Episode Details

You’ve spotted the signs—wear, scalloping, fragmentation, maybe even a low AHI—but what does that really mean?

When the data doesn’t match the symptoms, how do you move forward?

And how do you integrate airway into full mouth rehab without compromising function, stability, or predictability?

In this episode, Jaz is joined by Dr. Aston Parmar to explore the real-world application of airway dentistry. They discuss how to help patients own their problem, why sleep testing matters, and how airway influences diagnosis, treatment planning, and long-term outcomes.

Protrusive Dental Pearl

Nasal Breathing and Simple Screening

• Nasal airflow can be a major limiting factor in sleep quality.
• Simple test: flare nostrils → if breathing improves, nasal resistance may be present.
• Nasal dilators can be a cheap, low-risk intervention for selected patients.
• Not all patients need mandibular advancement — sometimes the issue is nasal.
• Second pearl: test snoring improvement by advancing the mandible.
• If forward positioning reduces snoring sound → mandibular advancement may help.

Key Takeaways

• Patients must own their problem before accepting treatment
• Airway dentistry is about risk reduction, not cure
• Apnea-Hypopnea Index (AHI) has limitations—context and patterns matter more than raw scores
• Upper Airway Resistance Syndrome (UARS) is common but underdiagnosed
• Sleep fragmentation can exist even with low AHI scores
• Myofunctional therapy improves compliance and outcomes
• Multi-night sleep testing provides more accurate insights
• Collaboration with ENT specialists improves diagnostic accuracy
• Airway is the bookend of full mouth rehab (start and end)
• Dentistry should be airway-sympathetic, not just tooth-focused
• Mandibular advancement devices are effective but require careful titration
• Morning occlusal guides help reduce bite changes from appliances
• Not all patients need the same pathway—risk stratification is key
• Predictability in dentistry depends on understanding the whole system
• The environment (airway, function, biology) matters more than the teeth

Highlights of this episode:

• 00:00 – Introduction to Upper Airway Resistance Syndrome
• 02:08 – Pearl: Nasal Breathing and Simple Screening
• 07:43 – Recap: Myofunctional Therapy and Indications
• 08:30 – Role of Myofunctional Therapy in Treatment Planning
• 09:40 – Patient Communication and Case Acceptance
• 23:20 – Sleep-Disordered Breathing Spectrum
• 23:50 – Apnea vs Hypopnea and Apnea-Hypopnea Index (AHI) Limitations
• 30:00 – Upper Airway Resistance Syndrome (UARS)
• 35:43 – Management of UARS
• 37:00 – Mandibular Advancement Devices (MAD)
• 39:00 – Maxillary Expansion and Surgical Options
• 41:00 – Treatment Pathway and ENT Involvement
• 44:00 – Risk Assessment in Full Mouth Rehab
• 59:30 – Airway-Sympathetic Dentistry
• 01:02:00 – Treatment Philosophy and Case Selection
• 01:07:00 – Airway as Bookends of Treatment
• 01:09:00 – Managing Side Effects of MAD
• 01:12:00 – Career Insight and Final Reflections

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