What is the Physiologic Approach?

With multiple years and a Fellowship undertaken in the USA, and a decade and a half of clinical work successes in sleep disorders and pain management, Dr Maratos doesn't simply take a 'cookie cutter' approach to his patient's symptoms; he treats the individual, and their unique jaw and bite to achieve maximum relief of symptoms. Add to this the 35 years Dr Maratos has spent as a Dental Surgeon and working in Family Dentistry & General Dentistry and you have an expert who really is....... The Snore Fix Doctor.

All of our patients are screened for SDB (Sleep Disordered Breathing) and TMD (Temporomandibular Dysfunction). This includes a questionnaire, muscle palpation and intra-oral examination / occlusal assessment.  If Dr Maratos suspects SDB, he will recommend an overnight sleep study after consultation with the patient’s own Medical Practitioner or Specialist Consultant.  This may necessitate a referral to a Sleep Physician, or Ear Nose and Throat (ENT), or Respiratory Physician for further diagnosis and management.  Often, Dr Maratos will request a CBCT of the neck, TMJs (temporomandibular joint) and airway to rule out more complicated pathology and as a tool in establishing a correct diagnosis and developing an appropriate treatment plan.

If a Mandibular Advancement Splint (or MAS) is recommended by the Specialist or GP, then Dr Maratos is able to construct unique appliance using a physiologic technique, rather than the typical mechanical method utilising a ‘George Gauge’.  This involves using ultra low frequency TENS, and measuring EMGs to verify true muscle relaxation, thereby ensuring the muscle fibres are at their ideal resting length.  

The NuCalm system of relaxation is often utilised to produce a deeply relaxed, meditative state and even lower EMGs.  Care is taken to ensure ideal posture and decompression of TMJs which is an important clinical objective. This technique results in a MAS with less protrusion, less risk of aggravating, or creating a TMD, and less risk of inadvertent teeth movement. 

Follow up includes regular repeat sleep screenings with either a Watchpat 200, or Braebon Medibyte Jnr, and titration until Dr Maratos is satisfied both subjectively, and objectively and the patient can then be referred back to their GP or Specialist.

A TMD patient is managed similarly with a sleep screening, as there is a very high correlation between TMD & SDB. Sometimes pain symptoms resolve simply by treating the SDB, however it may be necessary to make a daytime orthotic to position the mandible, neck and muscles in the most relaxed, decompressed position that will allow healing over time.  

Long term, it may be possible to ‘wean’ the patient off the daytime orthotic, or fabricate a more durable orthotic, or restore the teeth to duplicate the orthotic position, or even treat orthodontically to duplicate the orthotic position which best serves the patient’s well-being. The focus at The Snore Fix Doctor will always be on alleviating pain, maximum comfort and functionality for the patient - and most importantly.....stopping the snoring.