Going to the dentist's:

a surgical microscope and stucco on the ceiling

The dental group practice Dr. Hoffmann, Dr. Drothen, Dr. Wächter is located in Jena, directly across from the world's longest-operating planetarium in the city's Damenviertel, where art nouveau-style houses come one right after the other and organic bakeries, flower shops and eco-hairdressers line the cobbled sidewalks. You open a heavy door and after heading down a short hallway you're standing in a series of rooms with wooden floorboards, decorative stucco effects on the ceiling and the warm and inviting atmosphere unique to old historic buildings. You could easily forget that you've just entered a dental practice.

All pillows and cushions?

Dr. Joachim Hoffmann hurries across the hallway and disappears into one of the rooms. The wooden floorboards creak and crack, showing their age. You might have expected a fancy chaise longue, plush pillows and expensive Meissen china – instead, the large surgical microscope that Joachim Hoffmann uses almost every day is hanging from the ceiling next to the dental chair.

Joachim Hoffmann has been working with this instrument since 1999, and it has rendered him tremendous services. Joachim Hoffmann explains: "As you can see, the floors vibrate in an old building like this with wooden beams and floorboards – but obviously there can't be any wobbling whenever a nurse walks through the room and I'm looking through the eyepiece."

However, it was not the advanced, spring-mounted mechanical system but rather the optics which 15 years ago convinced the dentist to adopt a surgical microscope as a tool. What led him to this decision? We decided to ask Joachim Hoffmann.

Mr. Hoffmann, a surgical microscope that is about two meters tall must unnerve your patients. People from all over Germany receive referrals to come and see you. How do you reassure them?

Joachim Hoffmann: It's true that an instrument of this size commands a certain degree of respect before treatment begins. But in my experience my patients actually feel reassured when I explain to them why the instrument is so useful.

How is it useful?

Joachim Hoffmann: For my patients it has direct and indirect benefits. As you can imagine, it's quite dark in a person's mouth. Human teeth and their roots, the gums and the jawbone are not readily accessible and tend to be tiny. The surgical microscope illuminates and enlarges what I have to treat. And it can make things up to 32 times larger. This makes my work easier, and I work more precisely and more reliably.

Of course this is good for your patients. But don't we expect reliable and precise work from every dentist?

Joachim Hoffmann: As a dentist, the microscope's capabilities assist me tremendously. For example, smaller instruments can be used in implantology thanks to image magnification. Microscopy in dentistry helps make my work minimally invasive and consequently far less traumatic.

Can you give us an example of a treatment where the surgical microscope was particularly useful?

Joachim Hoffmann: One of my patients had a broken screw in the inside of an implant. I was really only able to remove the busted screw from the implant by magnifying and illuminating the problem area with the microscope. Otherwise I would have had to operate – good optics spared the patient surgery.

You mentioned indirect benefits...

Joachim Hoffmann: Yeah, by this I meant the digitization of microscopy and that's equally important: with this instrument you can record a video sequence of the operation. For example, digitization allows my colleagues and me to better analyze good outcomes or complicated procedures in retrospect, focusing in particular on a patient's oral anatomy and the suitability of the technology for the treatment. I have learned a great deal in the past 16 years since I started using the surgical microscope. I still watch the video after every single procedure. I always want to know if I can improve and how.

You have also prepared a few videos for colleagues and students.

Joachim Hoffmann: These films show the operation from the "perpetrator's" perspective – just like you see on a police procedural. This allows colleagues and students to see details that they would never have seen otherwise. And I want to make it possible for them to observe and assess the particular technology using different examples from actual treatments: what works well? how did mistakes get made? A few years ago I edited a couple of the videos and published them for my colleagues.

Dr. Hoffmann, thanks for talking with us!
Dr. Joachim Hoffmann
The dentist Dr. Joachim Hoffmann with the surgical microscope at his dental practice in Jena