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I recently had the opportunity to sit down with Phoenix based dentist Dr. Isaac LaVant. Dr. LaVant was born and raised right here in Phoenix, AZ. He began his education at Phoenix Christian High School, then went on to North Dakota State University for his undergraduate studies. After receiving a bachelor’s degree, he went on to complete dental school at Meharry Medical College, Nashville, TN.
Upon graduation, he completed an intense one-year general practice residency at Bronx-Lebanon Hospital (now the BronxCare Health System). This residency is specifically dedicated to providing advanced dental training in the areas of general dentistry, full-mouth rehabilitation, dental implants, emergency family dentistry, cosmetic dentistry, dentures, and restorative/preventive dentistry.
To keep up-to-date on dental treatments, Dr. LaVant takes far above the mandatory continued education hours required by the Arizona State Board of Dental Examiners. Dr. LaVant has trained with one of the best post Graduate programs at the Spear Institute; he has also earned the recognition as Diplomate in the American Sleep and Breathing Academy which focuses on airway issues, treatment of mild to moderate sleep apnea, upper airway resistance syndrome (UARS), and snoring. In recognition of his dedication to his craft, Dr. LaVant received the distinguished the following awards: Top Dentist 2020, Phoenix Magazine Top Dentist 2021, and 2023. He was also voted one of the Top 15 Healthcare Influencers in the January 2021 issue of Phoenix Entrepreneurs magazine
The Amazing Outcome of the Niece
My eight-year-old niece, who experiences severe seizures up to 30 times a day, came to stay at my house. Her doctors had even suggested brain surgery to help manage her condition. That night, my sister gave me strict instructions to keep a close eye on her, as most of her seizures tend to happen while she's sleeping. There have been studies correlating the quality of sleep and breathing at night (sleep apnea) to issues connected to over-sympathetic load during sleep and intermittent hypoxia. It’s important to understand that seizures and neuropathology do have links to untreated sleep breathing issues and fragmented sleep.
Continuing with the story, that night, while my niece was sleeping, I heard her breathing. It sounded almost exactly like the voice of "Darth Vader"—heavy and labored. It startled me, so I kept going into the room to check on her. I was so concerned. I eventually woke her up to see if she was okay. Unfortunately, She was so used to this exhausting routine. She then, calmly told me, "It's okay, I'm just having a seizure." I asked her, "Is this how you usually breathe at night?" and she replied, "Yes." The next morning, I told my sister, "I think you should have her airway evaluated."
Even without formal evidence and testing, it was clear to me that she had serious airway and breathing issues. She wasn't getting enough oxygen, which could be contributing to her seizures. Coincidentally, I was attending an ASBA conference at the time, so I consulted with several colleagues about my niece's condition. Knowing that sleep could affect her seizures, I asked around for advice. The doctors and experts I spoke to have all recommended that I suggest to my sister that she take her to see an ENT specialist.
The family contacted an ENT to have her adenoids and tonsils examined. Surgery was later scheduled, but I continued searching for answers and persuaded my sister to have her airway evaluated to understand how it might be affecting everything. The ENT examined her and noticed her enlarged tonsils, observed that she breathes through her mouth, and saw that her tongue even hangs slightly outside her mouth because she can't get enough air. Naturally, surgery was highly recommended.
Surgery
Surgery was scheduled, and a couple of months later, her tonsils were removed. Almost immediately, her breathing became much quieter. My sister, who was used to hearing her daughter's breathing from across the hallway, now found herself going into her room frequently to check on her. In addition to the quieter breathing, her seizures significantly decreased. Although she was still experiencing multiple seizures, averaging 8-10 per week, my sister felt this was a positive step forward.
ASBA Study Club
I attended a second ASBA conference, where I had a discussion with Dr. Suzanne Mericle. She encouraged me to continue exploring treatment options for my niece. Dr. Mericle introduced me to David Gergen, and I arranged for my niece to see him for an evaluation. During the examination, it was clear that her mouth was very narrow and needed to be expanded. I explained to David that, thanks to the surgery, her seizures had significantly decreased from 30 per night to a more manageable 8-10 times per week, and her mother was relieved with this progress.
However, a new issue had emerged: she had become a mouth breather, with her mouth always slightly open and her tongue pushed forward. This led to a rash on the side of her mouth, as excess saliva was frequently escaping, even to the point where a scar was beginning to form. The next step was to focus on getting her mouth to stay closed and encouraging nasal breathing to increase nitric oxide production and improve blood flow to the brain. Those principles of myofunctional therapy and doing myofunctional exercises were so important.
Expansion Therapy
My sister started using mouth tape and nasal strips, along with some myofunctional therapy, to help her keep her mouth closed and breathe through her nose more consistently. Working with David Gergen, we fitted her with an expansion Schwartz appliance, to further assist in widening her airway.
Outcome
Two months later, I saw my niece at a family birthday party, and she looked like a completely different person. Her mouth was now closing naturally, she was breathing through her nose, and her midface was beginning to develop. She had lost some weight and overall appeared much healthier. I asked about her seizures and learned that they had decreased from 8-10 events per week to about half that number. Her father came over and invited us to dinner. As a way to say thank you, during the dinner, he expressed that this was by far the best thing that had happened to her. He said, "The treatment and advice you've given her has changed her life." While she still has seizures, her quality of life is so much better. Actually, she is now is a whole new world. I'm happy to report she looks like a normal little girl.”
ASBA Study Club
I am now a member of the ASBA study club as I continue to pursue further education and training. ASBA is an important part of the future of sleep medicine. The Academy works inter-disciplinary, bringing together physicians, dentists, myologists, chiropractors (SOT/AO) and physical therapists all together working for a common goal of improving sleep apnea awareness, treatment, and education. I highly recommend it to other doctors who are looking to specialize in sleep medicine.