“Six-Foot Tiger, Three-Foot Cage: Take Charge of Your Health by Taking Charge of Your Mouth” is Dr. Liao’s way as a dentist to educate the public on what Impaired Mouth Syndrome is. The “three-foot cage” represents underdeveloped jaws and the “six-foot tiger” tells us the tongue is too big for the cage it lives in. When the mouth is in this situation the airway can become blocked by the tongue. This is made worse if the airway is structurally too small to begin with. Imagine breathing through a coffee straw versus a garden hose. The domino effect leads to snoring, grinding teeth at night, high blood pressure, brain fog, chronic pain & daytime sleepiness.
Dr. Liao says, “The diagnoses also suggests its own solution: enlarge the tongue’s habitat, and good sleep and energy will naturally follow.” His approach is using biomimetic oral appliances to turn on craniofacial growth to slowly widen one or both of the maxilla or mandible (upper or lower jaw). You can visualize making the cage larger.
I like that Dr. Liao addresses both adults and children with airway issues in this book. He talks about the importance of addressing a tongue tie if present. One big take away that I got is if you are already going in for a CBCT scan to analyze your TMJ function be sure to include an airway evaluation. Identifying a narrow airway could be used as a tool to assess the presence and severity of obstructive sleep apnea (OSA). That can be used to drive your health and dental decisions.
All of the current run of books I’ve been reading have been confirming the same ideas I teach table side: blockers to normal dental-facial development include tongue-tie, nasal congestion, and habitual mouth breathing.
“It is time to break out of the tunnel vision and see the airway as the starting point of dental care.”