Special care dentistry in the world of COVID-19.

I think back to our Special Care Dentistry Association (SCDA) board meeting that occurred in October when we had a futurist talk as part of our strategic planning session. He believed that we would have a resurgence of the Roaring Twenties with significant societal and technological changes in the upcoming decade. Who knew he was prophetic? Just like the 1920s, our 2020s began with a pandemic. As all of our worlds have been flipped by COVID‐19, I worry about the levels of susceptibility and severity of the disease in our clients living in nursing homes, institutions, group homes, and among those who are medically compromised. I also worry about our members, staff, residents, and students. With the mandatory closing of practices, our increased susceptibility to contracting the infection due to our work in the upper airway, providers asked to work in emergency departments, educational programs placed on hold, and the lingering question of when will this end; the mental, physical, and financial toll placed on us is unprecedented during our lifetimes.

Because of my position as chair of a department in a medical school, I sit on community boards and university and hospital committees. After the initial stress of the events has settled down, new emotions have begun to take hold in all of them: hope and opportunity. As one member proclaimed, “a crisis is a terrible thing to waste.” I asked him to elaborate. He stated that “when an event like this occurs, it is a perfect opportunity for re‐evaluation, innovation, and exploration. What happens these next two months will set the tone for years to come.” So how do SCDA, the way we care for our special patients, and we as clinicians go through a metamorphosis as result of the crisis? This is a question that I ask myself daily. Our patients, our institutions, our practices, and our organization are dependent upon us evolving from what we were into something quite different.

So where will special care dentistry be after the fallout from the corona virus? Our patients will continue to need our services because we are the group of providers with the passion and ability to care for these complex patients. Our practices will not be the same as they were at the end of 2019. If you told me 2 months ago that I would be working on creating the platform at my institution for dentistry to be performed via telehealth, I would have said it was infeasible. However, now, I understand the importance to being connected with our patients through multiple mediums in order to ensure their and my well‐being. The utilization of technology has permanently changed how we care for patients and how we educate caregivers, students, and residents. Once created, these systems will continue to expand due to a new‐found efficiency and acceptance. There is no turning back, and that will benefit our patients.

This time we are now in the perfect learning laboratory. We are implementing ideas and models of care that in the past we would have never fathomed to attempt, but now we are encouraged to do out of necessity. Some of our ideas will be failures, but it is as important to learn from our missteps as it is from our successes. We need to be cognizant of what other professionals and industries are attempting and learn how we can adapt their ideas to improve the well‐being of our patients. Mimicry often creates lasting changes. Now more than ever, we need to document our successes and failures through data collection and share best practices by submitting journal articles, presenting at meetings, and using social media to disseminate information.

I miss shaking hands with my patients and caregivers and because we are masked, some of the small visual clues we give and get from our patients on a daily basis are hidden. Until we have a vaccine or herd immunity for this virus, those little joys will have to wait. Times have changed, and only through our innovation will we be able to continue to provide the needed services to our special care populations. We will adapt. We must.