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RALEIGH DENTAL ARTS

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RALEIGH DENTAL ARTS
Tarun Agarwal, DDS

8304 Creedmoor Road
Raleigh, NC 27613
Telephone: (919) 870-7645
www.raleighdentalarts.com

MATRx Plus Tests Viability
of Sleep Apnea Devices

In a relatively brief period, Dr, Tarun Agarwal of Raleigh Dental Arts has become a national presence in working with dentists to help identify and effectively treat their patients with sleep apnea—a potentially lethal obstructive breathing condition.

Dr. Agarwal with the MATRx plus device that tests the viability of appliance therapy devices in easing the effects of sleep apnea.

“There are ultimately three methods for treatment of sleep apnea,” he explains “Number one, challenging but effective, is use of a CPAP device, a ventilator that a patient wears nightly while sleeping, creating continuous positive airway pressure so the individual can breathe. A second less costly and less cumbersome choice is being fitted for and using an oral appliance; and a last resort is surgery.”

Dr. Agarwal’s own diagnosis with severe sleep apnea, and the difficulties he experienced using the CPAP device prompted him to become a student and ultimately a master of oral appliance technology. Creating oral appliances for his sleep apnea patients is now an important part of his practice. And, in his Raleigh location and in study groups throughout the country, he shares vital information about effective treatment of sleep apnea with his dental colleagues. 

Dr. Agarwal wearing the MATRx Plus sleep apnea testing equipment.

Notes Dr. Agarwal, “One of the questions I’m often asked is whether oral appliance therapy is really effective in treating sleep apnea—and if so, how effective? In the past we haven’t had an effective way of testing these devices, other than trial-and-error—making the appliance and then doing an after-test to see if and how well it’s working.

“I’m pleased to say, we’ve been quite successful in making effective appliances with only such trial-and-error testing. However, I’m even more pleased to announce the development of a new technology that enables us to test our patients before we start a remedial process, to determine whether or not oral appliance therapy will be effective, and if so, to what degree. Now, instead of having to go through the process of making an expensive appliance, and not knowing whether or not we’re going to get really good results, we can tell quite accurately whether and how well it will work.”

Testing Oral Appliance Effectiveness

“Basically, this FDA approved test, MATRx Plus (see photos), works like a home sleep test,” explains Dr. Agarwal. “You wear a device on your chest while sleeping. At the same time, there is a semi-custom-fitted mouthpiece with a micro motor that attaches to your mouth, moving the appliance backwards and forwards, measuring how well you’re oxygenating in different positions.

Do You Have
Sleep Apnea?

Do you snore and gasp for air while sleeping? Feel tired during the day? Is your snoring so loud that no one can sleep beside you? Are you irritable, have headaches, or difficulty concentrating in your waking hours?

These are all symptoms of sleep apnea, a potentially dangerous sleep disorder in which you start and stop breathing during the night. The most common form, obstructive sleep apnea, frequently occurs when someone is over-weight. The excess weight causes muscles in the mouth and throat to relax, in turn blocking the airway passage.

One way sleep apnea is diagnosed is at a sleep center where you spend the night, hooked up to devices that monitor your heart, lung, and brain activity, breath-ing patterns, arm and leg move-ments, and blood oxygen levels.

Another, less expensive, method of diagnosing sleep apnea is with a home sleep test that measures heart rate, blood oxygen levels, airflow, and breathing patterns. These tests must be ordered by your physician. Both tests are accurate, but the sleep center test provides more data. Typically, 80 percent of patients do not need the more extensive sleep center test. Once you have been diagnosed with sleep apnea, you need to find a way to curb the effects of the condition.

“An oral appliance works by moving your jaw forward, and that forward movement anatomically gives more space in your airway, which in theory should allow you to breathe and oxygenate better. So accurately determining the optimum jaw position is extremely important.”

This testing is very helpful for patients who are refusing, or failing, CPAP therapy, explains Dr. Agarwal. Often, oral appliance therapy has been viewed as a second choice to CPAP. “But what we’re finding now is that, in many instances, we can get great results with appliance therapy—and it can be a first choice—a far more comfortable and far less costly choice.”

He adds, “In the past, an appliance often wouldn’t be tried because there was no advance way of knowing if it would work and so people were guided towards CPAPs. Now we can tell people that we can test them for an appliance, see if it works, and if it does work, they can move forward with this less costly device.”

Dr. Agarwal notes that patients who have oral appliances that may not be completely effective might want to take the test to determine if an adjusted appliance might work better. “We know that appliance therapy works,” he says. “What this test will show is whether we need to move the appliance further forward than it already is. If so, we will have to make a new appliance in this new targeted position—but that may be a good choice for some patients.

“It’s all about peace of mind. When I did my MATRx Plus test,” he recalls, “the position I had naturally moved myself toward turned out to be pretty close to what this new machine said my position should be.
“Another benefit of the MATRx testing that we’re discovering,” says Dr. Agarwal, “is that this test alleviates jaw joint issues, which come from moving the jaw too far forward. Using this test, we often find that we don’t need to move them as far forward as we thought, while still achieving good results.  We can be more conservative in our stress on the muscles and the joint itself.”

The “Sleep Apnea” Dentist

“I’ve spent an enormous amount of time, energy, and resources studying sleep apnea,” says Dr. Agarwal. “I did this because it’s changed my life.

“The work I do with sleep apnea patients—identifying the problem and creating oral appliances—is one aspect of dentistry that allows me to feel a lot of satisfaction in helping create better quality of life for those patients. We’re helping people live longer and stay in the same room as their bed partners; they’re feeling less tired during the day and more productive at work. We’re helping people gain more energy and have the ability to lose the weight they need to lose. We’re making real connections with patients. That is wonderfully satisfying.

“I always think back to how it all started for me when I first had my sleep test because my wife was tired of my snoring. I thought snoring was normal, but it turned out I had severe sleep apnea. I began my therapy with a CPAP device and eventually moved on to appliance therapy because it was more comfortable. So this work is my personal story; I feel the same pain my patients do. I’ve been in appliance therapy for eight years and, while it’s not perfect, it is far better and safer than the alternative of doing nothing.

“And this is work that is important professionally as well as personally. With the new MATRx technology, I have a wonderful tool to make oral appliances more effective than ever. For example, we have a patient who’s taking the test home tonight—because without that test information, I’m not sure that we can help him. So, before we have somebody spend two or three thousand dollars or use their medical insurance benefits, I want to know whether this will work.

“My goal is to let people know that appliance therapy exists, and that it’s a viable option. We now have good equipment and testing ability to be able to tell people whether or not it makes sense for them. It’s true at this point that our medical and patient communities do not yet know enough about appliance therapy—that it’s a feasible choice to dramatically improve the quality of lives of many people who have sleep apnea.”