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In Episode 60 of The Alfi Podcast, Dr. David Alfi sits down with Dr. Mark Cruz, a true pioneer in airway-focused dentistry for a deep, wide-ranging conversation that challenges “orthodox thinking” in healthcare. Dr. Cruz breaks down what airway actually means (it’s not just expanders or devices), framing it as the intersection of structure, function, and behavior and why the airway acts as the keystone of facial growth. From the agricultural and industrial revolutions to modern convenience (soft diets, sleep habits, C-sections, allergies, tech exposure), they explore how our environment may be reshaping craniofacial development, fueling downstream issues like sleep fragmentation, anxiety, metabolic dysfunction, and TMJ breakdown. They also debate the limitations of “gold standards” like AHI and raise thought-provoking concerns about long-term CPAP implications while emphasizing measurable, outcomes-driven, interdisciplinary care. If you’re a provider, patient, or anyone “down the rabbit hole,” this is the airway conversation you’ll want to share. Our team can help you get to the ROOT cause — jaw alignment and airway. Call: 713-489-6984 Email: info@alporalsurgery.com (Reference “The Alfi Podcast” when you reach out.) ABOUT THE ALFI PODCAST Every week, Dr. David Alfi sits down with elite performers — athletes, entrepreneurs, creators and thought leaders — to explore how breathing, sleep, jaw alignment and mindset unlock the highest level of human performance. Subscribe for more conversations on: • Elite performance & recovery • Airway, sleep and jaw health • Biohacking, discipline and faith • Raising strong, resilient kids Like, comment and share this episode if it inspired you — it keeps the mission growing. 0:00 – The OG Airway Doctor + episode intro 0:27 – Why airway medicine was controversial 3:00 – What “airway” actually means 5:10 – Structure, function & breathing behavior 7:06 – Why humans are meant to breathe through the nose 9:15 – Dentistry’s biggest blind spot 11:13 – Breathing & sleep as the foundation of health 15:02 – How modern life changed human faces 18:00 – Diet, chewing & craniofacial development 22:16 – Childhood airway patterns & long-term health 27:26 – Evolution, language & compromised breathing 32:01 – Why airway problems aren’t “one thing” 35:12 – Disease management vs root-cause medicine 41:01 – Why airway care takes more time (and why that matters) 46:49 – Teeth & TMJ as warning signs 51:10 – Preventing jaw surgery in the next generation 53:09 – CPAP: benefits, limits & risks 57:26 – Do TMJ joints really need replacement? 1:03:04 – Orthognathic surgery through an airway lens 1:09:25 – Function vs aesthetics: what patients don’t expect 1:11:35 – Final thoughts + why this matters now