Skip to main content

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