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Tarun Agarwal, DDS

8304 Creedmoor Road
Raleigh, NC 27613
Telephone: (919) 870-7645

Overcoming Dental Trauma:
In a Few Hours, Not Many Days

Gary Krill recalls how he overcame an uncomfortable, slightly traumatic dental event several years ago, with the help of his family dentist, Dr. Tarun Agarwal at Raleigh Dental Arts on Creedmoor Road.

Dr. Agarwal Dr. Agarwal and the CEREC-3D device with the image of Gary Krill’s teeth.

“I woke up one morning and felt a piece of loose tooth in my mouth,” he recalls. “Not a big deal, I thought. It looked pretty benign, so I planned to do something about it in a day or two. Then, later in the day, another piece from the same tooth came out, so I did the obvious: I called Dr. Agarwal for an appointment.

“To my surprise, he said he could see me the same day if I was a little flexible about time, so within a couple of hours I was in his office. He took a look in my mouth and told me that an old crown had disintegrated, but the gum looked healthy and free of damage. He recommended that we put a new crown in place.

“I was willing to do that, and I reflected on past experiences with crowns. The dentist would make an impression, drill it down, then put the crown on with what was called a ‘temporary.’ Then you would have to deal with the temporary while the dentist sent the impression off to the lab to have the permanent crown made. Usually within a couple of weeks, it was back to the dentist to have the new crown put in place. Unless, of course, the temporary had come off earlier requiring still another trip to the dentist to glue it back in place.

“I wasn’t excited about the whole process, but I knew it was necessary so I said ‘OK, let’s get started.’ And then he said to my surprise, ‘Relax, this will be quick and easy. We’ll have you out of here in a half hour with your permanent new crown.’

“So he starts taking pictures with this phenomenal X-ray machine where you can see all the inner workings of your mouth in 3-D, from every conceivable angle. And then he wheels in the CEREC machine, and simply downloaded all the information from the computer into the CEREC machine and then, within minutes, the finished tooth comes out. He fixed it in place, and at that point I was, I will tell you, a happy camper.

“Over the passing months, the crown is behaving perfectly. The bite is perfect. Everything about the experience was A+. No problems of any kind.
“Dr. A’s office has been a positive influence for me and my family. My daughter has gone to Dr. A for cosmetic dentistry, and she travels from Greensboro to work with him for all her dental needs. He’s done two implants for my wife, and two implants for me. We’re mighty happy to be part of his practice.”

The Doctor’s Perspective

Notes Dr. Agarwal, “I started working with the CEREC technology in 2003, not long after it was first introduced to the dental profession. And over time, my relationship with Sirona, the company that produces the CEREC devices, has transformed my practice. The company is based in Germany, with U.S. headquarters in Charlotte and a major presence in Australia. I have no financial incentives with Sirona, but for some years I have been engaged in a comprehensive training program for the company, including a whirlwind training trip to Australia to work with about 200 prospective users and representatives of the product.

Dr. Agarwal conducts a training session on identifying and treating obstructive sleep apnea for 14 dentists from throughout the country. At the same time, another 24 dental team members were engaged in separate training in their areas.

“Over this period of time, clinical testing and education of other dentists has come to occupy about a third of my time—and of course my principal interest remains with the patients in my own practice.

“Gary Krill’s experience is typical for my patients where CEREC is the digital tool at work. The results are immediate and there are no clinical or aesthetic compromises. And of greatest benefit, it is a great time-saver for the patient at no additional cost. It’s all a digital miracle. Gary comes to us with a broken crown. We stick a magic wand in his mouth to take digital impressions, digitally transport that information into the CEREC machines, where the resulting crown is digitally designed and milled. And the results are available in a matter of minutes rather than days or weeks.”

Preventing Damage

“In Gary’s case,” continues Dr. Agarwal, “we were able to repair damage quickly and effectively, and we care every bit as much about avoiding damage as we do about repairing damage. For many of our patients, a night guard is an effective tool. As we get a bit older, most of us—out of our awareness—have a tendency to put more force into the action of our jaws, which was the case for Gary.

“Night guards are extremely helpful for many of our patients. We often use a product called the NTI, specifically designed to relax the masseter and temporalis muscles, which ultimately works by keeping our back teeth from touching during the night. If your back teeth aren’t touching, you obviously are not putting force on them. And we know that a great many people suffer from tension-type headaches, or headaches in the front of their head, caused by clenching and grinding of their teeth, out of their awareness.

“We also know that bruxism—the professional name for clenching and grinding of teeth—is highly correlated to obstructive sleep apnea. When you’re not breathing well, your teeth have a tendency to want to shift and move around to accommodate breathing. Sometimes, the right night guard is a sleep appliance to help protect the teeth and help minimize the effects of obstructive sleep apnea. We care a great deal about these issues, and work with our patients to resolve them.”