Discover Your Oral Health’s Hidden Impact On Parkinson’s

Joseph Bradshaw, DMD

Yes, thank you for having me. It is a pleasure.

Kenneth Sharlin, MD

Well, tell me a little bit about how you got interested in Dentistry and a little bit about what your journey has been.

Joseph Bradshaw, DMD

Well, as far as dentistry goes, I was planning on being a chemical engineer, so my dad worked for semiconductor materials, and I was planning on going the chemical engineering route. But it became very clear early—I would say two years into my undergraduate career—that I did not enjoy being in the lab that much and that I enjoyed interacting with people much more. I remember my dentist pulling my wisdom teeth and telling me I was going to be a chemical engineer, but I am so glad I got into dentistry. I had not seen him in years, but I called him up and said, Hey, I have been thinking about changing it. He said, Come on by, I want you to see what I do. Yes. Then I went and observed him a bunch, and I got into dentistry and left chemistry behind. There is a lot of chemistry in dentistry.

Kenneth Sharlin, MD

Well, what do you see when you go to the office, when you see that patient when you think about them as dentistry? Tell me about your passion. Tell me about what excites you when you think about this broad field.

Joseph Bradshaw, DMD

Well, in all of dentistry, what excites me is, that I never thought this would happen, but I am more excited about developing in helping people breathe. About nine years ago, I ran into a case where a gentleman had a bridge made across the front of his teeth. He was from Czechoslovakia and was a really interesting guy. In that bridge, he did not see it the way it looked; it just looked flat to him. But more importantly, he was grinding the very back molars down to nothing all of a sudden. That was a new thing for him. Well, I did not know everything that was going on. I took his case to a group called Spear Education which I was a member of. A well-known group in dentistry, continuing education. Immediately, these guys know a lot more than I do. They looked at him, and they said, We know what is going on. He has a breathing problem. His airway is being limited by that new bridge that has gone, and it was a millimeter or two-millimeter change, but it was enough to push his tongue back, block his airway, and give him something called upper airway resistance. Now he was grinding away his molars. That was it. This started to answer questions about all these patients that I had seen, where I was seeing these same patterns in their teeth. It started to make more sense to me. Well, this is what could be occurring, and for the last nine years, I have just been delving into this, and I am super passionate about learning how these dots connect.

Kenneth Sharlin, MD

Yes. My wife Valerie is a health coach, and she is very integral to our brain tumor program here in the office. One of the areas that she is passionate about is the use of a biofeedback device called HeartMath that helps people integrate breath into their biological rhythms overall and to be in what we call coherence. But one of the things that she discovered very early on, even before delving into HeartMath, is that she would sit down with our patients who would say they were in pain or had other issues and just observe their breathing. 

She would say the most fundamental thing: they do not know how to take a breath. The thing that gives life yet so many of us are not doing that properly. It begins with the mouth and the nose. I know you are going to, and I probably jumped ahead for you a little bit to talk about that, but let’s talk about what we need up here. Because, as I said before, we started the recording, is it really that the mouth or the nose is more than just a hole that gets us to our lungs or our stomach and the rest of the digestive system? What are the parts that we need to be thinking about?

Joseph Bradshaw, DMD

Well, probably if we get to the core issue, we call it the roof of our mouth, but it is not the roof, that is a ceiling. The roof is on the other side. The floor of the nose is the roof. If the ceiling of the mouth and the roof of the mouth do not develop correctly, you get a lot of underdeveloped areas of the upper airway. If the roof of the mouth is too thin or narrow, or if it is what we call vaulted, maybe the child sucked their thumb, or maybe they have what is called a reverse swallowing pattern. Again, something we all take for granted: swallowing you correctly. If you engage the correct muscles when you swallow, then that sends you down a pathway of underdevelopment of the arches and bones. That floor of the nose, so many people nowadays have deviated septum. For example, the septum is that middle piece between the two nostrils, and it is just kinked a little bit or pushed to one side. That deviated septum just affects breathing and any limitations up here. You end up using your mouth to breathe. 

Mouths are not for breathing unless you are pushing yourself to exercise hard and you need some extra breaths, I guess. But the tongue is pushed up against the roof of the mouth; that is the natural position of the tongue. Something that you and I have talked about before: if the DNA was the blueprint in the past, we have considered the DNA the driver in ourselves, but it is just the blueprint, the RNA, and how the body translates or interprets the DNA, what genes are expressed. That is what we see here. epigenetically. The DNA will just follow what we are doing in the environment or what our choices are. It will express the genes that create what we see. If we get to the source of that, the centerpiece here just has so much to do with everything. If the tongue and correct swallowing are occurring, then breathing happens through the nose, as it is supposed to, and then the jaws develop, as they are supposed to go down and forward. Now, I jumped ahead. Go ahead.

Kenneth Sharlin, MD

That is okay because it begs the question, and folks are enjoying this summit to find solutions that maybe they have not heard of in the regular doctor’s office, things that they can do. What should we be doing about this? 

Joseph Bradshaw, DMD

Good question. Well, you would want to discover as much as you can about how to breathe effectively through the nose. If you breathe effectively through your nose, especially as a young person, then the jaws have a chance to develop down and forward. This is not something; you do not go to your physician and say, Well, I want to teach me how to work this down here. A lot of times in medicine nowadays, we just go straight to medication. There is no medication to handle that, just to help you along the way. 

For example, if somebody comes in and there’s just always congestion up here, you and I both know that the nitric oxide that gets excreted from the sinuses—the different sinuses in our skull—needs that nitric oxide. It opens up our airways, lowers blood pressure, and has a lot of health benefits. But if we are always breathing through our mouths, we skip over that whole thing that we need for our good health. That is just an example; learning how to clean up or get your upper airway taken care of and not using your mouth for breathing is a good beginning as far as what to do about it; that is a general thing.

Kenneth Sharlin, MD

That is awesome. We were talking about this. There have been some studies that have looked at the use of antiseptic mouthwash because everybody thinks, well, gingivitis is such a problem, cavities, that thing. One of the ways I can circumvent that problem or minimize it is by using mouthwash regularly. There is a product out there in particular that I am thinking of that staked its entire reputation on and made probably millions upon millions of dollars, commercially, plus all the knockoffs and the store brands that are similar to it. I will not name that product, of course, but what it does is wipe out or certainly shift that oral microbiome, these bacteria and microbes that are part of the sinus cavity or part of the mouth. As a result, it is been noted and published in peer-reviewed scientific literature that without those nitric oxide-producing bacteria, there is an immediate rise in blood pressure.

It tells us that, even in the spectrum of gut health overall and, of course, the oral cavity as part of digestive and gut health, there is a spectrum where, yes, there are bacteria that contribute to gingivitis. Some even think that the very same bacteria contributes to the risk of Alzheimer’s disease that is been looked at. There is a clinical trial to see who could prevent Alzheimer’s by targeting that specific bacteria. That is called bad bacteria. But then there can be good bacteria. then, of course, on the other end of the spectrum, we can have a more aseptic, I suppose, oral cavity where we just wipe out the bacteria to a great degree overall. Just the lower digestive tract, when that happens after repeated use of antibiotics and there’s a potentially deadly disease called C. diff colitis, you can have serious problems by wiping out the oral microbiome.

Joseph Bradshaw, DMD

Absolutely. Yes. I would say it makes as much sense to say, Well, I feel sick; my stomach hurts. I am going to go take three antibiotics and wipe out all of my gut biomes. That makes no sense at all. Hopefully, people have learned now that that is not what you want to do. You need that bacteria in your gut. It gives us so many other benefits, well, that it makes as much sense to do that here as to just wipe everything out. It is impossible to sterilize your mouth. 

You are going to have some type of bacteria. the bad bacteria, the ones that we are all trying to fight against, and some take it to the nth degree. That is just a small group. There are many bacteria in our mouths that give us so many benefits. There is even a type of bacteria that is been shown to prevent decay. It keeps the bad bacteria from coming in and eating into your teeth. You have a biome here, and you need that bacteria to wipe it out is not the solution. That just sounds like the medicine-type approach would give me something to rinse that will just clean everything out. Sepsis is fantastic when we are trying to do surgery, but if you are just living life, you do not need to eradicate everything. You need those partners.

Kenneth Sharlin, MD

What can we do to best take care of that?

Joseph Bradshaw, DMD

Do not breathe through your mouth. Look, you breathe through your mouth. You dry your mouth out, and it changes that oral biome. It does. The bacteria that live well in that environment are the bad ones. Let us say there are two classes: there are the cavity-causing bacteria, and they love acidity, and it only helps them win the war against the good kind if you breathe through your mouth and dry things out because you are removing your saliva, and saliva is not water; it is you spitting it out; it is all bubbly. 

It has a lot of chemistry going on in your saliva. It is not just plain water. but it does dilute acid, and it does fight against acid. If you are breathing through your mouth, you immediately limit the saliva in your mouth, raising the acidity level, and you put yourself more at risk. amazingly, again, not to name this company, but the mouthwash companies, a lot of them put alcohol in their mouthwashes, and alcohol has been shown to dry the mouth out further. It is causing the problem, and they are going to help you fix the problem that they are causing.

Kenneth Sharlin, MD

Of course, my dentist tells me, You never got to brush your teeth. I go, and I do brush my teeth, by the way. But I come home from my preventative dental appointment with a bag of goodies: a toothbrush, some toothpaste, and some dental floss. I am guilty of not consistently flossing. I know I should be, but these are obvious things, yet why are they important? What happens when we do not brush our teeth, floss, or do that thing?

Joseph Bradshaw, DMD

Well, the main thing they have shown with brushing your teeth is that toothpaste gives you the best benefit. The toothpaste itself, the brushing—you are just trying to start brushing and flossing—is the same thing. They just attack different areas because they are treating different sides of the teeth. floss and brush. That is all low-tech stuff. All you are doing is stirring up that bacteria so that it cannot create a colony. Because when you create a colony, which is the fuzziness on your teeth, that is where the bad bacteria can get a foothold. It only takes about 12 hours for that gum disease to cause bacteria. They call it biofilm, the stuff that sticks to the teeth within 12 hours. It is already starting to pull calcium from your saliva and start to harden and attach itself to barnacles on a ship. 

All of us need to go see a dentist regularly. I have every tool at my disposal, and I am aware of them all, but I still have to go lay in the chair and have the hygienist scrape that barnacle stuff off. Brushing and flossing—that is just to stir bacteria up. It does not kill anything. We are not trying to, but the fluoride will put a coating on the teeth, and that coating makes it so that the acidity level has to drop another level and the other acidity has to go up. It is a logarithmic scale, so it is by a thousand and has to go up a lot stronger to dissolve away the teeth. Fluoride is what prevents decay. What I would tell people is that you do not need a lot if you use a little bit of toothpaste brush and spit up the extra. Do not rinse your mouth out, though.

Kenneth Sharlin, MD

Any particular, we do not necessarily have to name brands per se, but when I am looking at toothpaste, say in the supermarket where health food stores are, where there are certain ingredients I should be saying or not, or avoiding, this is a holistic health summit. Some folks want to brush their teeth with clay-based products, such as baking soda. Yes. What are your thoughts there?

Joseph Bradshaw, DMD

I would say three things to stay away from, but I will name four because I do not think you should use clay, but we will group that with baking soda. Anything abrasive is not a good idea because all it is doing is removing any protection you had there before. It is removing that because it will remove the outer layers of your teeth, and over time, you will get that wear on the teeth. Baking soda’s not helping you as much as you think, but it does take stains away because it is brushing your teeth with sand. It will take the stain away. You want to stay away from all abrasive stuff, like clay and baking soda. 

Also, stay away from activated charcoal. I know they say that activated charcoal is supposed to trap bacteria, but the activated charcoal is not giving people the benefit that they want. It is just a gimmick. That is my opinion. But from what I see, it does not work that well. The other thing to look out for is that you do want to have fluoride, but you do not want to necessarily have something called lauryl sulfate. Lauryl sulfate is hand soap. People make their toothpaste foam. That is why the big companies put that in there. But in my family, we have sensitive skin. My wife and children all have red hair. They have sensitive skin, so lauryl sulfate does something to the gums. It makes their skin more inflamed. I would say stay away from the lauryl sulfates, it is not necessary. The most important element is fluoride. If you get the fluoride on there make sure you do not rinse it off because it will work for up to 2 hours, put that coating on there that protects you from the bad bacteria.

Kenneth Sharlin, MD

Excellent. To your passion for sleep, let us talk about how we might recognize poor sleep.

Joseph Bradshaw, DMD

Recognizing poor sleep. Well, I will tell you first: how do I recognize it? That will help you see because we all look at our teeth. We want our teeth to look nice. Here is how I recognize poor sleep as a dentist: When somebody comes into the office and I look inside their mouth, there are certain things that I see. One of them is that they will have tongue scalloping, as we call it. In other words, it looks like they have been chewing on their tongue. They just have the tongue shape, or, excuse me, the tooth shape, on the edge of their tongue all the way around. That is caused by the body trying to push the tongue up against the teeth during the day, flexing it against the teeth to release it better. That is a sign something’s going on in the sleep. 

Then, we mentioned this a little bit before, but if I see lots of wear, then I know that is probably something that could be happening during the day, but probably something’s happening at night because during the day, unless you are somebody that eats all day every day or your drink soda completely all day, or there is a gentleman I met one time that just had three lemon trees and he had lemons all day long. He had worn his teeth away a whole lot. Besides the extreme cases, if I see wear on the teeth, I know something is going on. Also, if somebody feels muscle pain in their jaws, most of the jaw problems that people complain of are called TMJ. That’s the temporomandibular joint. But TMJ, or TMD, is the disorder; that means something is going on in the muscles. Usually, it is not bone changes. It takes a long time for these joints to change as far as the bone goes, but with the muscles being sore, that is not a good sign. 

If you think about it, if you exercise, let us say you decide you are going to be a bodybuilder and you are just going to start lifting weights. If you are getting good restorative sleep, you’ll feel sore for a couple of days, but you will not be sore for weeks on end because you are recovering. As long as you are recovering, then the muscles will bulk up, but they will not stay sore up here. If you have sore muscles all the time in your jaws, that is not a good sign. That means you are not getting restorative sleep, and these are probably the ones that are working all night long. That is one of the ways I can tell if somebody, especially on the inside, has a couple of muscles way in the back. If those are sore to the touch, I know they are grinding their teeth at night. That is one of the ways you can detect poor sleep. Do I wake up with sore muscles, or do I wake up with headaches?

Kenneth Sharlin, MD

Oh.

Joseph Bradshaw, DMD

Sometimes we just live with that stuff because it is small. Take somebody appropriate or take some Tylenol and be done with it. Just move on. But if it is happening day upon day or frequently, three or four days a week, yes, something is going on with the sleep.

Kenneth Sharlin, MD

Definitely.  For the folks who are watching this, I also think about the fact that we are going to get into sleep apnea now, but the low oxygen that goes along with that and then waking up with a headache. Yes, it can be an overworking of those muscles and be more of a tension-type headache. But if you are dropping your oxygen saturation over and over again, which cumulatively adds up to a long time as you try on your breath for 10 minutes, there is no way I would die. Well, you do that when you are sleeping. Believe it or not, if you have severe sleep apnea, you will wake up with a headache. That is probably the tip of the iceberg, because who knows how many brain cells have been killed and how much coronary ischemia you have had in the meantime while you are holding your breath? Very serious.

Joseph Bradshaw, DMD

Not just that, I was just reading the papers that deal with Parkinson’s. Parkinson’s runs in my family and there were some papers—research papers—that said there is an association between hypoxia. They did not call it sleep apnea. They are not relating it to sleep apnea, but just hypoxia lowered oxygen, and the development of Lewy bodies and alpha-synuclein.

Kenneth Sharlin, MD

We recognize that sleep apnea, for example, is a major risk factor for Alzheimer’s disease. What you are saying is that it is a major risk factor for Parkinson’s and probably quite a few other chronic neurological conditions. Folks come to me because they want to investigate the root causes of their condition and address them. There are a few more straightforward things and, in our face, excuse the pun, than the treatment of breathing disorders of sleep.

Joseph Bradshaw, DMD

Yes, exactly. That is why I call it breathing-disordered sleep instead of sleep disorder. Breathing sleep disorder. Breathing is the catch-all term, but really, that makes it sound like sleep is messing up our breathing—sleep-disordered breathing. It is not that we all need to sleep. That’s the natural state. The unnatural thing is that when the breathing is disordered in sleep, it is fragmenting. Sleep is a word that is used a lot in literature. If our sleep is fragmented all night, we do not get that restorative sleep. At the same time, our oxygen is dropping repeatedly. That thing. It is the repeated stuff that is happening night after night. Those are the things that cause chronic conditions.

Kenneth Sharlin, MD

I want to share that your comment about the scalloped tongue is so interesting to me because I see it frequently, and I have never put all of that together. But by analogy, there are different indications to send someone for a sleep study. Of course, if their bed partner is observing episodes of that person’s stopping, breathing, or shallow breathing, whereas if you are waking yourself up, choking, or gasping for air, those are important clues.  Another one is that if the person is on more than two blood pressure medications, that is an automatic insurance-approved indication for a sleep study. Whether you think you have a sleep problem or not, which leads me to the question of, as a clinician, when I look in someone’s mouth, it is part of the neurological examination and see that scalloped tongue. What do you recommend to me, to other clinicians, or at least to the person who’s looking in the mirror and sticking their tongue out, and, well, my tongue is scalloped? What should their next step be? Should they go to you? Should they go to a dentist to evaluate that question?

Joseph Bradshaw, DMD

Because there are dentists that specialize in airway stuff, but you are not one of them. In other words, it has taken a little bit of time, but here I have been able to develop a network, and I know how to get people connected with getting a sleep test done quickly. sometimes, especially in the last couple of years, not just from COVID-19, but there was an equipment specialist who had a big problem with one of their machines, and it ended up throwing the entire system behind for months or years. I would say that in the past three years, people have really struggled to get sleep tests done quickly, and nowadays it is starting to ramp up again. But the next step would be to get in contact with your physician. I would say, Look, I have these concerns. I see this on my tongue, and I think I need to get it. 

Other things are happening. I would never say, Well, your tongue has scaled up. You have a problem there. Usually, multiple signs go along with it, and then you get evaluated by your physician. They will have a contact to get tested. Nowadays, it is much easier to get tested because there are home sleep tests that are fantastic. Now, an in-lab study where you have to go to the clinic, stay the night, get hooked up to all of these leads, and it is uncomfortable, and you’ll feel it is the worst night’s sleep. But they are going to get the data that they need. That’s good. If you need some neurological stuff evaluated, it may pick up other data. But if you are trying to evaluate yourself for loss of oxygen and sleep apnea, the home sleep tests are good. They will get it done. Yes, through your physician; that is probably the best way to go. If you go to your dentist, they will scramble a little bit, maybe, and then you would need to find one that specializes in it.

Kenneth Sharlin, MD

You are saying if you see the scalloped tongue, think about other things that might also be associated with that. Are you a mouth-breather? Do you snore? Has your bed partner observed you stop breathing in your sleep or choking or gasping for air, whether you remember it or not? Because there is a doctor who has looked at many sleep studies. We use the term arousal, and you can have 100 arousals through the course. The person has no recollection. Arousal is not equated with full awareness or conscious smartness; it is a disruption of the normal sleep architecture.

Joseph Bradshaw, DMD

Yes, that is correct. There are a lot of things that go on in our bodies that we are not aware of. I was just talking to an ear, nose, and throat specialist, and he said, Everybody says they breathe fine through their nose, but then they go in and examine the sinuses. Many times they are just packed, they are completely occluded, they are congested, and they cannot breathe through those sinuses. same with sleep. You do not know what you are doing when you are asleep; you are unconscious. Unless somebody observes you and stops breathing, it is time to go get tested. You do not need to wait for any other evidence that means something is going on. 

I think it is good to say there are two areas here. There is sleep apnea, and then there is something called upper airway resistance, and then there is snoring. That is another one. They all overlap with each other. You could have multiple or all three types of sleep apnea to qualify as sleep apnea, where you stop breathing and your oxygen drops for 10 seconds. Well, then all the events happen that are less than 10 seconds, and you are still going through two different things: hormonal changes and lots of things that are not good for the body. They wear the body out. That is the upper airway resistance. That is the arousal area where your body is not waking completely, but your muscles are getting turned back on, and you are jumping out of sleep mode, and it is fragmenting the sleep. You want to go get evaluated. But if somebody sees you, stop breathing for 10 seconds. Chances are, you have other stuff going on.

Kenneth Sharlin, MD

What we are hearing, folks, and just to be absolutely clear, the word apnea means to stop breathing altogether. But you can have shallow breaths or difficulty pulling that air through, and that can be just as serious, potentially, and certainly warrants attention. Now, a lot of folks think about sleep apnea, and they look down at their waistline and say, Hey, I know sleep apnea is associated with carrying a little too much weight around, but in fact, that is not always the case because it is not necessarily the belly fat down here at the size of your girth. That is an important risk factor. But we are saying that there are factors that are from the shoulders up to the neck, the jaw, and the oral cavity. Is that correct?

Joseph Bradshaw, DMD

Yes. Thank you for asking about this, I screened patients for seven and a half years, and I would say the number of people who were overweight and ended up having an upper airway issue was a very small percentage, maybe 5%. The other 40 to 45% of people that came back and had an airway issue that I screened in my dental office were fit a lot of times. Or they were not overweight by any description. Other things are going on that caused this issue. Unfortunately, it is progressive. More and more, it is being shown that if you have this upper airway resistance and you do nothing, there is one option. If you do nothing about it, over time, it’ll turn into sleep apnea. You can think of it over here. Your body is trying to manage the breathing situation, but it gets worn out, and over time it starts to switch to, well, let us just shut things down for a second, and 10 seconds, go by, and then you have an apneic event. It is progressive. You want to catch it early.

Kenneth Sharlin, MD

Absolutely. We are going to catch this early. Folks, this is not just about what caused your Parkinson’s disease, because we talk a lot in the Brain Tune-Up Program about changing the trajectory. That is really what the Solution Summit is about. How do you change your trajectory? You have to stop that pattern that may have gotten you here in the first place. As Dr. Bradshaw was saying, Fundamentally, yes, it is about getting oxygen to your lungs, to your bloodstream, to your brain, to your heart, to your kidneys, and so forth. But it is also about all the other systemic changes that occur in your immune system—your mitochondria, your hormones, all of that—even your microbiome is affected by sleep apnea. If you want to alter how this course of Parkinson’s disease can go for you, you are going to have to address that sleep apnea. 

Now, I want to fast forward just a little bit, because as we get toward the end of our interview, there are a couple of super important things that we want to get into, and that is that we have talked a little bit about the testing, and you can do that in a lab. You can now do that at home. That is probably the majority of the sleep tests that I order now. They are very inexpensive. The out-of-pocket costs for a home sleep study are generally less than what your insurance would bill you after they pay for it. It is just a few hundred dollars, including the interpretation and from the doctor. But then folks are going to say, But that machine, that machine—I do not have that machine that I have to wear. That is called Continuous Positive Airway Pressure. In other words, that is the machine they are talking about CPAP.

There are other types, which are a little beyond the discussion for today. But if you have a variety of obstructive sleep apnea and the doctor says you need CPAP, first of all, it is important to understand what that machine is doing because people call it a breathing machine. Well, it is not breathing for you, some machines assist with breathing, but this type of machine does not. We want to think about the air that would hold the walls of an inflated balloon open because that machine is providing anatomical air pressure to create anatomical changes within that upper airway to allow you to breathe on your own. It has to be paired with a mask, as we call it. 

There are different types of masks, but I want to reassure folks who are so many types of masks that if you are afraid of CPAP because you do not think you can wear the mask because you think you are claustrophobic, talk to your respiratory care company to find the mask that is right for you. Just go over the nose, put a few pillows in the nose, and grow up over the head so you can find a mask that is right for you. You can get a chinstrap that helps you close your mouth. However, what do we also want to be thinking about? If just if CPAP is not, or if there are alternatives to CPAP? Dr. Bradshaw, can you talk about the oral appliance?

Joseph Bradshaw, DMD

Yes. Thank you. In the past, the CPAP machine was considered the gold standard because it would open everything up, push air in, open up all of the airways, and allow air to pass in and out. Now, if the obstruction is caused by the jaw position, one variable here, and if we can move the jaw slightly forward, and we are talking millimeters, not a lot because the tongue is attached down here; it will lift the tongue off the back of the throat, and just one or two millimeters of change just opens up the volume back there and makes it that much easier to breathe. 

An oral device is a retainer that you wear on the top and bottom, and they are connected somehow, and then it moves the jaw slightly forward. An oral device is now considered a first-line treatment, just like CPAP for mild and moderate sleep apnea. I would also tell you about upper airway resistance. It is a way just the CPAP machine does not permanently solve anything. What it does is control the situation. An oral device can also control the situation. There are other options out there that do the same thing. The Inspire surgery, for example, is where somebody gets an implantable device on the side and it is a hypoglossal, glossal for the tongue. In other words, the lead goes to the tongue, and it flexes the tongue forward. Another way that you can flex every time there’s a breathing effort then that also to hold the tongue forward. Now, that is only being used for somebody who has severe sleep apnea and meets the requirements. Somebody whose body mass index cannot be too high. 

But these are control strategies you could think of. We want to control the situation, get the sleep apnea under control, or get the upper airway resistance under control. There are also resolution strategies. If somebody has very swollen adenoids in the back, an ear, nose, or throat specialist could recommend maybe having the inflammation taken down, or is it especially if it is chronic respiratory allergies? There’s an acronym called SLIT Sublingual Immunotherapy. That is fantastic.  It is not very expensive. For a few hundred dollars a year. Everybody can get drops underneath their tongue that desensitize their immune system to those respiratory allergies. If that is the reason why the adenoids are swollen, well, that is a lot better than having them removed surgically. There are other options out there. CPAP is not the only option. Alternatives to CPAP, but oral devices are also considered a first-line treatment now for mild or moderate

Kenneth Sharlin, MD

Practice breathing through your nose.

Joseph Bradshaw, DMD

Yes. There is an Eastern medicine, the BUTEYKO method deals with helping people breathe through their noses. B-U-T-E-Y-K-O. It involves people putting, you might have heard of mouth-taping online. I do not recommend sealing your mouth shut with tape, but just a vertical piece of soft tape can help somebody teach themselves to breathe through their nose.

Kenneth Sharlin, MD

Wow. Well, Dr. Joseph Bradshaw, you specialize in oral appliances, among other things. If someone wanted to reach out to you, tell me a little bit about what that looks like. What can you do in terms of an initial consultation and then providing that service to them?

Joseph Bradshaw, DMD

For initial consultations, we provide those complementarily, and really, that is because so many people come from different areas and we want to help them get on the same page. We do specialize in oral devices, but our company is Bradshaw Sleep Solutions. It is using the networks that we have to get people connected with those they need to see. If you need a sleep test, we can help you get that done. We do not do that. We do those here. I am not a sleep physician, but we can help you get that done. 

We can help you get connected with ear, nose, and throat specialists, neurologists, Dr. Sharlin, and a cardiologist if that is what you need. A lot of times, those sleep tests will pick up other things, and you need to have a place to go. If you are not currently connected with the specialists you need to see, If somebody wants to get ahold of us, they can email us. You do not necessarily have to have a referral. We can seek all of that stuff afterward through your primary care physician, your cardiologist, or somebody that you already see. Our email is [email protected].

Kenneth Sharlin, MD

That is [email protected]. Write that one down. Well, thank you, Dr. Joseph Bradshaw. This is an engaging conversation. I hope some time we can pick up where we left off and continue the discussion. There is so much to learn about the mouth and nose, the oral cavity, and the nasal oral cavity that teaches us about our health. There is that old expression. The eyes are the windows to the soul. I have heard that the mouth is the key to understanding health overall, whether it is your brain or your heart. It is so important. Take care of your mouth and take care of your teeth, folks. If nothing else, just breathe.

Joseph Bradshaw, DMD

Yes. Thanks so much, Dr. Sharlin.

Kenneth Sharlin, MD

Thank you. You have been enjoying the Parkinson’s Solutions Summit. Stay tuned for more outstanding interviews, folks. Thanks so much for tuning in.