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Letter to the Editor, Iss. 7.3

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

http://dx.doi.org/10.15331/jdsm.7148

G. Dave Singh DMD PhD DDSc
 
Founder and Chief Medical Officer, Vivos Therapeutics, Inc.


Dear Sir:
 
The recent Editorial1 was timely and interesting; however, certain key issues were either omitted or inadvertently neglected.  In response to some of the points raised, it should be noted that:
 
  1. Although positive airway pressure (PAP) therapy potentially raises SARS-CoV-2 transmission risks, preventative precautions, such as social distancing, personal protective equipment use, etc. may help alleviate this risk.
  2. Modified PAP therapy may be deployed as ventilators to treat non-obstructive sleep apnea patients diagnosed with COVID-19.2
  3. Oral appliance therapies that target the nasal airway3,4 might be preferable since nasal lymph vessels that drain to local lymph nodes are thought to initiate immune responses, such as helper CD4+ T cells.5
  4. Oral appliance therapies that target the paranasal sinuses6 might be preferable since it is thought that nitric oxide (NO) produced in the maxillary sinuses inhibits the replication cycle of the SARS coronavirus.7
 
Sincerely,
 
Dr G. Dave Singh DMD PhD DDSc
Founder and Chief Medical Officer
Vivos Therapeutics, Inc.
Highlands Ranch, CO 80129
Email: drsingh@vivoslife.com

CITATION

Singh GD. Response to “Oral appliance therapy should be prescribed as a first-line therapy for OSA during the COVID-19 pandemic”. J Dent Sleep Med. 2020;7(3).

REFERENCES

  1. Schwartz D, Addy N, Levine M, Smith H. Oral appliance therapy should be prescribed as a first-line therapy for OSA during the COVI-19 pandemic. J Dent Sleep Med. 2020;7(3).
  2. Melillo G.  Researchers modify sleep apnea machines to ease ventilator shortage.  American Journal of Managed Care. April 15, 2020. Accessed June 12, 2020. https://www.ajmc.com/focus-of-the-week/researchers-modify-sleep-apnea-machines-to-ease-ventilator-shortage. 
  3. Singh GD, Heit T, Preble D, Chandrashekhar R.  Changes in 3D nasal cavity volume after biomimetic oral appliance therapy in adults.  Cranio. 2016;34(1):6-12.
  4. Singh GD, Kim HN.  Changes in nasal airway volume after biomimetic oral appliance therapy in Korean adults.  Am J Respir Crit Care Med 2020;201:A2442.
  5. Braun J, Loyal L, Frentsch M, Wendisch D, Georg P, et al.  Presence of SARS-CoV-2 reactive T cells in COVID-19 patients and healthy donors.  medExiv. doi: https://doi.org/10.1101/2020.04.17.20061440.
  6. Hwang H, Hwang C, West J, Singh GD.  Changes in pediatric paranasal sinuses following biomimetic oral appliance therapy: 3 case report. Cranio. 2019;2:1-6.
  7. Akerström S, Mousavi-Jazi M, Klingström J, Leijon M, Lundkvist A, Mirazimi A.  Nitric oxide inhibits the replication cycle of severe acute respiratory syndrome coronavirus.  J Virol. 2005;79(3):1966-9.

SUBMISSION & CORRESPONDENCE INFORMATION

Submitted for publication May 16, 2020
Accepted for publication June 9, 2020
 
Address correspondence to: Dr G. Dave Singh DMD PhD DDSc, Founder and Chief Medical Officer, Vivos Therapeutics, Inc., Highlands Ranch, CO 80129; Email: drsingh@vivoslife.com

DISCLOSURE STATEMENT

Dr Singh is Founder and Chief Medical Officer, Vivos Therapeutics, Inc., Highlands Ranch, CO 80129.


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