Sunday Dental Thread: Crisis Looming.

[PCIntern]

http://www.cnn.com/2013/03/30/health/oklahoma-dental-warning/index.html

Tulsa, Oklahoma (CNN) -- They'd gone to W. Scott Harrington's dentist office in a Tulsa, Oklahoma, suburb to have a wisdom tooth pulled or perhaps have their jaw realigned.
On Saturday, scores of his patients were waiting to be checked once again -- this time not to replace missing teeth, say, but to find out whether they'd been exposed to hepatitis or HIV.
By 3 p.m. local time Saturday, one hour later than planned, some 420 people -- out of 7,000 of Harrington's patients from the past six years who health authorities reached out to -- had been screened for hepatitis B, hepatitis C and HIV at the Tulsa Health Department. They came after investigators discovered unsanitary, unprofessional conditions at Harrington's office in Owasso, 14 miles northeast of Tulsa, that one official said created a "perfect storm" for infections.
Within two weeks, those tested Saturday (and when the screenings resume starting Monday) should get the results back -- all because they'd gone to see an oral surgeon with 35 years of experience.

More at the link...


As a dentist, I don't even know where to begin. We know absolutely nothing about anything in particular, but this story may eclipse that of the psychopath dentist who injected several patients with his own serum, HIV tainted, all those years ago. Although it is possible that no patients of his were exposed to any of the three diseases we so fear, AIDS, Hep B, and Hep C, due to the nature of the Internet and cable news, this will have, IMO, greater fallout. My office complies with all legal requirements, and then some, but you just never know what can happen in this setting. I went and checked that none of instruments have the slightest visible corrosion, that the sterilizer was working and that the tests came back negative.
But let me tell you, that you just never know 100% of the time that you're doing everything possible and that the regulations are extremely onerous to even discern when you read them and know what the intent is. For example, in recent years the is a reg on the books here in PA that anyone, including dentists, who takes radiographs must take a continuing education course every four years and be recertified. Which we did. Recently. It was recent only because no one informed us of the need to take this because the law was passed but no one, including the State Board or the local dental societies, bothered to contact practitioners and explain what was required of them, exactly. There's a rumor going around that you can do this with online study, but no one seems to know if that really is acceptable or not, and the fact is that of the ten people I called to find out what they'd done, not one person knew about the requirement, and they're old pros a t this. Some were incredulous that this happened and they knew nothing about it. For the record we all took the course over four hours at an accredited center for teaching it, so you folk ready to jump in can relax for a minute, until you find something else that I say reprehensible.

I see major health inspections coming to a dentist near you soon. I also see the hiring of health care attorneys to defend against major cases brought against unwitting dentists who may or may not be aware of regulations surreptitiously passed and not communicated.

It will be very interesting to hear how this plays out, both legally and in the media. Please believe me when I tell you that the vast majority of us are doing everything we can to ensure health and safety of patients and employees. Honest to God we are.

[Skittles]

1. question for you PCIntern

if you asked a dental practice what their hygiene practices are, would they have it in written form? Also perhaps you could provide tips on what to be aware of. I, for example, would have been very alarmed if anyone other than the actual DENTIST administered anesthesia

[PCIntern]

3. Probably not, it is complex and to my knowledge,

It isn't written by each practice, at lest in PA. Might be a requirement elsewhere.

Nd to the second query, depends upon the state. Also complex answer to simple question...

Thanks!

[DollarBillHines]

2. Those onerous regulations

One thing the article did not mention is that OK has all of five inspectors to cover the state's 2,000 dentists.

The article did mention, however, that inspections are undertaken only after a complaint is filed (which is probably pretty damned rarely).

Free Market, baby...

[PCIntern]

4. Board Of Health can take over

And every municipality has one. And they can inspect for no reason at all if they want in most jurisdictions.

[DollarBillHines]

5. I wonder if that is an option in OK.

It is such a bassackward place.

[PCIntern]

8. It will be interesting to watch the fallout

From this. My guess is Big Trouble.

[DollarBillHines]

10. I'm guessing (hoping) national repercussion

Keep your lamp trimmed and burnin', PC
DBH

[Mika]

6. I hear you.

Floriduh has changed their regs and reqs too. The chain of prosthetic production has to be maintained in each case file. So, if my lab outsources a process to another lab that outsources a subset of their manufacturing process, which is ALL the rage now w/digital impression & CAD/CAM production, it all requires documentation by certified (by the state) labs. So, if one of your labs outsources to another lab that has not registered nor been certified by the state, then that prosthesis is illegal.

Do you get how utterly onerous this has become?


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[PCIntern]

7. Nobody gives a damn about that in PA

At least no one has TOLD me that anyone does....

Good luck with that....

[nadinbrzezinski]

9. I trust you

And I know how onerous the sterilizing procedures are. Been tree, done that.

All I can tell you is most health pros do their jobs. It's Te few a-holes.

And people are afraid of the dentist to boot.

[MichaelSoE]

11. is it safe?

[Jamastiene]

12. Of course, the majority most likely do try your best to be clean.

I don't see holding all dentists responsible for what one did. I know my dentist is clean. Then again, I've known my dentist for years. I still won't be joining any pitchfork and torch carrying march to dentists' offices any time soon.