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Table 1 Possibilities for clinical routine during a SARS-CoV-2 pandemic to protect patients and the dental team. It is particularly important to identify potential risks and to identify measures to minimize risks that an asymptomatic carrier infects another person directly or indirectly

From: SARS-CoV-2 and regular patient treatment – from the use of rapid antigen testing up to treatment specific precaution measures

No Group/Location Discipline Activities Risk 1. Substitution 2. Technical measures 3. Organizational measures 4. Personal protective equipment (PPE) 
Front desk
1) Receptionist/Lobby Appointments, conversations Infection risk by transmission via droplets if the minimum distance cannot be maintained. Clarify as much as possible by phone in advance Protective screen   Mouth nose protective mask/FFP2 mask
2) Receptionist/Lobby Receipt of patient data via Chipcard Contact transmission Not possible Card reader in front of screen. Card handled by patient. No handing out of chip card, No physical contact, in case of contact hand disinfection. Mouth Nose protective mask/FFP2 mask
Preparation work
3) Dental Assistant/ Waiting room/ hallway Patients are called in and guided to the Treatment room Infection risk by transmission via droplets if the minimum distance is not maintained. Not possible None Maintain minimum distance of 1.5 m. No physical contact Mouth Nose protective mask/FFP2 mask
4) Dental Assistant/ Treatment room Preparation work such as put on a napkin, patient cape Infection risk by transmission via droplets as the minimum distance cannot be maintained. Not possible None 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask
Diagnostic & Non-invasive Activities
5) Dentist/Treatment room  Activities, without invasive treatment, such as diagnosis consultation Infection risk by transmission via droplets as the minimum distance cannot be maintained [3, 4] Not possible None 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask, Eye protection (Goggle, Visor), Gloves. Caps, Single use cape [3, 18]
6) Dental Assistant/Dentist/Treatment room Radiograph Infection risk by transmission via droplets as the minimum distance cannot be maintained. Not possible In patients with more gagging avoid optional intraoral x-ray, If necessary make an orthopantomo-gram 1% H202 Mouth wash for 60 s before treatment by patient  Mouth Nose protective mask/FFP2 mask
7) Dental assistant/ Dentist/ Treatment room Handling of the Dental impression Contact transmission Not possible Optional digital dental impressions Rinse with water and disinfection solution - Mouth Nose protective mask/FFP2 mask, Eye protection (Goggle, Visor), Gloves. Caps, Single use cape [3, 18]
 Invasive Activities
8) Dental Hygienist Prophylaxis(tooth cleaning) Scaling and root planning, Polishing, working with rotating instruments, sonic-/ ultrasonic, air abrasion tool Infection risk by transmission via droplets and aerosols as the minimum distance cannot be maintained [3, 4] Possible Reduction of aerosol development using only manual instruments(non sonic/ ultrasonic) Postpone to a later date, Mouth Nose protective mask/FFP2 mask, Eye protection (Goggle, Visor), Gloves. Caps, Single use cape [3, 18]
9) Dental Assistant/Dentist/ Treatment room Periodontal initial treatments/ recalls  Scaling and root planning, working with rotating instrument, sonic-/ ultrasonic, air abrasion tool Infection risk by transmission via droplets and aerosols as the minimum distance cannot be maintained [3, 4] Not possible Reduction of Aerosol development using predominantly manual instruments 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask,Eye protection (Goggle, Visor), Gloves. Caps, Single use cape [3, 18]
10) Dental Assistant/ Dentist/ Treatment room Restorative Treatment:Direct/ Indirect restaurations working with rotating and sonic-/ ultrasonic equipment Infection risk by transmission via droplets and aerosols, as the minimum distance cannot be maintained [3, 4] Possible Mouth covered using the dental dam. Reduction of aerosol development minimal use of sonic and ultrasonic instruments and turbine driven instruments. 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask,Eye protection (Goggle, Visor), Gloves. Caps, Single use cape [3, 18]
11) Dental Assistant/Dentist/ Treatment room Prothetic Dentistry:  working with rotating and sonic-/ ultrasonic equipment Infection risk by transmission via droplets and aerosols, as the minimum distance cannot be maintained [3, 4] Not possible None 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask,Eye protection (Goggle, Visor), Gloves. Caps, Single use cape[3, 18] Optional prior Covid test recommended for the patient in case of larger preparations (several teeth)
12) Dental Assistant/Dentist/ Treatment room Endodontic Treatment working with rotating and sonic-/ ultrasonic equipment Infection risk by transmission via droplets and aerosols, as the minimum distance cannot be maintained [3, 4] Not possible Mouth covered using the dental dam. Desinfection of the tooth prior trepanation. Reduction of aerosol development minimal use of sonic and ultrasonic instruments and turbine driven instruments. 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask,Eye protection (Goggle, Visor), Gloves. Caps, Single use cape[3, 18] 
13) Dental Assistant/Dentist/ Treatment room Orthodontics Brackets insertion or removal Infection risk by transmission via droplets and aerosols, as the minimum distance cannot be maintained [3, 4] Not possible None 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask,Eye protection (Goggle, Visor), Gloves.Caps, Single use cape[3, 18] 
14) Dental Assistant/Dentist/ Treatment room Oral Maxillo Facial surgery working with cutting/ oscillating/ rotating and sonic-/ ultrasonic equipment Infection risk by transmission via droplets and aerosols, as the minimum distance cannot be maintained [3, 4] Not possible Postpone elective therapies in periods with high infection rates 1% H202 Mouth wash for 60 s before treatment by patient Mouth Nose protective mask/FFP2 mask,Eye protection (Goggle, Visor), Gloves.Caps, Single use cape [3, 18]Optional prior Covid test recommended for the patient in case of elective surgery with increased aerosol developments
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Head & Face Medicine

ISSN: 1746-160X

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