The Sleep-Related Breathing Disorders discussed on this site, and treated in Katoomba at Mountains Dental Sleep Medicine, as well as TMJ Disorders, Malocclusions, and a host of other associated problems, all tend to originate in disturbances to the growth and development of the midface and jaws, and the upper airway in early childhood.
My learning has been influenced by some of the greatest Teachers and Mentors of our time in the areas of TMJD and Sleep. They have all provided pieces of the puzzle, helping me to see the picture, which may never be fully complete. This is why I keep studying and learning…
All I know has come from my teachers, and I thank them and acknowledge them here.
Dr Trevor Baret (2021)
On this page, I will reproduce some of the wisdom of my mentors, as well as other information about the origins of TMJDs and SRBDs.
Recently, an excellent TED talk was published, featuring a dentist (and proud mother), Dr Kathleen Carson. Dr Carson talks about airway problems and the early development of the midface and jaws.
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My Mentors – or some of them…
Dr Bill Comcovich – early 1980s – Occlusion in everyday dentistry, and basic TMJ Disorders and their treatments. Bill got me reinvigorated in Continuing education, and started to consolidate my understanding of the importance of occlusion for long term stability. Although what Bill taught me was very basic, he had a massive influence on the future of my professional development – simply be being a great teacher and sparking in me a new interest in learning.
Dr Bernie Williams – early 1980s – more advanced TMD diagnosis and treatment planning. Bernie taught me about the various stressors involved in Temporomandibular Disorders, including – Structural, Biochemical, Psychological, Environmental, Microbiological and Social. This is why, four decades later, I am still assessing all of these areas of my patients’ history while determining the cause of their problems.
Dr John Wellington “Skip Truitt” – early 1980s – Dentofacial Orthopaedics and Orthodontics. Skip basically helped me to put together the occlusion and TMD that I had learned and show how it relates to orthodontics. This consolidated my direction for all future studies. Putting what I learned from Skip into practice also started to show me how airway and breathing fit in. The principles of functional orthodontics that I learned from Skip remain an important part of my treatments still.
Dr Bill McHorris – mid 1980s – More advanced occlusion and TMD. Bill taught me more about the details of finishing the occlusion, about the functional anatomy of occlusion and how each tooth relates to the TMJs. The pattern of ridges and grooves on the biting surfaces of each tooth is affected by, and affects, both joints.
Dr Robert Ricketts – late 1980s – One of the most prolific researchers in history in the area of orthodontics. “Rick” taught me about certain details in diagnosis. His analysis of both the Lateral Cephalometric and the PA Cephalometric x-rays heightened my interest in these analyses in general. He also taught me about his “Bioprogressive” approach to orthodontics, which still influences my orthodontic treatment today.
Dr Brock Rondeau – 1980s and 90s – Functional Orthodontics and TMD. Dr. Brock Rondeau lectures on the subject of orthodontics, orthopedics, snoring and TMJ and is recognized as one of the leaders in the area of early orthodontic treatment and functional appliances. Brock is still a highly respected teacher in these areas, as well as having a successful clinic in Ontario, Canada.
Dr Brendan Stack – 1980s – Orthodontist and renowned TMJ specialist. Brendan taught me about treating TMJ Dysfunction in a different way, and more about how to protect the joints during orthodontic treatment. Dr Jeffrey Brown wrote – “Dr. Stack was sometimes introduced as “the very controversial Dr. Stack” because his work was so new, so poorly understood, and even to this day, there are few doctors who understand the importance of the articular discs.”
Sadly, it is still true that many do not understand the importance of the articular disc – but this was one of the best lessons I had from Brendan. He showed the relationship between articular disc (function and dysfunction), cervical function and various neurological and organ problems.
Prof John Mew – about 1990 – John gave me the next major piece of the puzzle. He showed me one of the major causes of problems with the TMJs, Occlusion and airway. He introduced me to his “Tropic Premise” which remains one of the major foundations of my treatment planning today. John is one of those innovative thinkers who refuses to be held back by the establishment – I learned a bit of that from him too. Because his treatment approach is based on a different foundation to traditional approaches, it is different, works differently and produces a better, more stable result.
Dr Robert Walker – 1990s – Bob is a chiropractor who knows more about occlusal function than most dentists. He developed the approach he calls “Chirodontics” and teaches Dentists and Chiropractors about the relationships between total Body Posture, Jaw Posture, Nutrition, Exercise and finishing Occlusion for stability, and the importance of treating the entire body, in order to achieve the best and most stable results. By adding more pieces to the puzzle, Bob helped me to put even more together.
Dr Steve Olmos – Late 1990s – 2000s – Steve taught possibly the most intense, detailed, academic, practical and satisfying long courses in TMD and Sleep Medicine there is. And I still consider his “mini-residency” run over the period of nearly a year to be the best there is in the study of TMJ and Sleep Therapy. This is probably why I repeated his mini-residency ten years after first completing it… Steve taught me much more about the anatomy and function (and dysfunction) of the airway. Again, what I learned in diagnosis and treatment planning from Steve forms a major part of what I still do today.
Dr Barry Glassman – Late 1990s – 2000s – Like Steve Olmos, Barry taught excellent courses in the areas of TMD and Sleep Medicine. He has gone on to be one of the most respected teachers in these closely related subjects. He taught me particularly about various treatment approaches, demonstrating that no single treatment is suitable for everyone.
Dr Jim Carlson – Early 2000s – Jim taught a different way of viewing the jaws and their relationships. He showed me how to measure the cranio-mandibular relationships in a new way, and how to replicate it in dental models. This allows a more accurate preparation for treatment of occlusal disorders. All of this is associated with his book – “Analysing the Stomatognathic System”. He teaches how the occlusion is supposed to work in harmony with the cranio-cervical system for structural and neurological stability.
Dr Derek Mahony – 2000s – Derek is probably the best known orthodontist, and most sought after orthodontic teacher in the world today. I have known him for over four decades, and we have been each other’s teachers over that time. His Orthodontic course (now a three year intensive course) is possibly the best in the world for general dentists. He started teaching his mini-residency in the early 2000s and I attended one of his early versions. i have since repeated this course and then repeated many modules two or three more times, and have the honour of teaching in one section of the course. This is the place to learn how to do orthodontice really well, while protecting the joints and the airway. It is my pleasiure to call Derek a friend, as well as a mentor.
Dr Christian Guilleminault – 2010s – One of the best and most respected of researchers and teachers in the area of airway, sleep and pain. I met him at a conference in Sydney, and had the pleasure of some one-on-one time with him over a meal. A true gentleman and scholar. Christian and his prolific research have taught me much more about Sleep Disorders in general and Sleep Related Breathing Disorders in particular. Sadly, in 2019, he passed away – “Gone too soon”. His ground-breaking work in Obstructive Sleep Apnoea will live on.
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Some of what they teach –
Here, I will be adding quotes from some of my mentors, describing their thoughts on the origin os SRBDs
Professor John Mew wrote –
“In my view Sleep Apnoea has an obvious cause although the cure is not so easy. The tongue should remain touching the palate whenever you are relaxed (or asleep) If the tongue drops down the Hyoid bone moves down and back bringing the epiglottis in contact with the back of the pharyngeal airway.
As I say the cure is more difficult. You need to regenerate the subconscious posture that held your tongue against your palate. It is buried and needs a lot of effort to recall, but anyone should be able to achieve this if they try hard enough.”
Prof John Mew, Sept 28th 2022