Answers from an E.N.T. Perspective with Dr. Kirt Beus

Answers from an E.N.T. Perspective with Dr. Kirt Beus

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Hello everyone, and welcome to the podcast. My name is Dr. Michael Bennett. I'm here with Dr. Kirk Buss, a great friend of mine and fellow colleague.

Thank you. Pleasure to be here.

Dr. Buss and I have referred patients back and forth over the years, probably at least 10 years by now. He's done an incredible job for patients. My practice is centered around opening the upper airway of patients nonsurgically, while Dr. Buss handles both the surgical and non-surgical aspects. I thought I’d invite him here to talk about why he became an ENT.

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Dr. Buss’s Journey into ENT

I don’t think I even knew ENT existed when I started medical school. I'm originally from Oregon and moved to Utah after completing my undergraduate studies. I went to medical school in St. Louis and did my residency at Penn State. I initially got into ENT through an attending who happened to be my neighbor and specialized in head and neck cancer. Over time, my interests shifted more toward nasal, thyroid, and parathyroid issues.

Over the last few years, what would you say has been the most eye-opening development in ENT?

There’s definitely been a shift toward more conservative, tissue-sparing approaches. Rather than invasive surgeries, we’re using methods that preserve anatomy. One of the biggest game changers is the balloon sinuplasty, which opens sinus pathways without removing tissue. It’s transformed how we treat sinus disease.

I especially appreciate that procedure for the patients I refer to you.

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Understanding Underdeveloped Faces

For context, I see patients with everything from mild to severe dental crowding. Most don’t have their third molars—do you still have yours?

I actually do.

Wow, I’m jealous. I’ve lost both third molars and premolars, so I’m down to 23 teeth. But for most people, facial structures are shrinking. In the fossil record, we see this clearly. Today, patients with crowded teeth often also have daytime symptoms—excessive sleepiness, irritability, lower IQ, underperformance in school. When I ask, “Why is the human face underdeveloped?” the root cause often leads back to an inability to breathe through the nose.

That’s fascinating. Honestly, this idea wasn’t part of my medical training. It’s something I’ve learned through our collaboration and more recent insights.

Right? In dental school, the focus was passing boards. But after practicing, I realized that brushing and flossing didn’t fully explain oral breakdown. Many patients couldn’t breathe well—and poor nasal breathing led to poor sleep, which led to inflammation, disease, and even facial development issues. That drove me to sell my dental practice and work on treating the airway directly.

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Treatment Process for Children

When I send you a child with dental crowding, mouth breathing, and poor sleep, what’s your clinical process?

I evaluate medical causes like allergies or nasal swelling. Then I check the tonsils and adenoids—both can block the airway and force mouth breathing. Adenoids in particular often play a big role in persistent nasal obstruction.

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The Nutrition Connection

How often do you see a link between nasal congestion and nutrition?

That's an interesting area. I’ve read about Dr. Weston A. Price, a dentist who studied indigenous populations and discovered that those eating whole, unprocessed foods had broad jaws, straight teeth, and no decay. But when they adopted modern diets high in sugar and refined flour, facial structures regressed, leading to crowding and inflammation.

That makes sense. Poor nutrition could cause inflammation, and that inflammation affects the nose and airway.

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Advice to Dental Professionals

If you could offer advice to dentists on how to work better with ENTs, what would it be?

Take a holistic approach. Look beyond the teeth—examine the oral pharynx, nasal cavity, and airway. If a child is grinding their teeth or mouth breathing, it may not just be a dental issue. Bruxism can often stem from nasal obstruction.

Do you examine tubal tonsils routinely?

Not specifically. They're tucked near the eustachian tube orifice in the nasopharynx. But significantly enlarged adenoids can block those areas and cause chronic ear infections.

That makes sense. I’ve seen children stop grinding their teeth after adenoid removal. And moms often report dramatic improvements in sleep and breathing.

Absolutely. Adenoid removal is standard during second-time ear tube placements, even if the adenoids aren’t visibly enlarged. It can reduce infection and improve nasal function.

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TMJ and Ear Pain

Let’s talk about the relationship between TMJ dysfunction and ear symptoms. You’ve referred some patients to me who complain of ear pain, but it turns out the root cause is jaw-related.

That happens more often than you'd think. Patients come in insisting it’s their ear, but their exam is normal. The referred pain from the temporomandibular joint is powerful and misleading. Even though they feel pain in the ear, it's often from TMJ dysfunction.

Exactly. I’ll place my pinky finger into the patient’s ear canal and have them bite down. You can often feel the displacement or derangement of the joint disc. It’s a quick way to diagnose posterior condylar displacement. And it explains the symptoms—clicking, popping, inability to open the mouth widely, and yes, ear pressure or discomfort.

It’s fascinating. And it’s true—patients can experience dizziness, aural fullness, or even muffled hearing, all because of TMJ dysfunction.

One thing I’ve noticed in those cases is excessive cerumen (earwax) buildup on the same side. It might be a result of chronic inflammation or neuromuscular irritation.

That’s a solid theory. Local inflammation could stimulate wax glands in the canal. It’s not something we’re taught, but it does happen.

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Ear Care Myths and Recommendations

Let’s shift gears—should people clean their ears with Q-tips?

Definitely not. The ear canal is self-cleaning. Using Q-tips just pushes the wax deeper, sometimes compacting it against the eardrum. I’ve seen indentations in impacted wax that match the tip of a Q-tip. A safer rule? Don’t put anything smaller than your elbow in your ear.

So just soap and water for the outer ear?

Exactly. Let the ear manage the rest on its own.

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Nasal Health During COVID-19

What about nasal care in this era of COVID-19? We know the virus tends to reside in the nasal cavity. Any tips?

Good nasal hygiene is important. Saline sprays can help moisturize and clean the nose, but there’s debate about whether rinsing might aerosolize the virus. At a minimum, use a saline spray for moisture. Wearing masks is still one of the best ways to reduce spread.

Some of my patients use humidifiers at night to avoid drying out the nasal passages.

Yes, humidifiers help maintain optimal nasal moisture and reduce crusting or inflammation.

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Final Thoughts

Thanks for joining me today. In summary, we’ve touched on how dentists and ENTs must collaborate to help patients—especially children—breathe better. Nasal breathing influences facial growth by encouraging proper tongue posture. If a child can’t breathe through their nose, the tongue can’t rest on the palate during sleep, and growth is stunted.

Exactly. And adults experience similar effects, just in a different form. Poor nasal breathing can lead to mouth breathing, which can move teeth, change bone structure, and contribute to sleep and jaw disorders.

Right. We also talked about the role of nutrition in reducing nasal inflammation. Whole, unprocessed foods—as shown by Weston A. Price—can positively affect facial development and airway health.

Yes. And let’s not forget the direct relationship between TMJ disorders and ear symptoms. Many ENT complaints are really jaw issues in disguise.

To the dentists out there: partner with an ENT you trust. Whether treating obstructive sleep apnea, enlarged adenoids, or simply helping a child develop a healthier airway, collaboration is key. The resources offered by Vivos Therapeutics and the Craniofacial Sleep Medicine Institute are also incredibly helpful.

Absolutely. It’s been great working together. Thanks again for having me on.

Thank you, Dr. Buss. And to our listeners, keep checking for crowded teeth and mouth breathing—especially in your children. Those signs are early indicators of bigger health issues down the road. Breathe well, sleep deeply, and stay healthy.

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