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The impact of oral health inequalities on one's ability to maintain good oral health is cumulative throughout life and accentuated in older age groups. While studies on factors influencing the decisions made by elders to seek dental care have been conducted in Israel and worldwide, the issue of access to and provision of dental care is complex. However, the need to address oral health issues is being voiced in high-level international meetings and there was never a better momentum to rethink the current oral health care delivery model beyond issues related solely to accessibility. Here we outline unique opportunities to ensure sustainable models of preventive services and oral health the effects of which would be amplified in concert with increases in the availability universal dental healthcare.

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The pathophysiology of SARS-CoV-2 infection is characterized by rapid virus replication and aggressive inflammatory responses that can lead to acute respiratory distress syndrome (ARDS) only a few days after the onset of symptoms. It is suspected that a dysfunctional immune response is the main cause of SARS-CoV-2 infection-induced lung destruction and mortality due to massive infiltration of hyperfunctional neutrophils in these organs. Similarly, neutrophils are recruited constantly to the oral cavity to combat microorganisms in the dental biofilm and hyperfunctional neutrophil phenotypes cause destruction of periodontal tissues when periodontitis develops. Both disease models arise because of elevated host defenses against invading organisms, while concurrently causing host damage/disease when the immune cells become hyperfunctional. This represents a clear nexus between periodontal and medical research. As researchers begin to understand the link between oral and systemic diseases and their potential synergistic impact on general health, we argue that translational research from studies in periodontology must be recognized as an important source of information that might lead to different therapeutic options which can be effective for the management of both oral and non-oral diseases. In this article we connect concepts from periodontal research on oral inflammation while exploring host modulation therapy used for periodontitis as a potential strategy for the prevention of ARDS a deadly outcome of COVID-19. We suggest that host modulation therapy, although developed initially for management of periodontitis, and which inhibits proteases, cytokines, and the oxidative stress that underlie ARDS, will provide an effective and safe treatment for COVID-19.

BackgroundPatients with special care needs (developmental disabilities) have unique and complex needs regarding their oral health and care. This qualitative study aimed to identify the experiences, preferences and challenges of dentists and caregivers regarding behavior guidance techniques for dental care in persons with special care needs.MethodsRelying on qualitative description as articulated by Sandelowski, we conducted telephone interviews with a purposeful sample of five special care dentists and seven caregivers. We analyzed the data using thematic analysis.ResultsFour themes were highlighted: (1) Neither pharmacological or non‐pharmacological behavior guidance techniques was universally suitable, (2) A patient‐centered approach was critical, (3) The dental environment triggered patients’ behaviors and anxiety levels, (4) There was more demand for, than supply of, qualified dentists to treat patients with special care needs.ConclusionsPersons with special care needs are heterogeneous and respond to various behavioral techniques required to deliver their treatment. Behavior guidance planning should be negotiated carefully with patients and caregivers and then individualized based on patients’ capabilities and needs for treatment. The necessity to manage complex behaviors has contributed to the limitation of access to dental care for persons with special care needs. Dentistry as a profession has the obligation to uphold the social contract and meet its responsibility to the dental care needs of this population.