 When I'm 80 years old, when I'm 90, hopefully when I'm 100 years old, I'll be able to interact with people. Things I always worry about is being dependent on somebody. Health, to be engaged and productive. I hope to become an old, young, active person. Over the course of human history, most people died before the age of 10, with an exceptional few living into their 60s and 70s. Around 150 years ago, a remarkable shift occurred and the average length of life began to increase. Every decade, about two years were added to average life expectancy. This trend continued in Western Europe and North America until, by the close of the 20th century, life expectancy had doubled for most people in the developed world. In those additional 30 years of life that we had in the 20th century, we call the first Longevity Revolution. It was primarily improvements in public health like clean water, sanitation, indoor living and working environments, controlled air temperature. These are all the things that created very harsh conditions for people in the early part of the 20th century. We wanted to live longer. We didn't want our children to die. We succeeded in doing this and we got exactly what we wished for. Today, the numbers of people living to old age and to super old age are rising around the globe. To live a long life is a monumental achievement and longer life spans are precious gifts for everyone. But there is another side to this story. 50% of the children born now will live naturally to over 100 years. But if we don't increase health span, what it means is that individuals are going to still succumb to cancer, heart disease, diabetes and neurodegenerative disease. At some point between their 40s and their 70s. Here with health span versus lifespan, if you're not, yes, life expectancy from birth has gone up. And health span, though, the time you get sick and how much of your old age extended lifespan, do you get to be healthy? It's not enough. And what I'm going to make an argument for today is aging begins in childhood perhaps in utero. The Barker hypothesis some of you might be familiar with, but we need to do things in early childhood. One of the speakers yesterday talked about cytokine drizzle, you know, before the storm. How about cytokine overcast in childhood? I mean, I propose these at every meeting I go to that's dealing with adult diseases. Rewilding the biome. How about rewilding the jaws in the face in the airway? Meaning to become more like our pre-industrial ancestors. So the goal here is to delay the onset of these diseases that really shorten our health span. We don't even approach our lifespan as being healthy. And what we need to do then is move that up, okay? So again, this is going to be my thesis today is that I think I found a way to do it. And I've got evidence that I produced over the last 10 years that I'm going to show some of it, but there's not enough time to show all of it. I'm Kevin Boyd. I'm a pediatric dentist. I have a master's in nutrition and dietetics, which I never became a dietitian because I got into dental school. I'm on a task force at the American Dental Association that is really aimed at getting dentists to recognize not just cavities and gum disease and other things that we're very good at and we're very necessary for, but also a child's airway and sleep hygiene. Hygiene means health. It doesn't mean clean. Cleanliness is a component of hygiene. It isn't hygiene. It's not synonymous. Does anyone know what movie this is from? Anyway, that's my favorite movie of all time. So early childhood malocclusion is a new definition. Early childhood cavities or caries was something that hadn't been clearly defined and thus insurance companies found ways to not pay for children who had to be put to sleep in a hospital to get all their cavities fixed because there was no clear definition of it. Early childhood preschool years, any kid who has a cavity under the age of 72 months old, 6 years old, that's called early childhood caries and it totally changed access to care for a lot of kids. Just that definition. So we're proposing myself in another group of a consortium where we're all working together on this. Early childhood malocclusion is just poorly aligned teeth and jaws. Well, the jaws and face are connected to the airway intimately. We call it the craniofacial respiratory complex and it is something that we call the back of the face, the airway. The front of the airway is the face. Change the face and jaws, you're going to change the airway whether you like it or not. Our ancestors, normal just means average, right? Well, normal used to mean optimal for health. It doesn't anymore. It just means average and it's usually not optimal for health. There's risk assessment tools. Chicago Hearts is physical risk assessments. We have established this flip chart and it's going around the room. James Nestor has it there. He's going to look at it and pass it around. I've also got pamphlets from our task force at the American Dental Association that has just gone live. So help yourself to that. If there's not enough, just you can email me and I'll send you one. And then, again, I talk about the craniofacial respiratory complex. We used to just say craniofacial, but there's more to it than that. Really assessing risk for visual acuity. It begins in very early childhood hearing acuity. But how about orthodontics? If you have kids, if you have grandkids, if you have nieces and nephews that even yourselves save up your money for braces as a common term, that means that a third-year dental student can look at a child of four or three years old and predict reliably this will persist and worsen and often already is or will become a comorbidity with sleep and breathing disorders, which is a comorbidity for you ready, lowered IQ, ADD, ADHD. Okay, so am I saying if you expand a child at three, you're going to avoid all that? I'm not saying that, but you can take it off the table as being a comorbidity factor. So I'm going to talk to you a little bit about this risk assessment tool that we developed in Chicago. Here's what happens when you widen a kid's jaw and you forward the face, you also improve the airway volume and area. They can breathe better. There's less resistance to nasally-inspired air. And all air is not created equal. Ambient air that we breathe in today, whether you're indoors or outdoors, is not the quality it was for our ancestors, our pre-industrial ancestors. Breathing through your mouth is emergency junk food air. Okay, when you're on the road and you're hungry and you need calories, go ahead and go have a burger king or whatever once in a while. It's emergency. That's what mouth breathing is. Okay, nose breathing confers such an advantage to the person because it mechanically filters, chemically filters with a compound called nitrogen oxide, which is released from the mucosal cells of the paranasal sinus complex. And it comes from L-arginine that's in there and it turns into this enzyme that will create a nitrogen and an oxygen, not nitrous. That's laughing gas. Nitrogen oxide kills all airborne pathogens, including COVID. Okay, it also is responsible for vasodilation and opening up the airway and facilitating warmed and humidified oxygen into the alveoli of the lungs to the hepatic portal system to the brain and the rest of the body. So there you have it. Breathing habitually through your nose when you're sleeping, especially when you're a child, is just paramount to optimal growth of the brain, the long bones, everything. And it should, they should nose breathe all day long as well. Adults should too, but you know what, if you're not going to save yourself, just pay attention to these kids. And again, your own kids, your patient's kids. So this just in, cardiorespiratory fitness. This is the oxygen utilization of skeletal muscle during exercise. And American kids are really in bad shape. Not a word mentioned about sleep apnea in this, but it definitely figures into it. I write a lot of letters to people, and I really want dentists to be, especially those who treat children, to be very involved with this. And also this just came out, is that uncorrected apnea in children will turn into cardiovascular risk, mainly in the form of hypertension and adolescence, but other components of cardiovascular disease that aren't mentioned. These are the main, when a kid has apnea, the gold standard is tonsils and adenoid surgery. Gold standard they call that. And CPAP for little kids. So those are tonsils, adenoids. Adenoid is a pathological moniker. You're not born with adenoids. You only get them if there's a pathological condition. And it's usually mouth breathing of airborne pathogens. It can be food allergies. It can be environmental allergies because it's lymph tissue. But the goal is to take them out. Well, that kid that you saw, that's an x-ray that I took, had apnea after he got his adenoids out. Recurrent apnea after TNA is a big, big problem, and it's been a problem in the medical and dental literature for over 100 years. These are things that happen afterwards. These kids, under three years old, if they get tonsils and adenoids, there's a certain significant percentage of them that have to be admitted because of morbidities that happen. And it's usually bleeding. And, you know, here's another one about relapse. And I was asked to write a chapter and a major textbook about this. But it is a big problem, and it's been a known problem for a long time. I'm going to write a commentary in one of the major sleep journals about this problem of recurrent symptoms after TNA surgery. These kids are seldom cured. And I have, in the bibliography, studies from the late 19th century. And I was surprised they published it. Oh, that's not evidence-based. My ass. It's observational studies. No random controlled trials until World War II, until shortly after World War II. Here's that same guy. Again, what do we do? Well, we advance the interior wall. So if you look that first red line after the adenoidectomy, all the tissue behind it was carved out. That's what an adenoid is. They scrape it off, you know, like scrambled eggs on an iron skillet. And what I did is I brought the interior wall forward. That's the soft palate. If I had a pointer where that yellow line is, that's the soft palate. The therapy that we're doing is a nonsurgical advancement of the entire maxillary complex. And it not only looks great and prevents major complicated corrective orthodontics when they're older. It doesn't prevent it. They still often benefit from Invisalign when they're 13 or whatever. It doesn't mean I failed any more than an ophthalmologist fails when they give a four-year-old glasses. You need six pair before you're driving a car. Big deal. You fix the problem when it occurs and as it occurs. This is what we do. We expand. We don't always put this reverse pole face mask on. We used to only do this for Jay Leno-type people, kids who had underbites. I had a subtle underbite when he was four. I got pictures of him and nobody knew how to do this for him. But we do it on kids who have excess overbites. We still make the upper jaw come even more forward. So the lower jaw can grow even more forward to give them nasal respiratory advantage. This is how it works. There's a suture. If you lick your tongue on the roof of your mouth, that's your hard palate, that line up there. And you go to, there's a bump. That's your, we call it the posterior nasal spine and the soft palate comes off of that. Well, way back in there, you have a suture called the Terrigal Maxillary Suture. And that will split open if you do it before the age of eight. So like I said, as long as you've got 20 teeth, two and a half years old. Most kids have 20 teeth. And I'll treat them at two and a half years old. And this is a, you know, Photoshop, not too scientific, but this is how it works. And it's attached to that posterior nasal spine is a soft palate. Here it is. Everybody said, well, expansion, of course it decreases nasal resistance because you're widening the nasal cavity, which is the floor of the nose is the roof of the mouth. It's the same wall. You not only do that, but you widen the nasal pharyngeal quarter in the back. It comes forward. The whole face will come forward. And that will open up that airway. So there's another way to do it. If you're squeamish, just close your eyes. But here's how you can bring a maxilla forward. Now, trick is you got to be 20 years old. Okay. But it works. Ask me how I know. I need one. And what I just explained to you, you all know more than I did when my four-year-old, five-year-old, six-year-old, you know, when she was under eight, my baby, she's 25 now, but she looks like a movie star. And that was what broke our heart. It's like, yeah, I can't breathe. Yeah, I got migraines. Yeah, you know, I got sleep apnea, but I don't like what I see in the mirror. And it really does make a difference. So my own kid had to have that done because her dad, who does it now for lots of people, couldn't do it for her. This is a metric that was developed in 1970 by a Swedish orthodontist named Linda Aronson. And he said by eight and a half years old, if you're not at a certain dimension, and the first one is 20 millimeters, the second one is 15, you're at high risk. You either are a habitual mouth breather or you're at risk for becoming one. Okay. So we do that measurement on every kid for the last 10 years. We have a database now of 60 children that started treatment before the age of six. And we're going to be publishing this as a retrospective observational trial, not prospective randomized controlled trial. It's still going to get published. So this is something I like to talk about ontogeny. And ontogeny, you know, from conception, you know, from in utero, through death. Okay. And when does it start? There are two types of malocclusion traits that will, there's actually four, but I'm going to talk about two of them. Narrowness, transverse, deficiency, and length. That's sagittal deficiency. Jay Leno being the perfect example of a maxillary sagittal deficiency as an adult. But this, you know, again, he could have been fixed when he was three or four years old. But he wouldn't be famous now probably, who knows. But, and then the other one is me. Okay, I'm chinless. I'm not overweight, but I snore like I'm a real fat guy. And it's because they pulled teeth on me when I was a little kid. They didn't treat me till I was 13. I wore headgear till my junior prom. So anyway, it's all wrong. It's all wrong what they're doing. And again, if you have children, you demand your pediatric dentist, general dentist who sees kids or orthodontist, how come you're not asking me about my child's airway? And how come you're telling me to wait until they're, you know, older? So this is a kid, one of the first kids I treated, referred, and I used to get, I'm not an orthodontist. I'm a pediatric dentist who only does orthodontics, period. I have drilled a tooth in about five years. My partner had me do one the other day, but I just, ugh, I hate it. I mean, tooth decay and early gum disease, they're preventable, completely preventable. Not suffered appreciably by anybody until agriculture, okay? So I'm making a great living off of putting out sugar fires. That's what I call it. And I just, we don't have much of it in our practice in Chicago anymore. This is, so I used to get a lot of crap from the orthodontist. You're not, you're not an RO, a real orthodontist, you know? I'm an imposter, right? Guess who refers to me? Allergist, ENTs, pediatricians, sleep medicine physicians, psychiatrist, psychologist, okay? They give me no shit anymore at all. And I'm sorry, you know, this is being recorded, but... I've never been happier being a dentist because I just don't do dentistry anymore. I'm doing something completely different. So these lines are off, but I, the slide must have moved, but this is a kid who almost died, wait, let me... Okay, she had sickle cell disease, hospitalized, admitted for two years, once a month, and for a pulmonic crisis associated with sickle cell disease. We put her on CPAP. Well, what does CPAP do? It saves her life. It blows air into airway. It also smushes in her face. So if you're starting out with an already neutral to protruded face and you put a kid in one of these, it's going to destroy their face. It affects like binding of the feet. Certain Asian cultures will bind the feet to keep the feet small. It works the same way. But when you see what we did, and that doesn't look like an appreciable change, that's huge. The law of laminar flow says if you change the radius, you affect resistance inversely to the power of four. Meaning, if I double that airway radius, I cut resistance not in half, one over two to the fourth power, one sixteenth. A soda straw becomes a fire hose. These kids respond to treatment so quickly, and it is so easy. They've been doing this on older kids, say 10 through 14, expansions, real common. If it'll work on a 10 to 14-year-old, it'll work on a two-year-old. Ah, what if they won't open their mouth? I'm a pediatric dentist. Are you kidding? We're pied pipers, we're taught that. We can't get board certified until we prove that we are competent at getting into the lives of children and their adult caregivers. So, they don't teach that in orthodontic residencies. They have no requirements to manage behavior guidance, we call it. Child development, none of that, because you're not going to be treating them until they're 11 or 12. Why should you need to learn all those things? So, that's got to change, and this is part of the Task Force, I'm not at the American Dental Association. So, this is, sorry, where do we go here? I'm getting away ahead of myself, sorry about that. I wasn't looking at that. So, I was actually trained at St. Louis University by one of the leading pediatric pulmonology neurologist sleep medicine doctors at Lurie Children's Hospital. He took us to St. Louis, a group of dentists, and trained us in assessment. Not how to do sleep studies or anything, how to really do validated risk assessment in children. And I've been doing it for 12 years now. I'm also so impressed, a 67-year-old getting a PhD. I've been a visiting scholar, consulting scholar at Penn in the Museum of Archaeology and Anthropology for eight years now. I will never get my PhD, but I have access to everything that a PhD student has. And it's gotten me all kinds of invitations to speak. And you met Janice yesterday through James Nestor, who's visited her as well. This is Mariana Evans, and we use her orthodontic office outside of Philadelphia to take these skulls out of the museum, and we do these three-dimensional radiographs. And we've established a new database, normative values that are anthropologically informed or pre-industrial informed. This is all it is, you guys. This is all your kid needs. Again, any relative neighbor, you know what? If it's obvious to you that, boy, that jaw doesn't look right, there's something wrong. And it could be affecting the airway, which could be affecting neurological development. So, again, normal isn't healthy anymore. It used to be. If normal wasn't healthy, guess what? You didn't survive childhood, period. And that is, I can say that with a high degree of scientific certainty, at least relative to the morphology of the craniophacial respiratory apparatus. This was first studied. This is well before I even was even curious about this. I found this paper, and now Jerry Rose hired me and I'm mentoring a PhD student in dental anthropology at University of Arkansas. And Robly, just like Mariana Evans at Philadelphia, has this three-dimensional machine and we take Native American skulls to his office and we analyze them. And that's Cheyenne Lewis. She's our PhD student there. Yesterday and Thursday, everybody, I was taking down notes. Everybody had something to say. People were talking about eczema. Oh, my God. I don't have time to talk about it, but that's a risk fact. That's a comorbidity with sleep and breathing disorders and malocclusion. Who knew that? Because of IgE. It affects respiratory function on every kid. So I ask every parent that brings their kid to me, did your child have eczema or do they know? Well, it's not a risk factor. They're saying it's a comorbidity. That's what we say. Anyway, this is what anyone who's heard me talk. This is what I always... And Todd, oh, my God. Todd, you are unbelievable. Every year he comes up with something novel and he lectures on it as if it's been his life's work. I don't know how he does that. Anyone who's heard me, it's just like, well, it's my life's work. And I'm giving you the most updated info, but I always digress back to where it all started for me. This is where jaws and faces started to get smaller with agriculture. And what else? Well, women had to enter the workforce. And when that happened, they stopped this lifelong commitment or at least the first three years of life to breastfeeding and baby-led weaning onto firm and fresh, unprocessed foods. So these are some of the talks. I was gonna... If I had more time, I would have just want to talk to about everybody here, but there just isn't time for it. So, again, early childhood malocclusion before the age of 72 months old. Five minutes left. How did that happen? Okay. This to me... This is bullshit, okay? First, orthodontic checkup at seven. That's a geriatric patient in my practice, okay? So, evolutionary medicine. Why do moths get sick? This should be affecting every aspect of health care, especially when it comes to children. Do you know about Luca? The last universal common ancestor to every life on Earth. So, you know, where does phylogy... Do you know what's common to everything alive since four billion years ago? RNA, become DNA. And the grip cycle. Everything alive that's ever lived, that's common to all of us. So, where does it all start? Malocclusion started probably around the time of the Industrial Revolution. Phylogeny, what is the family? Phylogeny just means the tribe, beginning of the tribe. Well, maybe we started as amoeba. You know, who knows? I'll just say anatomically modern humans. Antagini is obviously... And we are doing a... We're proposing a trial at Tufts University in the orthodontic department that says that we might be able to predict these comorbidities for apnea based upon the shape of the jaw in utero at 20 weeks. Stay tuned. That'll be what I'll talk about next year or the year after. So, every single skull that Mariana and I and Cheyenne look at, 100% that the maxilla is forward and wide. 100% before the Industrial Revolution. You can reasonably predict what that looked like as a baby when you see that. That's one of my patients. Can you tell me what he looked like as a baby? No, because we have orthodontics. They didn't. If you didn't have perfect jaws at two, three, four years old, you're dead. You do not survive a child. There's other reasons to die in childhood, but nobody died. If you reached the age of two or three, you had perfect jaws, and that means you were a nurse and weaned according to an ancestral pattern. So, I am just going to skip to one of them because of that awful audio you guys heard. I want you to hear something better. These are... I'm sorry. A lot of this stuff is like literature that's over 100 years old. Look at that. You know, persistent mouth breathing after adenoidectomy is 1913. These are kids I fixed for various reasons. There's one testimonial that I just need to offset the awful one that you heard. There's just no way I need the first randomized trial at World War II. Hand washing, scurvy. Those are all things based on observational trials, not random controlled trials. There he is. That's my guy. Hello, my name is Jeanette Castillo. This is Julian. Julian is 10 years old. He is diagnosed with Down syndrome along with some medical conditions, other medical conditions. We found Dr. Boyd through Dr. Lovmani. We came here three years ago asking for help to improve his breathing after a few surgeries with no success to help with severe sleep apnea. Dr. Boyd and staff have been a blessing to our family. Not just his breathing got better, but also his hearing got better. His hearing improved tremendously. Julian is now sleeping better, sleeping all night, and he's also hearing better. His speech has improved tremendously. Thanks to his hearing, we are so grateful for Dr. Boyd and staff. We get that stuff every day. You tell me I don't love going to work. That kid had irreversible hearing loss. We think it was misdiagnosed because we've known conductive hearing loss is reversible with expansion, but this is a kid who said he would never talk and now he talks. So that was pretty amazing. So who's to say? If we do this to a kid, am I going to increase their life expectancy at birth lifespan and maybe improve the amount of time that they get to stay alive and be healthy? I think it's a reasonable hypothesis that I'm going to spend the rest of my life. Do no retraction. Don't push the face back. Don't delay treatment. And has anyone seen this by JFK? Comfortable inaction. I love it. We don't do these things because they're easy. We do them because they're hard. He also said that and that's been inspirational to me. This was 1918. Sound familiar? And look at this. Does everyone know that your seasonal flu shot is because of variations from the Spanish flu? And once the pandemic's over, we're going to need two seasonal flu shots. We're going to need one for the Spanish flu, which we do now, and one for COVID. Men needed more convincing. Does that sound familiar? And they thought they were sissy. Well, thanks for your attention. We are going to open the microphones for questions, but I have a question. What do you think about or how should a parent help their kids work their jaw muscles with baby lead feeding? What are your thoughts on that? In addition to baby lead weaning and nursing, according to an ancestral pattern, I've had lots of moms. I nursed them, told two, and you're treating all five of them. You didn't nurse like an ancestor, but the other thing I've learned is men clinicians should never weigh in on breastfeeding. Okay, because we can't do it. And women... So I have a speech pathologist who works with me, Jody Walker, and she's also a certified or a facial myofunctional therapist. So or a facial myofunctional therapy. And you have one of the best in the world right here in L.A., Joy Moeller, her name is. So if anybody... I have every child get a myofunctional assessment. And also, pregnancy wellness. It's not just yoga. It's not just folic acid. It's breathing. There's something called gestational apnea. Women who do not breathe well during sleep, they can really enter uterine growth restriction, preterm birth, low birth weight. These are all things that can happen. Even if you're eating well and exercising, but if you're not breathing well, you can affect the delivery of oxygen to the fetus. I think he might be next. I was just curious about your thoughts on devices like the myobrace and myomunchie for kids of all ages, like infants through elementary school and beyond. Yeah, myobrace, infant trainers are the ones I use, myomunchies, myogysmuscle. These are little devices that have been designed to help children put their tongue on the roof of the mouth. And the earlier you start, I'm all for them. I don't really use them much because I start expanding. I can do this. Not a lot of people are really comfortable doing expansion on kids, so I use it to desensitize. There's some kids that they're just not ready. I just ask the parent, do you think he's ready? No, okay, then they're not ready. I don't want to treat yet, but let's try this. They have their place. Does it actually work to expand the airway? The tongue does the expansion. Whenever there's a conflict between muscle and bone, bone will always yield. In a little kid, if the kid's tongue is free, it doesn't have a tongue tie, and they can get their lips closed, the tongue will actually, that's what our ancestors did. They were papoost, when the hunter gathers, when the women went out in the fields and suckled, and the kids had to hold their heads up while they were papoost. Click sounds, forming consonants before we really had the types of language that's a lot of force on the palatal-facial sutural complex. There's lots that goes into it, and myobrace and things like that really do help that. Thanks for your talk. At the very beginning, you were talking about the distinction between health span and lifespan, and it struck me that in our meetings we talk a lot about that, and I just wanted to share a resource that I use in my talks. It seems like we're in a health shock for the millennials right now. They're really doing poorly. And so, if you want some data on that, I recommend the economic consequences of millennial health by Blue Cross and Moody's Analytics. And what they did is they compared the health of the cohort of the millennials with the same age group, but from prior decades. And it's measurably less healthy. I'd love it if you'd send me a link to that. The other one is the health span initiative. That's what I, Martha Stewart narrated thing, the health span initiative. It's amazing. So I think all of those things would work together quite well. Incidentally, the person who wrote Survival of the Sickest, you know how he got onto that? He discovers that his grandfather had hemochromatosis, and he felt better after he donated blood. And then it went back that bubonic plague was actually the hemochromatosis protected people against bubonic plague. There's all kinds of things in that book. I was so glad to hear. Oh, it's a brilliant book, yeah. Thank you. So my question is after the period of nursing that early part of life, would it have some correctional would it affect some correctional malformation if the food, the diet was chewy, kind of meat centric for young child? I'm all for you know, baby lead weaning you've probably heard of. But give it, you know, as long as a kid can sit up and you still have to watch them, give them a pork chop. I mean, and let them start knowing that. Oh yeah. Say I'm a college student and I want to follow in your footsteps. What do I study? Well, I every kid, and I've raised up, brought kids, bring their own kids to me now that I've started seeing years ago. Great question, because I get to tell you something I just love doing is I ask these kids as they're going off to college promise Dr. Kev something. Yeah, what Dr. Kev? Take one anthropology class because it's not required. Cultural anthropology, evolution by please, because it's a Rosetta stone, you can figure out everything if you start to think about how things go from simple to complex. It's just that everything works that way. Everything. So that would be my one nugget that I would like to give kids. And a lot of them take me up on it. Yeah. Is it your opinion that the malocclusions you're seeing in the face are leading, in utero, are leading to breastfeeding issues? Yeah, they could. We can't even say that they, even though we know like if a child is born with no chin, that showed up in utero, okay? It doesn't just happen. And when you see it in early childhood, postnatally, it will always reliably persist, worsen, and it either is or will become a comorbidity with sleeping, breathing, and neurological and other systemic issues. So if a kid comes out, retranathic, which many do, and there's some orthodontic textbooks that say, oh, it's an advantage, evolutionary. The chin holds in so that the delivery through the birth canal is easier. Bullshit. It's not true. The chin goes nowhere near the pelvis when a baby's being born. So in all the skulls that Mariana and I have looked at, even fetal skulls, the jaws are forward. It looks like I've gotten in there and done treatment on them. So it can make it difficult, but so can tongue tie, so can lip tie. There's people, lactation consultants, and there just needs to be more people that probably can help reverse that. It's a reasonable hypothesis. Hello, Sharona. Thank you so much for a fantastic talk. I just wanted to say that as a periodonist, people in their adult years, 50, 60s come to me like, why am I losing my teeth? I brush, I have the best toothbrush, I see my hygienist every three months. Why am I losing my teeth? Why am I losing my dental implants? And I can almost always trace it back to childhood, mouth breathing, and of course also low vitamin D levels. To me, those are the two biggest risk factors. So much of what you do prevents these horrible problems later on in life. Yeah, we think pre-temporal mandibular disfunction, pre, pre. It starts in early childhood and it isn't jaw pain, it's asymptomatic. But you see signs, they're grinding their teeth, they're wearing them down. And it's not really oral hygiene. I mean our pre-industrial hunter-gatherer ancestors, they didn't have toothbrushes, they just didn't eat crap. There wasn't, you know, so good point. Okay, we are ready for break and if you have any questions, you can approach the front of the room. Thank you.