The world has not faced a pandemic of this magnitude in our lifetime. The recommendations from the CDC, local governments, our medical and dental organizations as well as the Trump administration continue to evolve as we begin to develop the proper framework to control the spread of the Coronavirus. Within days, social gatherings recently limited to under 500 people has been modified to under 10 people. Controlling the trajectory of the spread of this infection is paramount to prevent overloading of the health care system and the health and safety of our nation.

And in response on March 16, 2020, ADA president Chad P Gehani stated “The ADA is deeply concerned for the health and well-being of the public and the dental team. In order for dentistry to do its part to mitigate the spread of COVID-19, the ADA recommends dentists nationwide postpone elective procedures for the next 3 weeks. Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments”.

Dentists around the country have responded by following these recommendations. But when it comes to the intersection of sleep medicine and dentistry (primarily with oral appliance therapy), we have an ideal application for telemedicine which can, perhaps, directly impact COVID-19 treatment for many patients.

A recent article in The Lancet (Vol 7/ August 2019) estimated that in the 30-69 year age group 936 million people have mild to severe sleep apnea and 425 million have moderate to severe sleep apnea. We know the effects of OSA are alarming with respect to coronary artery disease (CAD), Diabetes, Hypertension, stroke and Increased chances of motor vehicle accidents. Although it is estimated that 75-80% of those patients that have OSA are undiagnosed, the diagnosis and treatment of this “global pandemic” should never be considered elective but rather critical to the health of the world’s population.

Digital technology (like we use with patients on this website) is now allowing many people to work from home in an effort to contain the spread of this disease. Certainly, telemedicine with sleep physicians and the utilization of HST’s via mail will allow us to continue to diagnose and treat this disorder in the face of the evolving global pandemic. With the proper COVID-19 screening and testing per CDC recommendations, dentists should be able to methodically treat their patients with OAT. The Telemedicine approach and diagnosis with disposable and hygienic HST’s can be accomplished within 2 weeks when, hopefully the ability to treat these patients becomes more feasible. Treatment of OSA should not be considered elective and placed into the general dentistry recommendations, providing the proper precautions are followed.

The AASM is recommending not starting patients with COVID infection on CPAP due to hygiene considerations. Although there are many companies that provide cleaning solutions to CPAP machines and supplies, treatment with OAT may be preferable to CPAP in this healthcare crisis. When considering mean disease alleviation and effective AHI the argument for timely treatment with a hygienic OA that minimizes contamination and can easily be disinfected may now be recommended as a viable and necessary alternative to CPAP. Treating OSA to help reduce the respiratory distress from OSA for those afflicted with COVID-19 is critically important and OAT may now be the best solution.

Sleep is vital to restore the immune system and improve our ability to fight infection. Successful management of sleep apnea helps control chronic disease manifestations thereby making patients more resistant to infections. Untreated sleep apnea may exacerbate chronic conditions thereby putting patients at increased risk of infection.