Dental Tribune International

Dentists across Europe face business challenges in times of COVID-19

While monthly dental practice operating costs are still running, dentists in Europe are finding it challenging to operate their businesses. (Image: Brian A Jackson/Shutterstock)
By Iveta Ramonaite, DTI
April 02, 2020

BRUSSELS, Belgium: Dentists all over Europe are doing their part to limit the spread of COVID-19 while staying up to date with national and local regulations. However, as an increasing number of member states have restricted the provision of dental care to medical emergencies only, some dentists are finding it difficult to fulfil their professional obligations and are struggling to comply with the existing and new infection control protocols. Since dentists are postponing elective procedures and reducing office hours, the number of dental patients being treated is low and dentists are starting to feel the tremendous long-term impact of the pandemic on their businesses.

Most dental procedures generate a large number of aerosols and droplets, endangering dental patients, and possibly causing dentists and other members of the dental team to become infected with SARS-CoV-2. To stop aerosol transmission in dental offices, it is crucial to use appropriate personal protective equipment. However, many countries are failing to supply dentists with protective clothing, such as FFP2 or FFP3 masks, making it nearly impossible for dentists to fulfil their professional obligations and limit the transmission of SARS-CoV-2.

In a recent statement, Council of European Dentists (CED) President Dr Marco Landi said, “The COVID-19 crisis has clearly showed the necessity for international cooperation in public health, for a strong EU role in health policy and for investing in health at all levels. The CED continues to support our members who are, together with other healthcare providers, in the forefront of the struggle against COVID-19, by sharing information on national measures related to oral care and transmitting general guidance made available by international sources such as the World Health Organization, the European Centre for Disease Prevention and Control and the European Commission.”

“We remain ready to take on additional tasks as necessary, in the interest of public health, our patients and our communities. We also call on the member states and the European Commission to take action to mitigate the long-term impact of COVID-19 on availability of oral care across Europe by supporting dentists, including those working in private practice, and including them in national emergency support instruments and giving them access to funding available at EU level,” Landi added.

How COVID-19 has affected dental practices in Germany

The German Dental Association and the National Association of Statutory Health Insurance Dentists have ordered dentists in Germany to keep their practices open, owing to their health insurance companies’ licensing. However, the Robert Koch Institute, the German Dental Association and the regional dental associations have recommended postponing treatments that can be deferred.

In an article published on a German television news channel n-tv, Dr Thorsten Nassauer, a dentist and dental practice owner in Wiesbaden in Germany, said that the number of patients who require dental emergency care usually make up about 20% of the average total revenue yearly. Since the majority of treatments can now be postponed, his dental practice is currently losing 80% of its earnings from treatments such as denture treatment and maintenance, fillings, periodontal treatment and professional tooth cleaning.

In order to mitigate the economic burden of the COVID-19 crisis, dentists in Germany can participate in various aid programmes offered by the German government, such as short-time work compensation and loans. A further billion-euro protective umbrella for micro-entrepreneurs is to be set up shortly, and the government stated that it is working hard to ensure that freelancers also receive financial support.

While federal and state governments are offering help to business owners, Nassauer said that, up until now, there have been no rescue packages for private practices. Hospitals in Germany are being required to waive all deferrable procedures in order to keep the beds free for infected patients and are being compensated for doing so. Similarly, dental practices are supporting the healthcare system by offering emergency care, which would otherwise be provided by doctors working in overburdened hospitals, but are not receiving any compensation, he noted and added that, even if dental practices received short-time work benefits, this would not help with the real issue, which is that dentists are rapidly losing their patients.

Protecting those in front lines against SARS-CoV-2

In a recent statement, European health professionals and their student organisations urged the European Commission and governments to support and protect healthcare professionals fighting SARS-CoV-2. Dentists are officially safeguarded under the EU Working Time Directive and should, therefore, be assured of adequate working conditions, breaks and time off between shifts. Finally, as working in current conditions may take a heavy toll on the mental well-being of staff, healthcare workers should be able to access mental health support services.

By 1 April, there were 503,730 confirmed cases of COVID-19 in Europe and 33,617 associated deaths, according to the World Health Organization.

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