Chicago — The cases under investigation in Oklahoma and Colorado involve oral surgeons suspected of not following standard precautions in areas of infection control. The suspected breaches of protocol may have put thousands of dental patients at risk for HBV, HCV, and HIV. Testing is being conducted and patients anxiously await the results.
The root of both of these health care upheavals seems to be lack of adherence to known standards, or lack of knowledge concerning these standards, or both.
In any dental practice, recommendations are set by the Centers for Disease Control and state regulations. But the question is, “Who is responsible for ensuring that these standards are met?” In most dental practices, the day-to-day enforcement of infection control protocol is delegated to a clinical dental assistant.
Carolyn Breen, EdD, CDA, RDA, RDH, president of the American Dental Assistants Association (ADAA), states, “ADAA supports education and credentialing of dental assistants nationwide in order to assure that dental assistants have a comprehensive understanding of state dental practice acts containing legally delegated responsibilities for dental assistants, as well as a thorough knowledge of infection control and appropriate treatment protocols and knowledge of many other critical aspects of dental assisting responsibilities related to high standard quality care and patient protection.”
In the absence of an informed, educated clinician directing the infection control in a practice, standards of the CDC or the state may not be met and patients’ health may be placed at risk.
What do these two cases have in common? Both practices may have employed dental assistants who were not fully educated about the law, and not properly trained to sterilize instruments or monitor sterilizers. According to the Associated Press (AP), Dr. Harrington of Oklahoma left questions about how to sterilize instruments and drug procedures up to his employees. Educated, credentialed assistants could be expected to know how to meet infection control standards.
Dr. Breen concludes, “ADAA believes that dental assistants have a responsibility to monitor themselves and inform their patients about the importance of licensed or registered dental assistants as part of the dental team. Unfortunately, many trained-on-the-job assistants can be taught improper sterilization techniques by others who were also improperly trained. A means to address this issue is for strict guidelines and training for infection control and sterilization to be instituted in the same way that several states have instituted guidelines with radiography and intraoral expanded functions – these guidelines should be applied equally in all states, not just a few.”
The ADAA is America's oldest and largest dental assisting association serving an estimated 300,000 dental assistants in the United States. It is dedicated to the development and recognition of professionalism through education, membership services, and public awareness programs. The ADAA is a strong advocate for legislation mandating credentialing for clinical dental assistants and greater recognition of the assistant's role in the professional dental team.