federal board? Let's do it. Can we have our own, our own federal board? I don't see why not, can we?

Speaker 2: 31:00

have our own federal board. I don't see why not.

Speaker 1: 31:01

I mean it's just because dental hygiene you know, most of the dental hygiene programs nowadays are two years and that's what people believe in, that it's just two years. No, we have to take the two years of prereq. So it's really the two years, the four year at least, Right, right, I think five years for my associates, right, five years for my associates and six, an extra year for my bachelors. It's crazy. We do have education but for some reason the general public does not really know what we do and we don't have a lot of, you know, people advocating for us. We usually have to work under a dentist for us for us to to be able to do anything. In most States I mean, georgia just passed anesthesia, like now there's still like two States, states, I think, that still don't allow. It is insane, which I'm kind of glad that I don't do hygiene anymore because I'm extremely scared and I would probably not be good at giving anesthesia.

Speaker 2: 32:00

Oh my gosh, you'd be amazing, because you know head and neck anatomy. That's the thing, you know it, you know it. That's that, and and the reality is it's so precise what we do. We don't appreciate that enough. Um, my, my. So I I random side note I had cyst surgery, like two months ago. I had a giant cyst in my left nasal sinus. So my ear, nose and throat specialist takes a cone beam, sees this like. I mean the. The entire cavity was filled with this giant cyst and um it was I.

Speaker 2: 32:35

It's good now, but it wasn't good at the time. I didn't even realize because a lot of people don't know.

Speaker 2: 32:41

No, exactly, I had no idea. I had, um, I had hoarseness in my voice that wouldn't go away. I blamed my speaking career for that, which is very easy. Do you see how people experience this stuff? I had, you know, post nasal drip, but I just figured like I'm in and out, of, you know hotel rooms and airplanes and blah, blah, blah, and I'm in and out of time zones and whatever. So I mean, this is the narrative. I told myself I was having massive migraines all the time. But you know, this is so crazy. My mom had massive migraines all the time and my mom was a bad sleeper and my mom cleared her throat all the time. Just all these things, right. So I went to my ENT and I was like something's not right. I I'm glad I went. I went because we lost my mom from an airway obstructive issue.

Speaker 2: 33:29

And so I thought, well, I want to get ahead of this. I don't want to, you know, experience the same thing myself. So I went in ENT finds this giant cyst. They're like, yeah, the cyst is the problem, you need to have the cyst removed. So they went in. They did a surgery where they took a camera. They went in so that they could see what they were doing. And then what they did was they took a tube with a balloon on the end of it and they put it like down into my nose and they opened up the balloon until it like popped the cyst and then I guess all the fluid drained out. I hope nobody's eating while they're listening to this. They had suction.

Speaker 2: 34:05

The suction is like sucking out all the fluid and whatever, and then they pack like a bunch of gauze and stuff in there. Then they let you sit. You're not allowed to blow your nose, You're not allowed to sneeze Neti pot. You can't do anything for like four days and then then they clear you to neti pot and it is the most magnificent moment for anybody who hasn't been able to breathe through their nose. You're sleeping with your mouth open, Like I thought about James Nestor in his book when he did the whole. Like you know, he occluded his nose and he could only breathe through his mouth for like a month or whatever, 10 days 10 days, that's what it was.

Speaker 1: 34:43

Yeah, and immediately, immediately, his blood pressure went up, his heart rate went up. I mean his whole health started.

Speaker 2: 34:50

He started snoring, he developed sleep apnea, that's right, he gained weight, his cholesterol, yeah, like all this stuff. He was eating a very controlled diet, but all this stuff, he was eating a very controlled diet, but all this stuff happened, right. So I thought about that. I was like, oh my gosh, because I couldn't breathe through my nose. I had this stuff in my nose, breathing through my mouth. Then I neti pot for the very first time and the stuff that came out and hit the shower floor when I was neti potting was like, as a hygienist, I was like, oh, like I love this. Right, my, my poor husband. I'm like, babe, get in here. You know I'm making him look at all this stuff. But it was like the outer casing of the cyst that had finally like sloughed and came out.

Speaker 2: 35:26

So my sister the foot doctor, is like, well, why would they pop the cyst and then pull it out? Couldn't they just pull it out? It's like the cyst was eight times the size of my nose hole. We're talking about things inside a body, and sinuses are cavities and spaces. Our physicians like my sister who's just cutting off a whole foot. It's very different. You have access to that right. If you amputate someone's foot, you tourniquet it and you slice it off. If my doctor in a perio office needs to extract a tooth, they have to get to the. You can't tourniquet a tooth.

Speaker 2: 36:06

You can't tourniquet the face. We know that bacteria is going to be entering the bloodstream and it's so close in approximation to the brain and to the heart. There's no question as to why we take dentistry so seriously, because it is located inside of the skull and there's a lot of important stuff in the skull. There's no question about it. But the idea for us in dentistry is that I think we've been playing small inside of really understanding our role in what we're doing, because we've been so sequestered and isolated inside of our world. We know our world really well. You know who doesn't know our world really well Medicine but we've spent a lot of time studying medicine. We've spent a lot of time understanding their world. And what does good blood pressure look like? What does bad blood pressure look like? What's a good INR like? What's a good INR level? What's a bad INR level Like? We've studied all of these things, including pharmacology, pharmacodynamics, pharmacokinetics. We study all of these things forward and backward and I think the opportunity now is to help our patients understand that we are here as advocates for their whole body health. You know, marouf et al did a study. This was in the early 2000s. They did a study of recare dental patients who come in for their dental visits every six months, and they asked these patients a really important question. They asked these patients do you get an oral cancer screening from your dental hygienist? And less than 15% of the patients said yes, I get an oral cancer screening from your dental hygienist. And less than 15% of the patients said yes, I get an oral cancer screening. Now the question that I ask and I share this in rooms that I'm lecturing the question that I always ask is why? Why less than 15%? And hygienists around the room they get it and they say, well, they are getting their oral cancer screening. We're just not telling them that that's what we're doing, right. So a huge issue, I think, for us in dentistry is we are not spending the time helping our patients understand what it is that we're doing. We are not taking the time or spending that time educating our patients on. This is what I'm looking for when I'm looking at your health history. This is what I'm looking for when I'm looking down your airway, when I'm asking you to move your tongue around. This is what I'm looking for when I'm asking you about the medications that you're taking or the supplements you're taking. This is why I'm asking these questions when I take your blood pressure. This is why I mean, I think a lot of times in dentistry we think the reason why we take blood pressure is in case we give the patient anesthesia.

Speaker 2: 38:43

Most clinicians will tell you that that's why we take blood pressure in dentistry. Well, hygienist, how many times are you taking blood pressure on a patient and you're not going to give them anesthesia today? So why are we really taking blood pressure? Oh, we're doing it because we are screening for inflammatory issues. We are doing it because we are screening for overt systemic diseases. We have to be able to differentiate that and understand our why. Why do we do these things? Why are we taking a health history on our patients? It shouldn't just be to cover our butts in case we get stuck in a court of law. The reason why we take these health histories is so that we can provide better whole body health and comprehensive care for our patients. So I don't know. I think we have an opportunity to really scrutinize the aspects of what we're already doing in dentistry and use that as an opportunity to help empower our patients and see the value of our work.

Speaker 1: 39:45

Oh, my goodness, thank you so much for saying that. I remember when I was still doing clinical hygiene, not treating patients because their blood pressure was too high, and I'm like you need to go straight to the hospital, yep, and asking questions like when was your last physical? And people look at me like what? Like just clean my teeth and shut up Like half of the time that's the reaction that you get. However, I've shared this before, I think, on this podcast, and I had a patient one time that I had just gotten back from my first airway course. So I'm taking x-rays in this patient and every time I get close to him with the, with the bite wings, his tongue gets huge and he starts gagging, you know, and I'm like airway, airway, sleep, how's your sleep? So I'm asking all these questions and he's the one I'm like you really, airway sleep, how's your sleep? So I'm asking all these questions and he's the one that I'm like you really should go get a physical. And two years later he comes back and he says Renata, I've been meaning, I've been coming back to the office for the last, you know, six months, last two years, every six months I wasn't there and he said I need to thank you and I'm like, oh, you know, and I'm like why? He said that day when I left here, all I could hear was your voice, go get a physical. And I said, well, I have that effect on people. You hear my voice right after you're talking to me. Yeah, and he went straight and scheduled his physical and some markers came back really abnormal and come to find out he had prostate cancer. Had no idea and I mean, that's not what I was looking for. Obviously I have no, you know, but just understanding a little bit about airway, I could tell that this was not a healthy patient. I thought he was healthy. There were many, many things there that were not ideal from what I had just learned and he started crying. He was like thank you so much, you saved my life. Now it's been a year since I've had my surgery. I'm cancer free. So you never know the impact that you may have on these patients.

Speaker 1: 41:48

Dental hygienist, all of you guys are out there that you know that think that you're just cleaning teeth. You're not. You are so much more. I mean, katrina just proved to you guys we have the training. We just have to have the confidence of you know understanding how important our role is in the whole body health of our patients. So don't be afraid of speaking up and talking to your dentist and saying listen, I've been learning a little bit more about this. Is there any way I can, you know, start talking to my patients a little bit more about screening for airway sleep tongue ties? I know that we have tongue ties on the title. I can literally sit here and talk to you all day. You're so easy to talk to. But let's talk a little bit about tongue ties. How did all of this come about? Um in your own journey, um with tongue ties and airway? When did you start noticing that it could be an issue?

Speaker 2: 42:43

Yeah, so I, I'll be honest, I had heard about it. I'd, you know, heard a hygienist are taking courses on tongue ties and youolabial frontal pulls and all of that. But I'm a periodontal hygienist, so I'm focused in periodontics, and it really wasn't until we had an issue with my mother's airway that I thought, holy cow, I need to take a step back. So many people know the story, but my mom passed away in 2018. She had an airway issue. She was seeing an ear, nose and throat specialist routinely. So how easy is that for us in dentistry to go? Oh so somebody's watching this for you Got it. We're good, Right. And as her daughter that was the narrative I told myself.

Speaker 2: 43:35

The last time I saw my mother alive was six weeks before she died. Kind of tragic. My grandfather had passed, so this is my mom's dad, Grampy passed. So we were all back in town for Grampy's funeral and my mom was breathing weird. She just it was like she. She was kind of struggling to take in a full breath. There was a wheeze when she'd breathe in. Now it's. It's weird Cause she was, we were at the funeral, we were planning the funeral and all this stuff, so she was crying a lot.

Speaker 2: 44:05

So I, you know it's hard to know, like people have weird crying sounds, so I didn't know, like really what was going on. But I I remember saying at breakfast before my mom arrived, I was like guys, mom is breathing weird, Like something is not right, and my sister said she's seeing an ENT. You know, they're looking at things and the last time I saw my mom alive was at that breakfast. Um, and you know, I got a call from dad six weeks later that mom had collapsed in the kitchen, she was on life support and that I should be prepared to come home, pack a black dress.

Speaker 2: 44:44

I'd be probably helping dad plan her funeral. And this is six weeks after your grandfather passed, after grampy passed, yeah so, but the bizarre thing was the morning that she passed, the morning that she collapsed. She woke up that morning feeling like she was really struggling to breathe. So she went into her ent that morning. She did like. She followed the directions, she did the steps, she did all the things right. She saw the ent. The ent did a scope, said all this is normal for you, like you've got scar tissue, but that's normal for you.

Speaker 2: 45:20

Here's a Z-Pak, just in case you got a little bug going on or something to help take the inflammation out, you're good. And my mom went to the store filled her Z-Pak, never took it because she collapsed before she could even take her first dose and it's incredible looking at the way in which the healthcare system, in my opinion, failed my mother. One of the things that I, after kind of healing from all of that that I popped up, was somebody was doing a course on oral myofunctional therapy and I thought, oh my gosh, yeah, this isn't just on the ENT, this is our opportunity as well. And how dare I point fingers and go well, the ENT didn't do a good job when I, as a clinician, stare down the airway of my patients for 45, 60, 90 minutes at a time, shame on me for not exploring this education. Shame on me for going well. I'm a periodontal hygienist, so it doesn't matter. Respectfully, patients in a perio office have a lot of comorbid issues that show up in airway, complicated situations and I'd mentioned earlier I'm of the generation. I was of the airway management population that had my first premolars extracted for ortho. Had my mandibular molars lingoverted At the time, mandibular molars, lingual averted At the time. You know, healthcare wasn't focused on tethered oral tissues. Like I remember my, my brother went to a speech pathologist. I mean I I'd love to have my parents alive now to learn a little bit more about like. Did we all have speech issues? Were we pronouncing our L's and our R's and our all differently and needed to see a speech pathologist? You go back in the history and you see those nuggets of those things and you go, oh my gosh, it was all there. It was all there.

Speaker 2: 47:28

When I was packing up we went back home for mom's funeral. I stayed for a couple of days afterwards to help dad pack up all of her you know as many of her clothes as he was ready to get rid of. And I remember taking all of her pill bottles, all the pills that my mom took, and putting them in a box. And she was taking GERD medication. She was pre-diabetic, so she was taking metformin. She was taking blood pressure medication. She was taking sleep medication because she would have really bad insomnia and then she would nap throughout the day.

Speaker 2: 48:01

I looked on her side of the bed. My mom had a stack of pillows on her side of the bed. It was all there. It was so obvious and it was one of those very eye-opening moments of like, and it was one of those very eye-opening moments of like. Holy cow, I'm sitting here, I'm standing on stages talking about how important preventive specialists are and how we need to do a better job of educating ourselves up there, telling all of these people and my own mother was suffering with an airway issue that I I didn't understand or take into consideration, that I was responsible for, so that for me, changed the journey.

Speaker 2: 48:45

It changed the dial.

Speaker 1: 48:47

It is. It is difficult, for we want to trust all this medical profession, medical professionals who are taking care of our friends and family, and it's easy for us to see well, I should have done something, I should have seen this. First of all, do not blame yourself. Second of all, what can we do to help the patients that we are helping? We're doing it, we're educating ourselves, and I say that because I have also a personal encounter with this airway.

Speaker 1: 49:20

My father has full-blown sleep apnea and his head is since. I can remember, you know, snoring very loudly, having to run to the bathroom in the middle of the night because it was choking on his spit. But I didn't know anything about sleep apnea treatment. I remember that after I started learning a little bit about it I mean, I still had been doing for probably about three years and I called my mom. I was like why is that not, you know, doing anything? And she was like, oh, he doesn't want to wear that thing. You know the CPAP machine. Who wants to wear a CPAP machine? Nobody, you know.

Speaker 1: 49:57

But I didn't know that, that there was treatment out there. So then I knew remember the guy that I said that I liked, yeah, yeah, yeah, he became a dentist and his father actually did snore guards. So I contacted him. I was like you know, and he lived like four hours away from my parents. But I was like, is there any way you guys can see my dad and do a snore guard? And I started talking to my parents but it didn't go anywhere. They didn't go get it done. You know, there was, just it was not there. It wasn't until probably a year and a half ago, maybe two years ago, that I called my sister. I was like that's it. We're calling a sleep doctor right now Because at that time my dad was seeing a neurologist because he started getting forgetful.

Speaker 1: 50:41

And the neurologist said no, this is longer than a year and a half ago. But the neurologist said was doing some treatment in tons of medication you know for, also metformin and antidepressant medication, I mean all these things. My dad's not depressed, but nobody was looking at his sleep Not one. And this is a neurologist who he's trained supposedly to be able to tell sleep issues and check your mic. By the way, way it's giving me whenever you speak and somebody just mentioned that it's it's giving a little noise whenever you speak with your mic. Just make sure, I guess.

Speaker 1: 51:22

Oh, weird way you started yeah for some reason, I'm not sure, uh, why? However, um, I then called my sister and I said that's it. It this ends today. So I found a sleep physician and we called and I was on the you know on like FaceTime with my sister and I was like tell him exactly this, this, this, no matter what happens, as soon as my dad walks in there, I want a sleep study, just do a sleep study. It came back that his oxygen was dropping to the seventies and his age I was like 49. That's severe sleep apnea and he also had central sleep apnea at that point.

Speaker 1: 52:00

So, if you guys don't know, obstructive sleep apnea is different than central sleep apnea. Obstructive sleep apnea is whenever you have some type of obstruction in your airway. It could be large tonsils, large adenoids, it could be your soft palate that's too long, it could be your tongue that's fallen into your airway Several different reasons why your airway can obstruct at night and then you stop breathing and then you move around and you wake up, your tongue moves or whatever, and you start breathing again. So you never get a full, really good quality of night of sleep. Central sleep apnea is whenever your brain just tells you to stop breathing. However, if somebody says somebody said and they really like your hair, and then somebody said Renata's hair, and then they said Renata's face and Katrina's hair combined, I don't know who you are, but thank you.

Speaker 2: 52:52

I'll skin my hair.

Speaker 1: 52:52

Send it to you.

Speaker 2: 52:52

I don't know who you are, but thank you.

Speaker 1: 52:55

I'll skin my hair and send it to you, but anyway. So he started wearing a CPAP at night. However, the damage was already done and, yes, I feel extremely guilty to this day that now I know these things and I can't do anything to help my own father. The other day he had a visit with his sleep physician and I said I want to be in the visit because I know that some of the medication that he's giving him especially the one for I think it's Albutrin for depression which he doesn't have depression but I want to know why you're giving, because maybe there's a reason you know whatever that medication does that he needs. So I just wanted to get some information. However, I know that this medication really impacts your REM sleep and what happened during REM.

Speaker 1: 53:42

It's memory consolidation and what's happening to my father. He can't remember things anymore and as soon as he started I was like it's Alzheimer's, it's Alzheimer's. It's Alzheimer's because of undiagnosed sleep apnea for so many years. And guess what? Last year my dad had to step down from his company of 35 years because he has Alzheimer's disease and it could no longer work. So this is heartbreaking and we don't. You know, you guys know how Alzheimer's goes. It's tough. There's still a lot of denial in my family. He's still driving, he's still doing his things, but he repeats himself a lot and he's been doing this. I mean it was five years ago. It's been a while. Last time.

Speaker 1: 54:25

I was in Brazil five years ago when he was telling me the same story over and over and I was like oh, oh, my Lord, there was something happening, but nobody wanted to listen to a dental hygienist. What do you know? You know what I mean. So definitely, if you guys have this education, go out there, if this is a passion for you in any way. There is so much more that we do for our patients than just clean their teeth. They're spending the most time with you. They trust you more than they trust anybody else in the practice. So use that to not only I was going to say your advantage, but their advantage, because it's their health. You're there to help them. Um, can we talk just a little bit before we go? How, since you are a periodontist hygienist, how are some of these findings in periodontal disease, mouth that could be related to airway? What impacts what? And are some of these patients tongue-tied? Do some of these patients have crowding? What do you find usually?

Speaker 2: 55:25

Oh gosh, so I hope my, is my mic better? By the way, I don't know if my mic is improving at all.

Speaker 1: 55:31

It is messing up for me. If you, I can, I can hear you. However, the sound is like super robotic, but I don't know if it's just my earbuds or you guys on instagram. Let me know if the audio is okay. I know there was one point there. I don't know what happened. It just switched. However, I hope that it's recording correctly and you guys can hear as well. Mic is is fine. All right, go for it. It's just my earbuds then.

Speaker 2: 55:55

Oh, okay, fabulous, All right. So let's start with some of the challenges that we're starting to see in periodontics today. So in periodontics we are seeing a population of individuals now not all, but a large body of them who are in their 50s and 60s. These individuals in the generations before would have probably suffered from serious perio to the point where they've lost multiple teeth and then they're in partial dentures or full dentures. In periodontics today we are doing a lot more in the way of minimally invasive and more early treatment of periodontitis and because of that, maybe we're not losing all teeth, but we are losing some teeth, uh, and then replacing them with bridge work, implants et cetera. But to really understand the foundation of what's going on here, we have to go back to the fact that we are currently working with a population where orthodontia was not as common as it is today. So orthodontia today it's, you know, very, very, very common. You know, kiddos born and you know, okay, we need to save up for college and we need to save up for braces. That's kind of how that goes right. Yeah, that's important, yeah, but this population we did not see early treatment of parafunctional issues, we didn't see early treatment of positioning the teeth and because of that, we didn't see early studying of tethered oral tissues, airway complications, etc. Airway complications, et cetera. In addition, things like a baby having colic was not super common but it was semi-common. Nowadays there are mommy bloggers out there. There are Instagram pages, there are dedicated Facebook groups to watching your baby sleep and should you put your baby on? How do you do this, and all these things. So women particularly are very curious about this and parents now are spending a lot more time studying things like prevention, things like probiotics, things like how do we create an opportunity for the next generation to have healthier mouths? But we're still in this space, in this gap right now, of individuals who didn't receive a lot of that care, so they maybe didn't go through braces. They didn't as their jaw was developing, corrections weren't happening. Then they get into their 50s or 60s and they go. You know what? What the heck? I never went through braces. It's always bothered me that this it's always an aesthetic thing, right. It's always bothered me that this tooth is rotated. I'm going to do a liner therapy. So they go through a liner therapy. I don't mean to say that there are problems with a liner therapy, but sometimes there are challenges sometimes with aligner therapy. So they go through aligner therapy and the aligner therapy just repositions the teeth.

Speaker 2: 59:07

It doesn't look at things like tethered oral tissues to go okay. Well, if we don't correct this tongue thrust, what's going to happen? If we don't correct, you know, this maxillary labial frenum, what's going to happen? Unfortunately, it doesn't look at that. Now periodontics does. When I have a patient come in because they have so much recession down on the lower anteriors that they've been referred for a tissue graft and I look down there and that frenal pull is very high. It's an apparent frenal pull where it's very high, where now we need to talk about releasing that frenum in treatment plan cases. Sure, we're housing that conversation but again, this is still relatively progressive or new inside of periodontics for us to be studying a lot of that right Before it was. We're going to put a tissue graft over this area. Hope it works out. Now we're going. Why do we need a tissue graft in this area? Oh, it's because of a tethered oral tissue. So we need to address this tethered oral tissue and unfortunately anectomy is the most common therapy that we're looking at because of how far down our patients are in periodontics.

Speaker 2: 1:00:20

A lot of times the reason why we're seeing periodontal issues is because of tooth malalignment or malpositioning, super eruption of the teeth. So the fact that our teeth have not been put into good function, the fact that there is a masticatory dysfunction, has created a major issue. We also see patients who are covered in exotosis and tori and palatal torus. That is a very common thing that we see in perio and alongside that we see patients who have had serious vaulting of the palate. Again, this wasn't addressed when the face was being developed, so these individuals have become very accustomed to.

Speaker 2: 1:01:07

This is just how I breathe and the body's amazing. It's resilient. It will overcorrect for things in an incorrect way, but it's trying. It's trying. So the concept of just putting a Band-Aid on things oh, it's a periodontal disease. Periodontal disease is a bacterial driven disease, so we're just going to get rid of the bacteria and everything's going to be fine that's putting a bandaid on the issue. The true issue stems from, like I said, you know, parafunctional issues. It stems from malalignments, it stems from just overt levels of disease that we have really struggled in dentistry to understand our role until now. What's so exciting about what you're doing, renata? What's so exciting about what clinicians working with you are doing is. You are creating and paving a way for future generations to literally breathe differently, and I do believe you are the change maker People like you are the change maker.

Speaker 2: 1:02:13

We are To say we need to be doing something different here and it's going to be slow, but it will move. It's going to be slow, but it will move. I hope that hygienists for generations from now are completely changing the way our patients interact with systemic disease, because we've taken such a prominent role in understanding the fact that we're interacting here, which is the portal so much.

Speaker 1: 1:02:38

And I am going to tell you guys, just because we're talking about breathing, can you tell how I'm breathing? I mean, there's a little bit of sound there.

Speaker 2: 1:02:50

I have the flu right now.

Speaker 1: 1:02:53

My son just got over the flu and I got it. However, because I have been training myself how to breathe through my nose. Even last night when I went to sleep, it was the worst night, where one side was very blocked, but I could breathe perfectly out of one side and I was able to sleep well. And even though I'm super sick, I can still breathe. If both of the sides are completely blocked, there's an issue. There's some drainage issues, so myofunctional therapy can help with that too. Just help your body function a little bit better, even when you're sick. That's right.

Speaker 1: 1:03:32

We are here, are the change makers, and I do believe that there's such a beautiful future for dental hygienists. So if you're listening to this right now, please send this podcast recording. It's a beauty of breathing. We are on Spotify, apple podcasts you guys can find us anywhere or video breathingcom. Send this episode to your dentist, to your periodontist, to your orthodontist. We need their help. We can't do like Katrina was saying. Our voice is very muffled in this in this group, so we need their help. We need their help to help us be able to do more for our patients.

Speaker 2: 1:04:09

Yeah, yeah, amen. Sister, you're spot on, and I will just share one final parting piece. I think a lot of times we get so transfixed or focused on the patients that don't want to hear from us or say like oh you're just a hygienist who cares what you have to say.

Speaker 2: 1:04:27

I think we get so focused on those patients that we forget, in the grand scheme of things. Truly, that is the minority, the average reasonable patient who trusts you and comes in to see you every three, four, six months. Those patients want to hear what you have to say about their overall health. It's really easy to let the one patient who says, ma, don't worry about my blood pressure, it's just white coat syndrome. It's really easy to let that one stick at top of mind. Think about the other seven patients that you saw today where you did take blood pressure and they said like wow, I've never had this done in a dental office. They're not saying it to judge you. They're saying it because they're tickled that you are so focused on their cardiovascular health.

Speaker 2: 1:05:15

Those are the patients where you can make a serious impact, and I don't mean to say for the negligent ones that you can't. But what I do mean to say is let's not get overwhelmed or feel low or give up what we're doing because a handful of patients aren't fully on board with what we're doing. Respectfully, there are a decent portion of our own kind hygienists who aren't on board with airway evaluation. So we have to be kind and recognize if you're going to be the change maker, if you're truly going to change the way you do things, you will be met with resistance because true change isn't met with. It's not easy. It's not easy. It's not easy healing the generational pain of what clinicians previously to us have done. That it's not easy, but that's what we're here to do. We're change agents.

Speaker 1: 1:06:12

Yes, and we can take, you can. We can use that to our whole lives, all areas of our lives. You know, if you constantly focus on the bad review, if you constantly focus on the person who told you you can't do what you want to do, if you constantly focus on the bad review, if you constantly focus on the person who told you you can't do what you want to do, if you constantly focus on those, you're not going to get anywhere. You have to be able to filter, because people are only going to give out what they have in. So if all they have in is hatred, is sadness, that's all it's going to come out. So always when I, when I hear something or when I see somebody do something like that, all I do is just a breathe and I tell myself that's all they have to give and you just move on, because even though that's all they have to give, they also need healing and maybe you're you're the one that's planting a little seed there.

Speaker 1: 1:06:58

My first tongue tie release patient. I worked on them for two years and they were good friends of mine and every time they came in, you know, the child was constantly moving around and I kept telling the mom and God forbid you say there's anything wrong with her child, you know? And she goes no, he's perfect, he sleeps fine. Two years later she came in and she was like you know what? I went into his bedroom the other day and he was sleeping with his mouth open. So it's okay for those people who, who you know, don't agree a hundred percent with what you're doing. You still keep doing what's in your heart. As long as you have the right purpose and the right reason why you're doing what you're doing, just keep doing. Don't. Don't look back. You should not get so affected by a good compliment, the same way that you should not get so affected by a negative message from somebody. So, anyways, seriously, best friends, we can stay here all day. We should have a weekly podcast with us.

Speaker 2: 1:07:56

I know, just talking about all this stuff, right?

Speaker 1: 1:08:00

Guys, thank you so much for hanging out with us today. Katrina, how can people find you?

Speaker 2: 1:08:06

Oh, fabulous. Thank you so much for asking. So I'm on Instagram. You can find me I am the dental wine genist on Instagram. I'm also on Facebook, the dental wine genist and LinkedIn, katrina M Sanders R DD-H, and then you can interact with my content. I've got lots of online modules and podcasts, so feel free to check out my website, wwwkatrinasanderscom.

Speaker 1: 1:08:33

Thank you so much. All right, we're going to make sure that we put all that on the show notes. Go check out everything, all the resources that Katrina has out there for everybody. Do you have things mainly for hygienists? Do you have anything for general public? Are these courses? Can you just talk a little bit about that?

Speaker 2: 1:08:47

Yeah, so thank you for asking. So my courses are really designed for hygienists. My podcasts I have a few podcasts actually. My sister and I have a podcast together called floss and flip flops Things that in between teeth and toes, right? So it's an oral systemic podcast that looks at various oral systemic diseases and the general public really loves it because we do talk about very specific diseases. So we do talk about airway, we've talked about diabetes, alzheimer's disease. I mean we talk about all different kinds of modalities and starting to kind of move progressively into what the healthcare industry is doing to address some of these key diseases. So lots of different, diverse opportunities to interact with this information and always making sure that I'm creating information that hopefully helps continue to progress and move our profession forward.

Speaker 1: 1:09:48

Perfect. Thank you, thank you so much. Guys, go check her out. Thanks for spending so much time with us today. We love you, we support everything that you're doing and thank you, thank you for working so hard to get our name out there and show to everybody how important and valuable a dental hygienist is to their practice. Thank you, have a wonderful day, everybody. We'll see you all next week. Bye-bye, yay.