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Troubleshooter: To report or not report poor and inconsistent infection control

Aug. 11, 2021
Only one person is gowned. The dentist doesn't wash her hands. The front office doesn't wear a mask. Should this hygienist contact OSHA?

Nearly everyone has problems and concerns on the job, and sometimes you're just too close to a situation to solve something yourself. Share your concerns with us, and we'll examine the issues and provide guidance. Send questions to [email protected]. To view more Troubleshooters, visit DentistryIQ.com and search "Troubleshooter."

QUESTION: Our very busy office has one each: dentist, assistant, office manager, hygienist, and front desk. My concern is our lack of consistency in washing hands, gloving, and masking. One of us may wear a disposable gown while others do not. Some may change masks regularly, while others wear one all day. The front desk person doesn't wear a mask or shield, and only the hygienist wears a gown. The dentist doesn’t even wash her hands when coming in for the hygiene exam. She just speaks to the patient and immediately dons gloves.

Our assistant is in charge of ordering supplies, and she always strives to find the cheapest items and doesn’t necessarily order what we need. There’s nothing wrong with following a budget, but some days we need high-quality and expensive items for more productive days.

Patients are questioning why our staff approaches infection control so differently.  I think there are a lot of things our office could be written up for and could be fined by OSHA. Should I contact OSHA and report the office? What should I do?

ANSWER FROM INDIA CHANCE, BSDH, RDH, compliance consultant with Learn2Prevent:
I’m so sorry to hear that you’re going through an infection prevention nightmare. As dental hygienists, we often find ourselves in situations where we can’t control the alarming breaches we witness each day. It’s important to remember there are a few options when approaching this type of situation before heading straight to the dental board or OSHA. 

You could decide that working in an environment where the practice owner doesn't lead the team well in infection prevention just might not be the place for you to continue your career. If leaving is not an option, then this will require a few steps.

First, you should write down all the infection control (IC) breaches you’ve witnessed throughout your days. Obtain a copy of the Centers for Disease Control and Prevention Recommendations for Dental Practice Settings, as well as OSHA Standards for Dental Practices, and highlight the corresponding recommendation or standard for each breach you witness. Then schedule a meeting with your doctor that is not during lunch time or patient appointment hours. This conversation needs dedicated time to be able to discuss all your concerns and hear the doctor’s responses.

Remember to be patient and remain respectful during the meeting because as crazy as it sounds, some practice owners are not aware of all the required recommendations and standards for the dental practice setting. It will be important to share the required recommendations and standards in writing to educate the doctor on what could potentially be a legal liability.

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Don't be shy! If you have a tough issue in your dental office that you would like addressed, send it to [email protected] for the experts to answer. Remember, you'll be helping others who share the same issue. Responses will come from various dental consultants, as well as other experts in the areas of human resources, coding, front office management, and more. These folks will assist dental professionals with their various issues on DentistryIQ because they're very familiar with the tough challenges day-to-day practice can bring.