We are committed to your health and safety.

The following are some new processes you will see for your next appointment. Please be assured that we have made these changes to help protect our patients and staff.

• You may be asked screening questions both before your appointment and when you arrive in the office.
• We will be taking your temperature at every appointment, and if the temperature is above >100.4 degrees, we will reschedule your appointment.
• Patients are asked not to bring others into the dental practice unless they are parents or guardians of patients who are minors or are special needs patients. If someone accompanies a patient, they will be asked to wait in their vehicle or outside the office.
• You will be asked to wash your hands with soap and water or use the hand sanitizer we will have available as soon as you enter the office.
• You may notice that our waiting room will no longer offer magazines, children’s toys, and other items that are difficult to clean.
• Appointments will be managed to allow for social distancing between patients. That might mean that you will be offered fewer options for scheduling your appointment.
• We will do our best to allow greater time between patients to reduce waiting time for you, as well as to reduce the number of patients in the reception area at any one time.
• You will be asked to bring a face mask or to wear one provided when you enter the office.
• You will have scheduled Teledentistry encounters with Dr. Galan, hygienist, or any other member of our team before or after your visits in order to expedite your visits.
• Please have all of your forms filled out prior to your visits and let us know in advance if you are having problems accessing them online.
• Please be on time for your appointment; any arrivals later than 15 minutes will be rescheduled with a charge.
• Estimated payments may be required prior to or at the time of service to minimize paperwork, expedite your appointments, reduce delays, and decrease cross-contamination.

Dentistry Is Essential Health Care

The American Dental Association Board of Trustees has adopted an ad interim policy stating dentistry is essential health care to help guide advocacy for the dental profession during the COVID-19 pandemic.

The Board established the ad interim policy via a video call on July 27, and the House of Delegates will consider it as a resolution during its virtual meeting in October.

“This policy was created to recognize that dentistry is an essential service. Whether it’s the current pandemic, a future epidemic or a natural disaster in a particular area, this policy recognizes the need for people to be able to continue to access the full range of dental services,” ADA President Chad P. Gehani said. “Doing so will help people maintain their oral health and contribute to their overall health. Oral health is integral to overall health — staying well often depends on having access to health care, which includes dental treatment.”

From March 16-April 30, the ADA called for dentists to postpone all but urgent and emergency procedures to help mitigate the spread of COVID-19, keep patients out of overburdened hospital emergency departments, and conserve personal protective equipment. By the end of May, most state governments had lifted restrictions on dental offices, but as COVID-19 cases continue to rise in many states, the dental community is concerned governors may again limit dental services to urgent and emergency care, which could negatively impact dentists and the oral health of the public, Dr. Gehani said.

The policy states oral health is an integral component of systemic health and dentistry is an essential health care service because of its role in evaluating, diagnosing, preventing and treating oral diseases, which can affect systemic health.

It advises that the ADA use the term “essential dental care” — defined as any care that prevents and eliminates infection and preserves the structure and function of teeth and orofacial hard and soft tissues — in place of “emergency dental care” and “elective dental care” when communicating with legislators, regulators, policymakers and the media about the care that should continue to be delivered during pandemics and other disasters.

“Using the term ‘elective dental procedures’ implies oral health care is optional and diminishes the evidence validating that oral health is an integral component of overall health,” Dr. Gehani said.

The policy also states the ADA will urge state agencies and officials to recognize the oral health workforce when designating its essential workforce during public health emergencies. Government agencies such as the Department of Homeland Security and Federal Emergency Management Agency have already acknowledged dentistry as an essential service.

Oral Appliance Therapy Should be Prescribed as a First-Line Therapy for OSA during the COVID-19 Pandemic

1. David Schwartz, DDS; 2. Nancy Addy, DDS; 3. Mitchell Levine, DMD; 4. Harold Smith, DDS

1. North Shore Family Dentistry, Skokie, IL;

2. Snoring and Sleep Apnea Dental Treatment Center, Leawood, KS;

3. Department of Orthodontics, University of Tennessee Health Science Center, Memphis, Tennessee;

4. Dental Sleep Medicine of Indiana, Indianapolis, Indiana

It is the position of the American Academy of Dental Sleep Medicine (AADSM) that oral appliance therapy (OAT) should be prescribed as first-line therapy for the treatment of obstructive sleep apnea (OSA) during the COVID-19 pandemic.

This recommendation is being made based on the following information:

• The American Academy of Sleep Medicine (AASM) has indicated that PAP therapy potentially exposes individuals, especially those in proximity to the patient, to increased risk of transmission of COVID-19. (1)
• A number of studies have found evidence that COVID-19 can remain suspended in the air in aerosol particles. (2)
• It is unknown whether it is possible for patients to be re-infected from re-using PAP tubing, filters, and/or masks.
• There have been reported shortages of distilled water and other supplies necessary for optimal use of PAP machines.
• Oral appliances do not generate aerosols and can be easily disinfected by patients to kill the COVID-19 virus.

According to the AADSM and AASM clinical practice guidelines, oral appliances should be prescribed for adult patients who prefer alternate therapy to PAP.3 During this pandemic, it is reasonable to assume that patients would prefer a therapy that both treats their OSA and does not increase the risk of COVID-19 transmission. Oral appliance therapy is an effective treatment for OSA3 without increased risks for transmitting COVID-19. Patients who prefer OAT may be more likely to adhere to treatment if they are confident that their therapy is not putting those in their household at an increased risk for COVID-19 exposure.

Citation

Schwartz D, Addy N, Levine M, Smith H. Oral appliance therapy should be prescribed as first-line therapy for OSA during the COVID-19 pandemic. J Dent Sleep Med. 2020;7(3).

References 

• COVID-19: FAQs for Sleep Clinicians. https://aasm.org/covid-19resources/covid-19-faq/. Accessed May 8, 2020.
• Liu, Y., Ning, Z., Chen, Y. et al. Aerodynamic analysis of SARSCoV-2 in two Wuhan hospitals. Nature (2020). https://doi.org/10.1038/s41586-020-2271-3
• Ramar K, Dort LC, et al. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015 An American Academy of Sleep Medicine and American Academy of Dental Sleep Medicine Clinical Practice Guideline. J Dent Sleep Med. 2015;2(3). doi:10.15331/jdsm.4868

Submission and Correspondence Information 

Submitted in the final revised form May 14, 2020.

Address correspondence to David Schwartz, DDS; Email: dschwartz@aadsm.org

Disclosure Statement

All authors are members of the AADSM Board of Directors Executive Committee. Dr. Schwartz is a consultant of ResMed and has conducted lectures and speaking engagements for SomnoMed and ProSomnus Sleep Technologies.

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