The DOC Podcast
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The Great Airway Debate: All That's Old is New Again (w/Dr. Duane Grummons) [Ep.162]

The DOC Podcast
Dela

Overview:
In this landmark episode, Dr. Mike sits down with Dr. Duane Grummons - a board-certified orthodontist, educator, and internationally recognized lecturer with over 50 years of clinical experience. Dr. Grummons traces the origins of airway-focused orthodontics from his early training under Ricketts, Bench, and Gugino in the 1970s, through the political and clinical headwinds of the 1990s, to the evidence-based framework he champions today. The conversation covers early facial orthopedics, slow maxillary expansion, mandibular arch development, face mask therapy, cone beam imaging, and the critical importance of treating the whole patient, not just the teeth.

Timestamps:

  • 0:00 — Welcome
  • 0:23 — Introduction of Dr. Duane Grummons and his 50+ year career in orthodontics
  • 3:16 — Dr. Grummons on his clinical history: Ricketts, Bench, Gugino, and learning to think in 3D from day one
  • 7:03 — "It's a fad" — addressing the critics of airway orthodontics and why this work is decades old
  • 21:03 — The 2026 AAO: only 1 out of 155 lectures addressed early treatment and airway
  • 24:44 — Why orthodontists fear lower arch expansion — and why they shouldn't
  • 30:57 — Advice for colleagues who want to shift toward earlier, airway-focused care
  • 38:26 — Why residency programs are still teaching that mandibular expansion is malpractice
  • 47:30 — The science behind slow maxillary expansion and why RPE may be the wrong tool for young kids
  • 1:01:22 — "Flying the maxillae": face mask therapy, tip/yaw/roll, and 3D orthopedic planning
  • 1:19:32 — CBCT and 3D imaging: why the debate is still happening and why Dr. Grummons can't practice without it
  • 1:28:39 — The power of parent testimonials and capturing outcomes on video
  • 1:33:59 — Facial descriptors, the hyoid complex, and why diagnosis must go beyond the teeth
  • 1:38:36 — Closing thoughts: health span, brain longevity, and rising above the circumstances

Summary:
This episode is an essential listen for any clinician serious about comprehensive, patient-centered orthodontic care. Dr. Grummons reminds us that the science has always been there, and that the most powerful thing we can do is go deep on diagnostics, treat early when the face is developing, and never stop learning.

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