Culture Apothecary with Alex Clark - Why So Many Women Have TMJ, Anxiety & Insomnia | Toothpillow DMD Hilary Fritsch
Episode Date: May 29, 2026We've all heard about how mouth breathing can affect kids — but what about adults?Dr. Hilary Fritsch, an airway-focused biological dentist and Montana's premier Toothpillow provider, uncover...s one of the most overlooked health crises of our time — exposing why your TMJ, neck pain, low libido, and hormone issues may all trace back to how you breathe. She reveals why modern humans are developing smaller jaws and skyrocketing rates of sleep apnea, and exactly what you can do to reverse the damage at any age.🦷 TOOTHPILLOW WEBSITE: Use code "ALEXCLARK" for a free video review upgradeThank you to our sponsors!TAYLOR DUKES WELLNESS: Use code "ALEXCLARK" for 10% off your purchaseA'DEL NATURAL COSMETICS: Use code "ALEX" for 25% off first time ordersGEVITI: Check out their free tier planPRIMALLY PURE: Use code ALEXCLARK for 15% off your first orderTECH WELLNESS: Use code "ALEX" for 15% off EMF-Free Air Tube HeadphonesZEBRA: Use code "ALEX" for 10% off any orderOur Guest:Dr. Hilary Fritsch, DMDDr. Hilary's Links:Personal IGDentistry IGFind an Airway DentistSaddle Peak Dental WebsiteFOLLOW ALEX:Instagram | @realalexclarkInstagram | @cultureapothecaryX | @yoalexrapzYouTube | @RealAlexClarkSpotify | Culture Apothecary with Alex Clark Apple Podcast | Culture Apothecary with Alex ClarkSubscribe to ‘Culture Apothecary’ on Apple Podcasts and Spotify. New episodes drop 6pm PST/ 9pm EST every Monday and Thursday.DISCLAIMER: This content is for informational purposes only and is not medical advice. Always talk to a qualified healthcare professional for any health-related questions or decisions.
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Can sleep disorder breathing wreck your libido?
When cortisol spikes, testosterone drops, and estrogen and progesterone also drop from that cortisol spike.
So it can absolutely kill your libido.
Not only do you not have enough energy, but your hormones are just not there.
So your wife is not not into you.
She's mouth breathing and she needs to see an airway dentist.
Absolutely.
Do women with airway issues tend to have higher cortisol?
Yeah.
So what's happening is if our airways are collapsing in the night, our bodies get into fight or flight,
and that spikes are cortisol in the middle of the night.
Those women really suffer and feel like their sleep is terrible
and they are HRV is impacted and they're in fight or flight all the time
and they don't get into rest and digest and their digestion is affected
and they feel irritated and stressed.
And that's what's leading to a lot of depression and anxiety as well.
And then everybody just thinks, oh, it's your job and motherhood
when really it's absolutely structural.
Your TMJ, tired mom syndrome, facial nerve pain,
lack of libido, shrinking jaw, hormone issues, and more may all be caused by one thing.
Airway issues and mouth breathing.
We've talked on the show about the problems that will arise if your child is mouth breathing
and why it's important to correct that as soon as possible at three years old as ideal.
But what if you're an adult who has an underdeveloped jaw, sunken face, and more?
Dr. Hillary Fritch is an airway-focused biological dentist in one of the leading voices exposing
why modern humans are developing smaller jaws, crowded teeth,
widespread sleep apnea. She specializes in non-surgical approaches that help children and adults
improve breathing, sleep, and jaw development. Today, she will educate families on how modern
diets, lifestyle, and outdated orthodonic approaches may be contributing to the epidemic of
airway dysfunction affecting millions. So whether you are an adult mouth breather or you have a
kid who is one, this episode is going to tell you exactly what to do to correct it and get your
life back. Watch this episode on the Culture Apothecary Spotify or Real Alex Clark on YouTube.
pause, leave a five-star review if you've listened to the show just a few times or have been listening for years.
That is like the number one way to help support me, my team, the work that we do.
It helps us chart, helps us become discoverable, helps bigger guests come on the show.
So it really means a lot.
It takes like five seconds to do.
Please welcome airway dentist, Dr. Hillary Fritch, to Culture Apothecary.
Are we literally becoming less attractive as human beings because from birth we are chewing less food?
Yeah, this is an actual problem that our faces are changing because of the way that we eat.
So when we chew hard foods, we develop the muscles and then the muscles develop the bones.
And when we breastfeed, we have to put our lower jaw forward, breathe through our nose, and use all those muscles.
And that whole system helps develop our baby's faces.
And our adult faces, too, can start to lose bone and shrink and teeth become collapsed and crowded when we don't use the muscles.
How does your jaw form if you're not chewing very much?
It just doesn't form enough.
It doesn't form forward or wide enough.
Basically, like this whole mid face where our maxilla is, is all attached to the cheekbones,
lip support, that whole thing.
When it grows forward and wide, it makes your face look really beautiful.
That's why people do that duck face to look good in their Instagram pictures,
is they're basically faking a good airway and good jaw development.
That is crazy because I do, and maybe this is the millennial in me, and I know Gen Z,
they don't do that. They kind of do the sunken dead eye look. It's millennials who do the duck face.
And you're right. We are like elongating our face doing that. And I do feel like I look cuter when I do that.
Yeah, it's really popular also to get fillers to make your chin look like it's more forward.
And all of that is mimicking good jaw development and good airway development. But that all comes from chewing hard foods and breastfeeding and epigenetic changes since breastfeeding and baby formula.
came out. When should we be giving baby's steak? That you should be giving baby's steak when as soon as
they start to eat hard foods. Because like the problem is when you transition your baby onto solids,
a lot of the time we're just giving them more mush, right? Yeah. Yeah, this was like what basically
got pushed through when Gerber came out. And they wanted everybody to eat everything pure aid and they
came to the doctors and said, your baby's going to choke. You got to teach them how to eat this
pure aid food. Tell them others. This is the best thing. And
And then it became the new normal was everything was purayed all the time.
So this was propaganda just to sell products.
Yeah.
Jeez.
And I mean, we've got these pouches, these applesauce pouches and yogurt pouches, these squeezy tubes.
Are those also super problematic?
Trash.
I mean, it's easy, right?
Like, you can lean on them when you're traveling.
But if the baby's not using their jaws and everything is squeezed and pouches and even
the hard foods, crunchy foods, just melt in your mouth, then we're not going to develop
a beautiful face. We're not going to develop a beautiful airway. And that means we're not going to
sleep and breathe well, which is a foundation for health. So really, really important that we dial
this all back and help moms learn more of like a baby-led weaning technique where we give kids a
mango pit to chew on or like a chicken bone or a big piece of steak and let them gnaw on it.
And they can also then learn how not to choke because they get exposed to chewing those foods
early on and they will only take as much as they can handle if you follow the directions properly
and kind of like pay attention to what they're what they're capable of chewing. So when you're like
cutting grapes in half and all this kind of stuff or biting the ends off of French fries and all
these things like this isn't something we're supposed to be doing long term. I mean because some
parents are doing that and their kids are like three years old. That's honestly a recipe for
a properly grown face. Really? So when do you think a kid should be able to
to eat a whole grape. I mean, grapes are probably one that I would be careful with, but like,
a nice mango pit is a really good one. A whole carrot is a really good one. Basically, anything
ancestral that we were eating, you should be able to give your kids. And if you follow a baby-led
weaning protocol, you can introduce the same foods that you're eating at home to your babies.
I've seen this face on TikTok. It's like, this is the TikTok mouth breathing face. Is that real?
Yeah, that is definitely real. Mouth breathing face.
is what happens when the, so the tongue is the architect of the face. So when the tongue is up on the roof of
the mouth, it helps us grow forward and wide. And so if we have our tongues low hanging down,
it actually grows the face down and narrow instead of developing cheekbones and forward growth
that everybody wants to see. And so mouth breathers usually get like this sunken under their eyes
because they don't have that mid-face development and their face is literally longer.
and usually pretty flat.
So we want to have the lips out in front of the forehead,
and mouth breather faces are often really flat.
And what that means is that this whole system of the upper and lower jaws,
the tonsular pillars, they don't grow forward and out of the airways,
so then the airway becomes really narrow because you have to picture there's a tube
from going through the nose behind the soft palate, behind the tongue,
and down into the lungs.
And if this part of the face doesn't grow forward, that tube gets really skinny.
So what year, what decade did we start seeing this,
problem really come to a head.
400 years ago, royal family started to have jaw development issues.
And that was because I believe they had chefs and everything was soft and puddings and
cooked and easy to chew.
And that was the beginning of some jaw development issues when we look back at skulls.
But in, you know, everyday mainstream life when we introduced baby formula was when
epigenetic changes happened, that really caused jaw development issues.
And we're now seven generations in.
And this is why every child that you know needs braces and their wisdom teeth out because no one is growing the jaws that they were meant to have anymore.
The reason we're told that people in Britain have worse teeth is because they have socialized health care.
But does this actually have to do then with just cultural trends of eating soft foods because the royal family was eating soft foods?
They have basically had a modern diet longer than probably any other population.
on the planet.
And so when you eat a modern diet, your teeth become crowded.
So do you know about Weston Price?
Yes.
Okay.
So he studied people in third world countries that were living on an ancestral diet to try and figure out why do they have these big, beautiful wide smiles, they don't have any cavities, they have enough room for their wisdom teeth.
And what's happening with a modern diet and what he found was that one generation of a modern diet will start to collapse the jaws and cause.
and cause more cavities and more mouth breathing, which is they all three go hand in hand. And so
in Britain, they've been on a modern diet for probably longer than anyone. Why? Well, because they have
been more, you know, westernized and more processed foods and they're not living off the land,
you know, for the long time now. And maybe it does stem from like rural families generationally
coming down the line. And because if you have someone in your family that didn't breastfeed,
that's going to change your jaw development. And so a lot of families will try and do everything right.
Like the crunchy moms that come into my office are like, I'm feeding them raw milk. We only get food from the farmer's market.
This kid has never had sugar. I breastfed for three years. How could this happen? And it's because we have these epigenetic changes down in the line and you are pushing up against that now.
How can you look at somebody and see chronic illness in their face? If you don't,
see if they've felt forward head posture, they have a recess chin or a recessed maxilla,
it's really obvious that they are not going to be getting good sleep. This is something that
I pay attention to every day, so it's really sad actually to walk around in public and see
how many people are mouth breathing and can't breathe through their nose. And what that means
is that they aren't going to get good sleep because they don't have enough room for their tongue in
their mouth. So their tongue is going to fall back in their airway that much faster every night,
especially if their mouth breathing. And then that means they're going to have fragmented sleep,
and that means they're not going to get good dip sleep, and they're not going to get good REM sleep,
and they're not going to get the hormone cascade that they need. And what happens is they get
in a fight or flight during night because they could choke and die. And so their body's cortisol
bumps up. And when that happens, it affects all the other hormones. And so those people
suffer big time from a lifetime of bad breathing and bad sleep. You know, when I think about it,
I can't think of like a newborn baby that I've seen that was mouth breathing. When they're sleeping,
their mouths are closed. And, you know, they're just like so angelic and they're just sitting there
and they're breathing through their nose. So then, but I see a lot of toddlers that are mouth breathing.
Yeah. And so what is changing between the newborn stage and the toddler stage that is
causing a lot of these toddlers to all of a sudden not be able to breathe through their nose.
Maybe they had a tongue tie. So if the, since the tongue is the architect of the face, if the tongue is tethered
down, it can't help them grow forward like they need to. And so those children will not develop their
palate nice and wide and the roof of the mouth is the floor of the nose. So if their palate is
narrow, then their nose is going to be affected. And then there's a domino effect of mouth breathing.
So what happened in like olden days when people were born with tongue ties? They say midwide.
used to keep one fingernail long and just slice it right at birth.
Gosh.
I could not be a midwife.
I could not be a doctor.
I could not work in the medical field.
I'm going to tell you right now, I am so squeamish with stuff.
But yeah, okay, so that makes sense.
So people were aware that you don't want to have that for a long time.
This isn't like a new phenomenon.
I just feel like I hear about it all the time now.
Yeah, no, it's not a new phenomenon.
And babies can be more in mouth breathing.
I have moms all the time that are like, this baby's my mouth breathing since birth.
Oh, really?
Yeah.
So that's, again, the just epigenetic changes.
And moms need to be paying attention when they are pregnant that they are getting enough oxygen because that can affect jaw development.
And when we're pregnant, we are 30% more likely to develop sleep apnea.
So it's a real situation where we should be checking for hypoxia and low oxygen and apnea events in pregnant women.
How do you check for that?
You just need to do a sleep study.
And then if you do have apnea events or sleep fragmentation or oxygen dropping, then we need to intervene and help.
these moms get enough.
There was a mom on my street growing up who just snapped one day.
Three kids, house, always a disaster, nobody listening, and one day she'd just join the circus.
I'm not kidding.
Packed up, left, became like a trapeze person, and I never disobeyed my mom again when she
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Whether your boyfriend is 24 or 84, he will love it.
You'll see a guy ordering an ice macho latte and he's got the single earring gently swaying like he just returned from a voyage across the Atlantic.
I always want to ask them, you know, if you're that committed to aesthetics, are you at least committed to clean personal care products?
Because a lot of the stuff people use every day, deodorant, toothpaste, floss, it's full of weird ingredients that you probably wouldn't voluntarily rub on your body if you knew what they were.
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Why do so many people all of the sudden, I mean, need jaw surgery or braces or retainers, wisdom teeth removal, or Botox for TMJ?
If they have sleep fragmentation or hypoxia, which means low oxygen during the night, they need intervention so that they don't get really sick as the years go on.
Because this can cause, like, everything from headaches and migraines and TMJ and neck pain to, you know, diabetes and high blood pressure and heart disease.
So TMJ could be because of mouth breathing.
Absolutely.
So TMJ is almost always airway related, and it's really, really common in our female patients.
What happens is we're compensating for our airway collapsing during the night, so our bodies know when we're mouth breathing and our tongue falls back and close up our airway.
If we clinch all those muscles, it's a way to open the airway again.
Those patients have constant head and neck tension because all night long they're doing little compensatory things to help their airway stay open.
So if they didn't get good jaw development and they do have maybe two millimeters of airway behind their soft palate, it doesn't take much when you're asleep and unconscious for that two millimeters to close off.
And so we got to get those patients to grow forward and restore the airway.
But they end up with chronic head and neck tension, TMJ pain, clenching and grinding, it beats their teeth up.
And a lot of times like back of the neck pain from having a forward head posture.
So when we tip our heads forward, it becomes way heavier and harder on the back of the neck.
So if you imagine if you hold a bowling ball on a stick straight up and down, you can hold it like that.
Fine.
But if you tip it five, 10 degrees forward, it gets way heavier.
So that causes a lot of strain on the back of the neck.
And if you walk around and look in public, everyone's got a forward head posture.
We always say that it's because they're looking at their phones, which probably does play a part.
But also, if you have a small airway and you stand straight up, it's going to pinch right.
off and get about half as big. And so those patients tend to keep their heads forward in order
to maintain their airway. This is such a pearl of wisdom because I see women my age constantly
talking about, hey, I have TMJ. I'm thinking about getting Botox to help it. You know, Botox was
suggested to me. What do you guys think? You know, asking for opinions online. And nobody is saying to
them, oh, are you mouth breathing? Yeah. I mean, Botox is a band-aid on that for sure. It's not looking at
the root cause. So that's great. We'll put some Botox in there, but you're still choking in the night
and not getting enough oxygen. It's really important that we dial that back and look at the root cause.
And the night guard is the same thing. I mean, people, like everyone I know is in an $800 night guard
to protect their teeth when nobody was like, why are you clenching and grinding? Everybody wants to say,
oh, it's stress. You're too busy. Or you're working too hard. It's motherhood. All of these things
when in reality it's structural.
Can bad breathing actually make you less attractive over time as you get older?
Yeah, for sure. People come in all the time and say, I feel like I don't look like I used to.
Like my face is more shrunken in and they say, look at my crowded teeth. They didn't used to be like this.
The tongue is kind of like God's retainer. It's meant to be pushing on the palate and maintain your architecture.
And if you're mouth breathing, then the whole face can kind of shrink back because there's nothing pushing.
So the tongue and the lips kind of do this game.
That's God's plan to help us grow forward and wide.
And if they aren't in balance and we just have the face, the lips and cheeks pulling in, then the actual jaw will decrease.
And the chin can come back and the maxilla can shrink back as well.
And then the teeth will come with it and become crowded again.
And that's happening to pretty much everyone.
If you talk to women in their 40s, they're all doing Invisaline again.
Everybody is doing Invisaline again.
Even my makeup artist is doing Invisaline again.
And I did Invisaline a couple years ago.
So I never had braces as a kid.
I have a slight over bite.
My top teeth are all very straight.
I have no problems with my top teeth.
My bottom teeth, I have a little bit of crowding, have worn Invisaline,
and I am really good about wearing my retainer every single night.
But still, and I had them do a metal bar for many years, one of those permanent retainers on my bottom teeth, because I was like, they move.
Like, if I forget one night, they will move.
And sure enough, I think I had about five days out of town.
I had forgot my invisible line.
It was like the first time I'd ever done that, came back.
And my bottom teeth are all starting to crowd again.
So I'm like, do I have to do inviseline again?
I mean, is it normal for them to shift that easily?
Yeah.
So the lower arch is a victim of the upper arch.
So if your upper arch is a little bit too narrow, then the lower arch is going to not really have
enough room for all the teeth, and they become crowded really quickly.
So we usually, those kind of patients, we need to really restore their arch width to, you know,
what it should have been before modern diets and epigenetic changes.
And when we make enough room for the teeth and have a little extra space in there, they're
way less likely to collapse in.
So if your upper jaw is locking in the lower and it's a little bit too narrow, you're little bit
too narrow, your lower teeth are really prone to collapsing. That's what's happening to me. Yeah, we should
probably, like, get you just a little bit wider, kick out the canines a little bit, so your lower jaw has a little bit more
room to come forward. So a lot of patients think like, my chin is too far back. Their chin is too far back
because it's trapped by the upper arch. So if we kick out the canines and the molars a little bit more,
we can give the lower arch room to come forward. And a lot of people have a trapped mandible where it's really,
if you look at a CT scan, you can see the TMJ is like really close to the ear and jam back.
And when they go to talk, they come forward and you can see their jaw like comes forward when they speak.
And then they go back into their bite in that retreated position.
So if we widen the maxilla, we can give them room to be in a more comfortable position and it release a lot of tension in the joint.
But it also makes the profile look better and gets their tongue and their lower jaw out of their airway.
Do you reach a point of no return as an adult where, look, if you're mouth breathing and you reach 30,
38 years old, you're toast kind of thing. Like you can't fix it after a certain point.
No, absolutely not. I fix people in their 70s. We can go back, do expanders, we can do clear aligners,
we can do myofunctional therapy, we can retrain the jaws to the tongue to get in the right
spot and regrow the jaws. And it's way easier to do for children while they're growing,
but it's not impossible to fix in an adult. Okay. So what are the devices that somebody can be
asking or treatments or whatever that somebody can be asking an airway dentist in their area for
if they are an adult who is mouth breathing and they want to stop this and they want to fix it and
they want to look more attractive and have a better jaw. Well, if you're mouth breathing,
I would really point people towards expanding their palate. So for me, I was a mouth breather my
whole life and I had an expander as a kid, but it was an upper only expander and it didn't do
enough and I still didn't really have a big enough palate and a big enough nose. I had surgery on
my nose 10 years ago. That didn't really work. And it relapse that happens to a lot of people if you
talk to them about getting sinus surgery done. Because if you don't establish a nasal breathing habit
afterwards, the tissues get congested and inflamed and swollen again because we need air going through
there all the time, all day and all night. I mean, if you really want to remodel the nose, you have to
open the palate up. And so that is typically a Marpe or a Vos expander. And that can, you can,
can be a game changer because it also, it not only opens the nose, but it also makes more room for
the tongue. So you have to picture your mouth is the garage for your tongue. And if your tongue
doesn't fit all the way in the garage, it's going to hang out the back. And that is what's causing
airway collapse. So the other tool that's really great that tooth pillow is doing is a clear
liners with an airway protocol. So like whenever someone says, oh, you know, like my makeup artist is
doing Invisaline, I am immediately like, this is probably not going to be enough because regular old
invisible line just lines up the teeth and it doesn't take airway into consideration at all. But
Toothpillow has a program for adults where you can get a free assessment and find out if you're a
good candidate for clear aligners that have an airway protocol that's going to make that garage bigger. So you
have way more room to get your tongue up in there. And it also makes your smile look really beautiful to
have it nice and wide. And like I was saying before, when we go wider, we can also make room for the
lower jaw to come forward. So if humans actually were evolving correctly and we were breastfeeding and we were
We were not doing formula.
We were not eating soft foods.
We were chewing from an earlier time.
Would our wisdom teeth fit?
Yeah, absolutely.
So they went back and looked at skulls in these caves from ancient humans.
And they had all their wisdom teeth straight in a line.
All the teeth were beautifully developed and into the jaws and not trapped.
And now I'm seeing a lot of children don't have room for their second millers even.
That's really, I mean, I did not know that.
That's very weird.
It's actually really upsetting because.
we're at such a point with this airway epidemic that we're now getting to the second molar
means our faces are not developing how they should be and we are not going to be sleeping and breathing well
and it's something that has changed in the 20 years that I've been in dentistry. I never really saw
children with second molars that didn't fit. Now it's kind of like the norm. I see it at least once a
week. So what are they doing, yanking them out? Yeah, sometimes we're yanking them out or we're pulling the
third molars and hoping that that can, as they're developing under the bone, we're hoping that
getting them out of the way will help it erupt and sometimes that does help. But really,
those kids should all be in an expander or a tooth pillow, you know, helping them grow.
I love how bug spray in America is basically like, hey, do you want to avoid mosquitoes?
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How many women do you think are being told
that they're just hormonal
when really they're chronically sleep deprived,
which is causing hormonal problems
because they're mouth breathing?
I think that's happening to pretty much every woman
that goes to the doctor.
Because everybody that comes to me
and says, yeah, oh, I'm tired all the time
because I make everyone fill out a questionnaire
and I'm like, you are really tired.
Are you doing okay?
And she's like, no, I sleep terrible.
I have insomnia or I can't sleep past 3 a.m.
Or I just don't feel like I have restful sleep.
And I went to the doctor and, you know, they blame it on motherhood or stress or their job or their homeowner.
And nobody's sleep testing these women because they are young and fit and skinny or in shape and accomplishing too much.
And we have it in our mind that only old fat men have sleep apnea.
so they're not even getting tested.
And if they do get lucky enough to get tested,
a lot of them aren't getting diagnosed with any kind of a problem
because women have a totally different sleep profile than men.
And the way that we score sleep apnea has been designed around men.
So you have to stop breathing or your oxygen has to decrease for 10 seconds or more
in order to get that to be called an apnea event.
And we add up all the events that happen over the night
and divided by the number of hours you slept and give you an average. And if it's over five events an hour where your oxygen dropped or you stop breathing, then we say, okay, you have apnea. But women have a lower threshold for arousal. So we won't stop breathing for 10 seconds. We might have five or eight seconds. And then we have a little microarousal where we wake up and do something to get our airway back. And so it doesn't look like apnea. But it's still massive sleep fragmentation where we could be having 30 microarousals an hour.
and they say, no, you don't have apnea and send you on your way.
That's been a real problem in my practice because people think, well, I checked that and
it's fine.
I don't have it.
But that sleep fragmentation and all those microarousals are causing major problems for
those women.
They don't get good deep sleep.
They don't get REM sleep.
And then they have depression and anxiety or they have fatigue, like chronic fatigue issues.
And their progesterone and estrogen and testosterone.
testosterone, cortisol, every hormone gets impacted by that lack of sleep. And so they are feeling
horrible and getting blamed on stress and motherhood. And then they're spending thousands on
Botox and supplements and hormone therapy and peptides and skin care. And meanwhile, it really
just could be they're not oxygenating properly at night. Yeah, it's actually structural. It's none of
those things. And sometimes it is layered. Like we need to get some HRT, some women.
They are actually, as women get older after menopause, hormone replacement therapy can cut their
risk for sleep apnea in half.
So progesterone is really protective for the airway.
It actually helps with the upper airway keeping it toned.
And it helps us promote good breathing.
And estrogen keeps our tissues elastic and strong.
And so those two are really important to protecting the airway.
So after menopause, women are way more likely, three times as likely to develop moderate to severe apnea.
hormones are really important. But if we don't look at the structural issues, then we can really miss the big picture. So I had a patient come in last week, who's 74-year-old woman, and she had trigeminal neuralgia, which is like a severe pain to these facial nerves. It feels like you're getting a hot poker in your face. For 15 years, she's had this. It's really horrible. She was describing to me how much discomfort that she's in and all these drugs that she's on to manage the pain.
And she also had basically every tooth in her mouth had been root canaled and all of her back teeth had been pulled because she was in so much pain all the time that people were like, maybe it's this tooth and they'd pull it.
Or maybe we need to do a root canal and they'd pull it.
And they just kept taking her teeth to try and get rid of the pain.
Oh my gosh.
Yeah.
And we did a CT scan on her and she had 1.9 millimeters of airway behind her soft palate.
Her airway was so small. She had like a coffee straw to breathe through. Oh my gosh. Yeah. And we were like, if someone had identified that for her, you know, 20 years ago even, we could have maybe helped her keep all her teeth. We could have gotten rid of this trigeminal neuralgia. And so all the pain and discomfort and dental issues that she's been dealing with, not to mention like the headaches and the inability to lead a normal life with that severe pain was all coming from.
and nobody looked at it. Do women with airway issues tend to have higher cortisol? Yeah. So what's
happening is if our airways are collapsing in the night, our bodies get into fight or flight,
and that spikes our cortisol in the middle of the night. This is really common where people feel
like they can't sleep and they're having so many of symptoms and really they're getting airway
collapse. And then their bodies know, like when I get into deep sleep or I get into REM, I don't get
enough oxygen. And so then they won't allow their body to get into deep sleep or REM. And cortisol
and melatonin directly pose each other like a seesaw. When one is high, the other's low, and vice versa.
And you cannot have cortisol high and melatonin high. So if your cortisol is spiking in the middle
of the night because you feel like you're going to die and you're underwater and you're not getting
enough oxygen, then your melatonin will drop and then the whole sleep cycle gets out of whack.
So we want our cortisol to spike in the morning. That's really important to like getting going
with the day and having lots of energy. And then as the cortisol drops throughout the day,
Melatonin rises in the night, and then we sleep really well, right? And if those two get messed up and the cortisol is spiking at 3 a.m. because you're in REM sleep and your body's paralyzed and none of your compensatory clenching and grinding is working to keep your airway open, then your cortisol is going to be all out of whack and there's like a domino effect for days from even one night like that. Those women really suffer and feel like their sleep is terrible and they are HRV is impacted and they're in fight or flight all the time and they don't get into rest and digest.
their digestion is affected and they feel like irritated and stressed and like that's what's
leading to a lot of depression and anxiety as well. And then everybody just thinks, oh, it's, it's
your job and motherhood when really it's, again, it's just absolutely structural. Can sleep
disordered breathing wreck your libido? Oh, absolutely. So when cortisol spikes, testosterone
drops and estrogen and progesterone also drop from that cortisol.
spike. So it can absolutely kill your libido. Not only do you not have enough energy, but your hormones
are just not there. So your wife is not not into you. She's mouth breathing and she needs to see an
airway dentist. Absolutely. She'll look better too. We can fix her airway. Is there any evidence that
mouth breathing and poor airway development can lead to infertility at all? Well, yeah, because if we're
dropping those hormones off and not getting good sleep, the whole the whole body suffers. So you've got to
remember, this is like 30% of your life you're spending with not enough oxygen and not getting
through the sleep cycles property and not getting good deep sleep, your fertility will absolutely
be impacted.
Can airway issues cause anxiety symptoms in women?
Yeah, absolutely.
So when we don't get good sleep or we have a compromised airway, then we will not get good
REM sleep, especially that's the one that's impacted the most because during REM sleep,
you're paralyzed because, you know, we aren't supposed to be acting out our dreams.
And when you're paralyzed, you can't do any of the compensation techniques that we do to keep our airway open, like joining your jaw for it or clenching your jaw.
So that airway collapse happens way more.
And so when we don't get good REM sleep, then we don't get to process our emotions.
And we don't get that healing brain sleep.
That's what REM sleep is for.
And that can really lead to depression and anxiety symptoms.
So I actually don't think anyone should go on an antidepressant without checking their sleep first.
Could all of this poor oxygenation also be causing panic attacks?
Yeah, absolutely. So if you don't get into rest and digest and you're always in fight or flight because your body feels unsafe, then that is way more likely to lead you to panic attacks. This is also making me think about kids in foster care that have gone through a lot of trauma, probably difficulty sleeping, but if they're also mouth breathing on top of dealing with that mental stress and trauma, how much worse their symptoms could be with anxiety, depression, or panic attacks.
Yeah, for sure. I mean, unfortunately, those kids probably didn't get the early intervention with dentistry that they needed either, and nobody's looking at whether they're mouth breathing or nasal breathing and they have crowded teeth. So they're having to juggle all of that. But PTSD symptoms are massively impacted by good REM sleep. And if we're not getting good REM sleep, then it's really hard to process all of that trauma. And that's been really obviously shown in the research.
We need pallet expanders for our military veterans.
Absolutely.
You know what I mean?
Like that could really be helpful.
They're talking about all these psychedelics and all that, which is super cool.
And I know that they've seen a lot of promising stuff with that for PTSD.
But I mean, we should also be looking at their airways.
Yeah, we need to be making sure they're getting enough sleep.
Yeah.
I see veterans all the time who the military gets everybody sleep tested before they retire them.
And almost all of those guys have apnea.
But the solutions that they give are a CPAP, which isn't really helping your REM sleep.
Usually people taking their CPAP off when they get into REM sleep because that's the most uncomfortable time to have it on.
And so we're really not helping them get into REM with a CPAP.
And so we need a more comprehensive approach for those kind of patients.
How can you get your spouse to stop snoring?
We'll take him to the airway dentist.
There's a few strategies that we have.
And I see patients all the time that are like, I don't know why I'm here.
My wife told me I'd have to come.
and people are sleep divorced where they're not sleeping in the same bed anymore.
And so we can do nightlays where we laser the soft palate.
We can do expansion.
We can do clear aligners.
A really great place to start is to go to tooth pillow and get assessment because it's
totally free.
Even if you just want.
As an adult, because we know about tooth pillow for kids, but you guys also have
tooth pillow for adults now.
Yeah.
Like just take your husband's pictures, fill out the questionnaire and submit his information.
You can get a free second opinion even and find out what it's going to take for you to
help him. Or wives, too, there are a lot of women who are embarrassed to talk about it, but they're
snoring because they didn't have good job development. And they also need a lot of support to
sleep better and get back in their bed with their husband. I don't mouth breathe. I mean,
what do you think? Do you think I'm a candidate for this still if I'm experiencing this crowding
in my bottom teeth a little bit? You know, like, should I do this and like walk my audience through
it and try it out? Yeah, absolutely. Like, do you, I mean, there's some people that you're going to be
like, this is not going to work for you? Yeah.
Some people are going to get denied because they need more support and they need to go in office to an airway dentist.
But for you, like, you have a beautiful forward growth.
That's why you have those nice cheekbones and a nice jaw line and good lip support.
Oh.
I like your forward growth.
But we could go wider.
And if we went a little wider with your smile, we could unlock that lower jaw a little bit.
My smile wider, I'm going to put Hillary swank to shame.
I mean, I have the biggest mouth on planet Earth.
You think it needs to be bigger?
A little bit.
I would actually go.
It's funny.
Like the numbers that a Caucasian should have are 40 millimeters between the molars across the palate if you measure out the gum line. And almost no one has that. I mean, you have a big wide smile for sure and way more than most people. But I bet that you're not at 40. Wow. Okay. No, I'm very interested in this. I want to try it out. I know one of my best friends, Allison, she's the owner, creator of Branch Basics. She just went and did this. She just did some kind of crazy palate expanding thing as an adult. So I've heard of people starting to do this.
And she's always like on the forefront of all things, you know, crunchy health and wellness or whatever.
My audience knows that.
So like when she starts telling me, oh, I'm doing this or whatever, and then I'm like, well, maybe I need to be doing it.
Like she's like the coolest.
Let's talk about kids who mouth breathe.
Why is this such a big deal?
Because I think a lot of people think like they're kids.
Like they're going to grow out of this.
Yeah.
Unfortunately, they're probably not going to grow out of it.
So if their mouth breathing, they're not going to get the jaw development that they need because their tongue is not on the roof of the mouth pushing forward and wide to get their face.
to get their face, the whole midface to grow forward, and their lower jaw can be trapped,
and it can cause a recess chin, which is all going to downstream cause airway issues and sleep
issues. So 90 to 95 percent facial development is done by age 12. So we are waiting way too long
traditional orthodontics, and they're not looking, traditional orthodontists aren't looking at airway
at all. They weren't trained to look at it. They don't, they don't ask you whether you're
nasal breathing. They don't teach you to get your tongue up on the roof of your mouth. It's all
just getting ignored, basically. And we need to be looking at those kids when there are three
to help them grow that face that they were meant to have, but also to help them get good sleep. So
if you're not getting good sleep, that's actually going to affect your brain development. And what
the research shows is that even once we fix the airway, we can't correct for the years of poor sleep
that affected brain. What is chronic mouth breathing due to a child's brain? It's going to affect
their ability to develop their brain properly because they're not getting the right hormones that they
need and they're not getting the right deep sleep and REM sleep that they need. And so that fragmentation,
when you look at their sleep study and they're jumping in and out of the sleep cycles all night
and they're not getting enough oxygen, it's actually preventing proper brain development. And so
I have a thing on Instagram where I share how a lot of psychopaths and assassins and people are
going and shooting in schools, they're all mouth breathers. You know what? And they do have a look.
Yeah. They all have a look. I mean, I'm thinking about the, the, the,
you know, President Trump's attempted assassination at the Butler school shooting. I mean,
geez, even Charlie Kirk's killer. Even Tyler Robinson has that recessed jaw. He absolutely,
I mean, if you look at somebody who's like, you're a mouth breather, he, the Columbine kids,
the shooter in Aurora, Colorado, that movie theater shooting. I mean, remember that? Yeah. Yeah.
like orange hair or whatever.
Yeah.
All of those kids look a certain way.
That Nicholas' kid from Parkland, Florida, that shooting.
Yeah.
They all have a mouth breather face, the long, narrow face, sunken under the eyes.
And I think that hypoxia is causing brain development issues that can need to being a sociopath.
And then they're all being put on SSRIs because they're like, oh, you have these symptoms of anxiety and depression.
Let's put you on these.
One of the biggest side effects of antidepressants and anti-inxiety medication is more depression.
anxiety, suicidality, right? So it's like, it's this whole chain leading to one another. This is crazy.
Yeah, there's something that I've been on the warpath with because I think we could potentially
decrease the amount of sociopaths in the world if we just started looking at everyone's airway.
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What are the signs that parents are missing when it comes to their kids' mouth breathing?
Yeah, so we kind of normalized to a lot of things like snoring and mouth breathing and dark circles under the eyes and restless sleep and ear infections and throat infections.
And people just think this is kids normal stuff.
but when you fix the airway all those things go away.
Even like my youngest kid, I thought he looked pretty good.
He had spaces in between his baby teeth.
We're supposed to have two to three millimeters of spacing in between all the baby teeth.
And they shouldn't be grinding their teeth and they shouldn't be wetting the bed.
They shouldn't have dark circles.
All of that is like clues that we don't have good job development.
But he looked really good.
But he would, he basically needed to get some expansion because I was starting to put together the clues.
And I thought, well, I'm going to intervene a little early just because I can.
A week into having his expander in, his whole life changed.
He stopped kicking.
Like, if he was in our bed, he would kick us in the night.
He stopped doing that.
He stopped wetting the bed.
He just started naturally nasal breathing.
And he was basically like a different kid, like a little bit calmer, a little bit more able to focus.
And how old was he?
He was five when I first started him.
Okay.
And then so lately, after his expander, I just got.
got him in a tooth pillow now that he's wearing to sleep. And because he started to relapse a little bit
and he was mouth breathing again. And we, because he hasn't done his myofunctional therapy yet,
which is where you do exercises to get the tongue and the lips strong to make sure your nasal
breathing at night. And because we hadn't done that yet, he started mouth breathing again because that's
part of a comprehensive package. We have to structurally change the jaw and then do the myo.
And then I got him wearing a tooth pillow at night, which forces him to breathe through his nose.
and it gets the tongue on the roof of the mouth so that it can maintain all the growth that we have.
I use it as a retainer after an expander.
So you can use a tooth pillow by itself, but in his case, it's a retainer.
And all of those symptoms went away again, like overnight.
It's wild to me how much of a difference the mouth reading actually makes.
So when you've got this precious little toddler and their teeth are all coming in, they have this like perfect smile.
And you're like, oh my gosh, my kid is perfect teeth.
That's actually a red flag.
Yeah, that's a red flag.
We have to have gaps, two to three millimeters, which is significant.
pretty big gaps in between all the teeth in order to have proper jaw development.
What is the ideal way for parents to navigate pacifiers in sippy cups?
Pacifiers are not my favorite because they do constrict the jaws.
And we see the teeth kind of tipping in lingually makes the garage too small like we were talking about earlier.
And in extreme cases, we can get an open bite where they can't even pull their front teeth together.
But in a way, a pacifier is a little bit better than a thumb.
Because when we can't take the thumb away, some of these kids develop really big jaw problems with a very narrow vaulted palate.
They can't pry through their nose at all and everything's tipped in and shrunken.
I'm a big fan of trying to push through those early times with nothing because the tongue is basically what they're trying to do is soothe themselves and trigger the vagus nerve.
So the vagus nerve is a master's switch for rest and digest.
And when we get vagus nerve stimulation, we can relax.
and good tongue posture and good nasal breathing will stimulate the vagus nerve.
So if we can train babies early to get good tongue posture, we can substitute for the passy.
Is it okay for a parent to get their kid braces without checking their airway first?
Not at all.
I think this is one of the big mistakes that we're making right now.
Dentistry knew 100 years ago about mouth breathing and airway development in Weston Prices research,
and that all kind of got thrown out the window in favor of fast orthodontics where we wait until
they're 12 and all the permanent teeth and then we just line everything up. Sometimes we're pulling teeth.
A lot of times we're doing retractive orthodontics and making the airway worse. And we could be
actually giving this patient sleep apnea with our orthodontics that doesn't look at airway. It's really
damaging. In fact, my oldest, I didn't know all the stuff that I know now when we were starting to do
orthodontics on her. And she had what we call a tongue thrust. So tongue thrust is when your tongue's
kind of pushing forward and creating gaps. And we thought her tongue was just misbehaving and we put a
device in to teach her tongue to not go forward. But really, her tongue was trying to get out of her
airway. And her tongue was trying to help her grow forward. So we went nice and wide, but we didn't get
her enough forward growth. And she had a really small airway behind her soft palate. So I've had to
completely rework her case. And if it weren't for the fact that she's my kid, no one would have
noticed this at all. And so kids have apnea really easily because they, they, they,
only have to have one event a night or an hour for them to be diagnosed with apnea.
When we start sleep testing kids, it's kind of shocking how many of them have apnea.
It's because we're not getting the jaw development that we were meant to have and then we just
slap braces on and line everything up. We are doing a major disservice of generation after
generation now. And parents are probably wasting tons of money on braces. I think this is why
so many girls that I went to high school with are now an adult braces. And they had they had braces
in high school too. So it's like they never fix the issue. Their teeth go right back to where they were.
Is that why? Because they're not fixing the palate issue. Yeah. And we haven't addressed the tongue.
So even if they wear their retainer every day, they're so prone to relapsing. And so that's like my
story about my youngest. We haven't done myofunctional therapy yet. And he's basically starting to
relapse quickly. So myofunctional therapy is the tongue posture, the lip strength, getting the tongue
strong, making sure the tongue can actually get on the roof of the mouth, create a big seal,
and lock into place so that it's not falling back in the airway. But also, that tongue is going to
be like your natural retainer that you were built in with. So if we don't address tongue posture
and we don't address nasal breathing, and we're just like, wear this retainer forever, that's a
recipe for relapse. So what is the difference between going to an appointment at an airway
dentist versus your conventional dentist that we're used to? So at an airway dentist, we're going to
usually test your sleep, we're taking a CT scan, looking at the airway, and we know what it's
supposed to look like. So a regular dentist doesn't really know how to look at airway. And we're
also going to look at your nose. Do you have how much volume do you have in there? Can you
breathe through it? Do both nostrils work? If you taped your mouth shut at night, could you actually
keep the tape on all night? Or is your nose closing up in the night? Because some people think that
they can sleep all night through their nose and they're not really. And we're looking at how much room
do you have for your tongue. There's basically four elements through a good airway. And we look
at all of them. One is does the nose work? Two, do you have enough room for your tongue? Three, is your tongue
strong enough to stay up and out of the airway? And then four is how big is the airway itself? So we also
looking for tongue ties. We're looking for the volume of the tube that you're breathing through. Is it
the coffee straw of my 74-year-old patient or do you have a nice big garden hose back there? And then we
kind of put together the pieces of what do we need to do to get this structurally where it's meant to be
and train your tongue to get nice and strong.
Like sometimes we add laser therapies in to tighten the soft palate up.
There's like a whole host of things that we can do that regular dentists do not know how to do.
With adult mouth breathing, how do you go about fixing this?
Like first step, like first, you know, give us like three things you need to do after this episode ends.
Well, I would definitely go to tooth pillow and get an assessment.
It's totally free.
And they can point you're in the right direction.
They know who the best airway dentists are in the country for one thing.
if they aren't able to help you.
And they can say, this is a clear aligner case or this is an expander case.
And so the other big piece of it is that myofunctional therapy that we talked about.
And that they can also help you find a good myo functional therapist.
And they have online courses for you to take so that you can, it's basically mewing,
like structured mewing with a PT that understands mewing at its depth.
So like for me, you know, if I'm doing tooth pillow as an adult, right now I wear this retains.
every single night, you know, that is my leftover emvisaline or whatever. So do I replace that
with the tooth pillow and then I just wear the tooth pillow? Well, for an adult that that appliance
is different. So the appliance that we talk about as a tooth pillow, that is for kids. For adults,
we would be doing a clear liner therapy and doing it with an airway protocol because regular,
I did envisaline for 20 years and it's really hard to move the molars in the way that you need to
to actually get the volume for the tongue. So the protocol that we're using for tooth pillow for
adults is clear aligners, but designed by the best airway dentists in the country. And with a
protocol that is going to actually get that volume change. And is it something that you have to
wear every night for the rest of your life? Like how I have to wear my retainer every single night or
whatever? Or do you only do this for a short period of time? You have to wear the liners 24-7, pretty much.
24-7, not even just at night?
Well, yeah, because we're trying to move the teeth, like when you're an active
invisaline.
Yeah, yeah, okay.
So for like a few months or something?
Yeah, it depends.
Everybody's different.
Some people, it's three months.
Some people, it's a year.
Some people, it's two years.
So, no, depending on how much movement that they need.
But then we go into my dysfunctional therapy and then a retainer phase, which I always give
patients a retainer because I don't know how strong their tongue is going to be.
I'm not sure they're going to be nasal breathing all night because that that soft tissue piece is
harder to identify.
So we will still give you a retainer just to make sure that things aren't relapsing.
But it's way easier to maintain what we did when we make a lot more room and the teeth aren't just fighting for every little.
They're so tight in there that it doesn't take much for them to slide out of place.
And then toddler through teenage, toddlers, little kids, you're doing tooth pillow.
What about, I don't know, 10 and above?
So tooth pillow goes all the way up to age 13.
Okay.
And after 13, that's when you.
you know, go see an airway dentist or do the adult tooth pillow protocol.
Where can people follow you?
I'm on Instagram at Hillary Fritch, DMD, and my website for my office is Saddle Peak Dental.
You practice in Montana?
I practice in Bozeman, Montana.
I ask every guest this.
If you could offer one remedy to heal a sick culture, physically, emotionally, or spiritually, what would it be?
I'm going to get on the nasal breathing trained.
You got to breathe through your nose.
And that will help you sleep better, which is 30% of your life.
and it affects every single hormone.
So I'm a huge proponent of that being the foundation for good health.
And if people want to find out about the adult version of Toothpillow or the Toothpillow for their kids, they just go to Toothpillow.com.
Use code Alex to get a free assessment, right?
Yeah.
Use code Alex, get a free assessment and find out if you're a good candidate for Toothpillow or if you want to get a second opinion on the local airway dentist, although there's so few of us that know what we're doing.
I think it's a great place to start.
Cool.
Thank you so much, Dr. Hillary, for coming on.
Thanks for having me.
We've been told mouth breathing is harmless,
that snoring is normal, that crowded teeth are genetic,
that everyone just needs braces.
And if you learned anything from this episode, it's all a lie.
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This content is for informational purposes only and is not intended to be taken as medical advice.
Always consult with a qualified healthcare professional regarding any questions or decisions related to your health or medical care.
I'm Alex Clark and this is Culture Apothecary.
