DR. CURTIS WESTERSUND, DDS
Improving Sleep Therapy With Digital Workflow
Tell us a little about yourself and your practice.
I graduated in 1979 from the University of Alberta. I practiced general dentistry for quite some time before getting deeper into the physiology of occlusion and airway development, and the connection to stress and strain in my patient’s function. Tying anatomy to human physiologic function soon became a passion of mine due to my own fights with migraines, upper airway restrictive syndrome and a bad bite. I became really interested in not only how to make myself better, but the science behind human physiology as it relates to our profession as dentists. I now focus my practice on the treatment of TMJ disorder, sleep apnea, and chronic pain.
Why did you get into sleep?
At one point, I was exposed to the physiology of obstructive sleep apnea and how that tied in to what I was seeing with patients in my practice. I started to become more and more interested in how occlusion interplays with breathing, as well as posture and muscle balance. I wanted to help my patients deal with this physiologic stress and strain in their body, both during the day and at night. My passion for addressing my own health issues and snoring also carried over to my practice; I wanted to help myself and my patients to perhaps live a little bit longer and have a better quality of life.
What challenges did you face?
As an early adopter in obstructive sleep apnea treatment, you come into a system with no set regulations or protocols within the medical and dental profession. There was also a lot of question as to if it was something dentists should even be part of. At my office, we started with home sleep tests but shortly after, in our province, it became a requirement that all HST results be interpreted by a local sleep physician. However, we were unable to establish a satisfactory protocol with the physician to assess the results and say, “yes, this patient has obstructive sleep apnea, go ahead and treat them with an oral appliance.” We began referring patients out for diagnosis, but then they were being lost in the process and it became more frustrating for us to get patients tested and taken care of.
How has MATRx plus helped your practice?
The fact that my actual home sleep studies are uploaded to the cloud, then sent directly to the sleep physician, and I get a direct reply back very quickly without legwork from my team, is amazing. I no longer lose patients into a sleep physician’s own system of care and I get clear direction, from a sleep physician of my choice, that the patient has obstructive sleep apnea and may be treated with an oral appliance, which is huge. But wait, there’s more! The coolest part is I can then do a theragnostic study with the patient that will actually let me know whether or not they will respond to a mandibular advancement device, and even give me the precise protruded position that was shown to work for that patient. So now, my patients can spend the money on an oral sleep appliance knowing it’s going to work for them. For me, it removes the angst of making the patient an expensive oral sleep appliance without knowing whether or not it had a hope of working.
I also deal with a lot of TMJ and part of my intake exam is to take a close look at the jaw joints and movement. With the MATRx plus, I have seen a dramatically smaller percentage of people with jaw issues from sleep appliance’s because they’re no longer being pushed out to their maximum protrusion. We now have patients who need much less than 70% protrusion to reach their optimal target position for the oral sleep appliance. This creates less strain and makes more patients candidates for oral sleep care.
Ultimately, it’s saving me time, it’s saving me money, and it’s made it easier for me to be confident with the patients.
What kind of patient response have you received?
When I first suggest getting a sleep test to my at-risk patients, I may get some push-back. Many think they need to go to a clinic and spend the night to determine if they have a sleep problem. When I explain that I can do a simple, inexpensive home sleep test that will let them know immediately if they have a problem, there is very little resistance from the patient to move forward. The vast majority of patients find it easy to use and sleep normal through the test without any problems. Our patients are definitely more confident moving forward with the oral appliance once they see the test results.
What would you say to a colleague who is considering MATRx plus for their practice?
It’s a fairly straight forward system. As a dentist, if you’ve had some sleep training and understand the concept, it’s very simple. As a patient, it is super easy to use. I’ve done the MATRx plus sleep test on myself; I went in blind, with no prior training, and was amazed how easy it was to put together and complete the test. These are the best results you’re going to get and the reporting from the sleep physician via the ‘cloud’ is fantastic. Previously we were not able to provide this therapy without a lot of investment of time and having to give up control of the patient.
My message to dentists is that we are in a digital world, and it is imperative to us as dentists to adopt digital workflow that allows us to measure pre and post treatment, no matter what we are doing. We are no longer able to guess at things, we need to be able to provide valuable data to ourselves to more effectively treat our patients. MATRx plus gives us this digital workflow for our sleep disturbance patients.