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Tarun Agarwal, DDS

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

Toxins and “Non-Toxins”:
Maintaining Oral Health

Sleep deprivation caused by sleep apnea is a serious toxic burden to human health, notes Dr. Tarun Agarwal of Raleigh Dental Arts—who in recent years has become a national expert on this topic. He divides his time between his local practice and an active training schedule with fellow dentists throughout the country. One recurring issue: learning to identify and effectively treat sleep apnea.

Dr. Agarwal, center, welcomes colleagues to his practice. Dr. Nate Leedy (left), has special interest and expertise in the treatment of infant frenectomies, as well as orthodontics treatment and tooth movement. Dr. Christian Nolten (right), has a special interest in preparing partial dentures and full dentures.

Says Dr. Agarwal, “At Raleigh Dental Arts we want to service the community better and have a more inclusive approach to dentistry; our goal is to offer our patients expert care in treating all their dental needs. Instead of having patients go from place to place to get things done, we are working to bring everything under one roof, creating an environment where dentists can collaborate with each other. Such an approach creates the opportunity to sit down with patients and listen to them, while giving them choices and letting them make their own decisions.”

“The fact is,” he says, “sleep apnea is a potentially dangerous sleep disorder in which a person repeatedly stops and starts breathing throughout the night. The result: oxygen deprivation.

“Oxygen is vital for literally every part of the body,” he emphasizes. “At Raleigh Dental Arts, we’re seeing more sleep-deprived patients, which perhaps is the effect of many different toxins in our environment. But the more likely cause is a lack of the vital ‘non-toxin’ in our environment—oxygen.”

 “Ultimately, oxygen is life,” he notes. “As human beings we can’t live without oxygen, and one of the keys to getting adequate oxygen is good breathing while sleeping. And, in fact, the most common time that we have difficulty breathing is during our sleep.

“What we’re seeing more frequently in our practice are people who are having either completely interrupted breathing or partially interrupted breathing, while sleeping. When this occurs, there’s a drop in oxygen saturation: a decrease in oxygen to the brain, to the muscles of the heart and muscles of the body, and proliferation in our lungs.

Body Signals of Sleep Apnea

“Our bodies are tremendously affected when they’re not getting enough oxygen. It’s not normal to wake up tired, yawning, and wanting to take a nap by lunch time. It’s definitely not normal to sleep 10 hours and not feel rested,” he adds.

“We encourage our patients to understand that snoring is a sign of a deadly condition. Sixty percent of people who snore have sleep apnea, as do 33 percent of people who are on blood pressure medications, 80 percent of people who are on multiple blood pressure medications, and 60 percent of diabetics. Too many people are not aware of these connections to sleep apnea, so they don’t get tested. They believe they are dealing with natural life events in the aging process.

“But the truth is that some people can run marathons and exert themselves in unbelievable ways, and not feel tired the next day, simply because they got adequate sleep and oxygen. People need to realize that there are ways to feel better and that the least they can do is take this very simple sleep apnea test—which has the potential to change your life.”

Warning signs of sleep apnea, notes Dr. Agarwal, include loud or frequent snoring, lapsed breathing and/or choking or gasping for air while sleeping, daytime fatigue, headaches, and more. Other subtle symptoms are varied, and include irritability and moodiness, elevated blood pressure, lowering of immune system response, weight gain, lower sex drive, and more. An estimated 25 million Americans—almost 8 percent of the population—have sleep apnea—80 to 90 percent of them are undiagnosed. He adds that severe sleep apnea patients are candidates for cardiovascular problems.

Identifying and Treating Sleep Apnea

Sleep apnea is diagnosed by having an in-lab or home sleep test done by a board-certified physician who interprets and scores the results. All of these tests are approved by the FDA, and most insurances can cover them.

“As a dentist with sleep apnea,” says Dr. Agarwal, “I wanted to make an oral appliance to treat myself, one that would be more comfortable to wear than a C-PAP device. This led me to using a specialized oral appliance, much like a mouth guard, that reduces the symptoms and risks. The appliance is especially designed to fit an individual’s mouth, positioning the jaw to create an optimal opening of the airway while sleeping. This appliance, or the C-PAP, allows you to sleep through the night, minimizing any interruptions in your breathing.

Environmental Toxins and Oral Health

“Sometimes we forget that everything that we eat or drink goes through our mouth,” says Dr. Agarwal. “Everything we breathe eventually moves through the oral airway. Everything we put into our body is connected to our mouth in some way. Our teeth are the only things that we use 24 hours a day, every day of our lives. We put a lot of pressure on them and we don’t appreciate them until they’re gone. It’s important to keep that in mind when considering the environmental toxins we’re exposed to. In fact, there are quite a few that affect oral health.

“First and foremost is smoking,” he says. “And now we have vaping, which introduces an entirely different set of problems. Vaping is very hot and it’s concentrated in one area of the mouth, destroying the teeth there. We also don’t know what’s in the vapor and how it will affect us in the future. We also are seeing a proliferation of methamphetamines and marijuana usage. These products are more detrimental to dental health than cigarettes. They can cause burns, decay, and other issues, and react with the mouth in different ways than smoking cigarettes ever has.

“There are other issues to consider, as well,” he says. “For example, I would say that toothpastes today are moving more towards a vitamin scenario, which is a positive. But, on the negative side they’re more abrasive, and with excessive and continued use we see more erosion on the teeth. Patients who have gum disease, or severe wear on their teeth, probably shouldn’t be using a regular toothpaste, but one more geared to their sensitivities.

“Each individual has different bacteria in their mouth; some of us have syrupy saliva, others very watery saliva. Some of us brush twice or three times a day, and some of us barely brush at all. We all know of people in our family that don’t take care of their teeth and yet they have fantastic teeth. And then we have people who are unbelievably particular about their teeth and oral health, yet they constantly get cavities. At the end of the day, it’s often about genetics. Knowing how to care for one’s own teeth is important.”