Dr Bastian Wessing runs a dental practice at Luisen Hospital, Aachen, Germany. Located close to where some of the earliest Coronavirus cases in the country were reported, the hospital reacted quickly and Dr. Wessing’s practice followed suit. While they have remained open throughout the Coronavirus crisis, many of their actions may well represent a “new normal” for dentistry in the foreseeable future after lockdown. Here he explains some of the key measures taken at his practice to minimize risk of infection.

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Split-shift system

“A fundamental factor in minimizing risk of infection is to reduce close human contact. Our first step was to implement a split-shift system. In the past, we had a cross-over period with all the staff in contact between 1.00 pm and 3.00 pm. We changed that right away at the start of the outbreak, and completely separated the teams to shifts from 7.00 am till 1.15 pm, and 2.00 pm till 8.00 pm. A number of our changes have been to limit cross-contact between teams, so if any team member is exposed to the virus or has symptoms, then it’s likely that fewer members of staff would need to go into isolation, and we could keep the practice in operation and continue treating our patients.”

Smaller teams in designated spaces

“Another way that we minimize human contact is by allocating each dentist only 1 or 2 assistants, and they are all allocated their own rooms. They also have the break-out times separately from the other teams.”

Constant surface disinfection

“Between the shifts, the practice is completely shut down and we do a thorough disinfection in all areas. We are also constantly disinfecting during throughout the day, cleaning all door handles every hour as well as after a patient has left.”

Mandatory masks at all times – with some help from DIY!

“All our staff, including administrative staff, must wear FFP1 masks at all times. During treatment and consultation, we wear FFP2 masks and face visors.The face visors have actually been quite a challenge – there has been extremely short supply, and back in March, a supplier told me there would be none available until July. My immediate solution was to go DIY. With materials purchased from the local hardware store, and help from two colleagues, we created our own simple visors in just a couple of days.”

All staff must wear masks at all times.

Social distancing and patient hygiene

“In our waiting areas, we have reorganized the seating plan to meet the commonly-used two-meter distancing principle. In the past we had one designated room, however we now only allow four people in that space at any one time, and we added more seating around the reception area to minimize any close contact between patients. At the reception desk I also built a plastic shield, and we have clear markings on the floor showing where patients can queue. Once in the treatment room, every patient, even during consultations, must also gargle and rinse with a mouthwash solution for one minute with a 0.1% benzalkonium chloride-containing treatment. We did in fact introduce this requirement to our practice several years ago, but the Coronavirus situation makes this more important than ever before.”

A plastic shield has been installed at the reception desks.

Patient communications

“We have a lot of calls and messages from patients, so it’s important for all the information about changes to our practice to be clear on our website. When booking appointments, we question each patient to assess their risk. We ask if they have had any symptoms of COVID-19, as well as if they have any underlying medical conditions that make them particularly vulnerable if catching the virus, such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer.”

More to explore

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Posted by Chris Kendall