By Mary Govoni, CDA, RDA, RDH, MBA
This weekend has been full of news reports of an Oklahoma oral surgeon who may have exposed as many as 7000 patients to HIV, hepatitis B and hepatitis C over the past six years. The Oklahoma Board of Dentistry conducted a surprise investigation of the dentist’s two offices as a result of a patient who tested positive for HIV and hepatitis C. This patient had no known exposure risks except for treatment in the dental facility. As a result of their inspection, officials from the Oklahoma Board reported having observed numerous violations of infection control protocols, as well as improper dispensing and recording of medications and illegal administration of intravenous sedation by dental assistants.
The media hype surrounding this incident has great potential to cause patients to avoid going to their dentist in Oklahoma as well as other areas around the country, just as it did in the early 1990s with the cases of HIV transmission from a dentist in Florida. The difference here is that social media was virtually non-existent then. Now stories of perceived unsanitary or unsafe conditions may proliferate in the social media as a result of this incident.
Consider reading:OSAP comments on Tulsa oral surgeon's infection control violations
Consider reading:Exclusive interview with Susan Rogers of the Oklahoma Board of Dentistry on Dr. Scott Harrington
Consider reading:RDH Infection Control columist: Reassure patients of your safety procedures
Dental teams need to be prepared for questions from patients about this incident in the upcoming days and weeks. Patients will need to be reassured about the practice’s infection prevention protocols, beginning with the cleanliness of the entire office and especially the sterilization area. Patients may want to actually see the sterilization area and/or teams may want to show it to patients. But make sure that it is clean and uncluttered. Nothing says non-sterile like a messy instrument processing area.
Patients should also see other visible signs of infection prevention, such as packaged instruments or wrapped cassettes, equipment barriers where appropriate, and the team’s use of personal protective equipment and hand washing procedures. The news coverage also mentioned “testing” or monitoring of sterilizers that is required monthly. Dental teams should make sure that the sterilizers are being monitored on a regular basis and inform patients regarding this practice. It is important to note, however, that while the media reported that monitoring should be done monthly, according to the CDC Infection Control Guidelines in Dental Health Care Settings – 2003, in should be done “at least weekly.”
Another important tool that dental practices can utilize to lessen the impact of this negative press is the use of their website and social media to educate and reassure patients. I always recommend that practices have information on their website about what they do to keep patients safe. In addition to the website, however, a more immediate response to this incident can be facilitated through social media. If a practice has a Facebook page, Twitter following or a YouTube channel, the doctor and team can post information regarding their infection prevention protocols and educate patients about the potential for transmission of blood borne infections during dental procedures. One important thing to emphasize in the social media is that what happened in Oklahoma is an isolated incident, and that there is not a resulting epidemic of HIV, hepatitis B and hepatitis C. Testing of the patients treated in the practice is a precautionary measure — it does not mean that they are all infected.
Once the media hype dies down, it is possible that state dental boards, especially the Oklahoma board, may implement new rules and/or inspection protocols for dental practices. In addition, since many infection prevention violations also pose risks to employees, OSHA may increase their scrutiny of dental facilities. In either case, it is in the best interest of every dental practice to make sure that employee safety training is up to date and that the OSHA-required infection/exposure control plans are also updated. Reviewing protocols for all infection prevention procedures is also warranted – everything from cleaning and disinfecting treatment rooms, to instrument cleaning and sterilization, to the use of appropriate products for cleaning and disinfection. Excellent resources for dental teams are available at the CDC (www.cdc.gov), the Organization for Safety Asepsis and Prevention (www.osap.org), and the American Dental Association (www.ada.org).
Doing the right things to protect patients is what the vast majority of dental practices demonstrate each and every day. It is sad that an isolated incident such as this can have such a negative impact on the profession of dentistry.
Mary Govoni, CDA, RDA, RDH, MBA, is the owner of Mary Govoni & Associates, a consulting company based in Michigan. She is a member of the Organization for Safety, Asepsis and Prevention. She can be contacted at [email protected] or www.marygovoni.com.