COVID-19 pandemic: Infection control in dental health care of infected patients-A state concept.

In December 2019, an outbreak of a new coronavirus was reported in the city Wuhan, China. End of January, the WHO declared this development as a public health emergency of international concern (WHO, 2020). Germany reported a rapidly increasing number of 186,461 infected persons in the period from February to June (Robert‐Koch‐Institut, 2020).

This pandemic, caused by a respiratory disease, presents the dental profession with an unprecedented challenge in terms of dental care for the population. There are great uncertainties as to whether and how patients by which institution should be treated as there were no guidelines or recommendations. A higher risk of infection compared to other medical professions has been described, especially for dentists (Peng et al., 2020; Zhiguo & Dan, 2020).

Germany did not have a national or regional official order to close practices under the Infection Protection Act. Colleagues in private practices were asked to focus on acute and emergency treatment.

In the federal state of Schleswig‐Holstein, the directors of the Dental Clinic of the University Hospital of the state together with the regional dental association decided very quickly to develop a joint concept as a federal state model with the aim to offer standardized diagnostic and therapy for infected patients and patients under quarantine and further to minimize the risk of infection for colleagues in private practices. Since then, these colleagues have been asked to send these patients to the dental clinic.

The Dental Clinic houses the Clinic for Oral and Maxillofacial Surgery and all other dental disciplines in one building. A diagnostic and treatment algorithm was developed in cooperation between all dental disciplines including the maxillofacial surgery in order to minimize the risk of infection for dentists, physicians, assistants, and administrative staff as much as possible. The algorithm takes into account the administrative patient management, the prevention and control of diagnosis and treatment under consideration of hygiene protective measures and infection control (Figure 1). The dental treatment algorithm has the goal to identify high‐risk patients, to physically separate them, and to ensure the least risky environment for infection for all patients and staff. Every dentists of physician on duty, regardless his specialty, are able to make these diagnoses and perform the corresponding therapy.

FIGURE 1

The description of treatment algorithm

This algorithm for a dental clinic was an important step to treat infected patients effectively and safely. Moreover, it also leads to relief for the dental colleagues in private practice. So far, the measures have proven to be effective and safe.

These country‐specific or regional algorithms are very important, because during dental treatment it is not possible to completely exclude the risk of infection. Therefore, it is all the more necessary to perform a good infection control in dental health care considering the local organizational structures and to integrate them into the processes as well (Dave, Seoudi, & Coulthard, 2020; Volgenant, Persoon, Ruijter, & de Soet, 2020). The state concept also allows the infection control algorithm to be used again as a blueprint or after adaptation for possible future epidemic or pandemic events.

CONFLICT OF INTEREST

There are no conflicts of interest among the authors.

AUTHOR CONTRIBUTION

Katrin Hertrampf: Conceptualization; Writing‐original draft. Christian Flörke: Conceptualization; Writing‐original draft. Jonas Conrad: Conceptualization; Data curation; Methodology; Writing‐review & editing. Nicole Passia: Conceptualization; Data curation; Methodology; Writing‐review & editing. Burkhard Kunzendorf: Conceptualization; Data curation; Methodology; Writing‐review & editing. Birte Grössner‐Schreiber: Conceptualization; Data curation; Methodology; Writing‐review & editing. Christof Dörfer: Conceptualization; Methodology. Matthias Kern: Conceptualization; Methodology; Writing‐review & editing. Wolfgang Orthuber: Writing‐review & editing. Jörg Wiltfang: Conceptualization; Methodology; Writing‐review & editing.