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Dr Howard

Authors : Dr Howard Farran.

What do Cecil the lion and a recent salmonella scandal have in common?

The answer: they’ve both been part of a perfect storm—a perfect storm with far-reaching consequences. There could be a problem of that magnitude on its way for dentistry, and I want to help you avoid it. More on that later. First, let’s explore the makings of a perfect storm.

When something huge happens, it’s not always the result of simple and predictable elements such as yes, no, left, right, up, down, and two plus two equals four. Sometimes, it takes inexplicable “X factors,” such as timing and mood and world events, to come together and create a giant mess.

We saw this with Cecil the lion. Lots of people have killed endangered animals illegally, but the issue never went viral like what we saw this year when a big-game-hunting dentist killed a protected lion in Zimbabwe. In that case, the exact combination of public sentiment and timing, coupled with the power of social media, resulted in global outrage.

You know how all that turned out. It absolutely exploded. Let’s look at another recent perfect storm that had severe consequences.

In September, the owner of a peanut company was sentenced to 28 years in prison for his role in a deadly outbreak of salmonella in peanut butter. This landmark case shows that the public, and the courts, will no longer consider public-safety cases like this to be a matter of making a mistake. Instead, people are viewing these cases as murder.

If a person runs a food-processing plant and a dozen people get food poisoning and someone dies, that’s not murder in the traditional sense, but society still wants justice served. People are asking, “How come if a person goes out and kills someone, they’re held accountable, but when the owner of a company does something irresponsible that kills people, that owner isn’t held accountable?” Those decision makers are being held accountable now. The public wants it that way.

Now how does this relate to dentistry?

If you do something at your dental practice that makes people ill and it gets traced back to you, guess what? The public is going to want you to be held accountable, too. They’re not going to say, “Dentists are nice, helpful people. We should just let this go.” Now what could a dentist possibly do to hurt many people? The main way: lax infection control.

I’ve researched cases of infection-control problems in the dental industry and in each case, the dentists were good guys. They were doing a lot of things the right way. You can be an accountable, responsible, smart, caring dentist and yet you can lose everything just because someone on your staff didn’t run an autoclave the right way. It’s overwhelming to realize that a tiny mistake can have such a terrible outcome, but you have to think about it. All of us dentists have to, or a lot of people could get sick. If that happens, it will not be a secret. Epidemiologists are effective at tracing back to the source.

The health-care system has had many disease outbreaks that are the result of mistakes at medical centers, and the public is sick of it (no pun intended). Some scandals have made huge headlines, especially with social media getting stronger every year. The health-care system gives infections to thousands of people every year. This is a fact. The data of just how many thousands of patients get hospital- acquired infections every year varies, depending on the source, but all credible organizations agree it’s in the thousands—many years, it’s in the hundreds of thousands. Dentistry is a relatively small part of the health-care industry, but we still see a staggering number of patients. Dentistry’s day in the mud could be coming.

Get enough patients sick, get a patient sick who has media contacts, do all this during a slow part of the news cycle, and couple those factors with whatever mood the nation is in, and when you combine all that with social media that is fast and furious, you will have a perfect storm violent enough to wreck everything you have worked for.

You’re not trying to get anyone sick. You’re trying to make people healthy. You are trying to help people. But if you do not have a handle on infection control, you could end up in a nightmare.

Even some of the best dentists out there aren’t paying enough attention to infection control. Many dentists just roll their eyes when I ask them if they have a written OSHA policy. Or they say, “We have an autoclave and it works,” but they don’t have a manual, they don’t have a process, and they’re not covering their bases.

Established protocols exist that should be followed, and the information is accessible. I’ve done podcast interviews with experts who tell you how to do it right. For instance, listen to “Confidently Clean: How OSHA Training Improves Your Office,” during which I talk with Leslie Canham, a leader in infection control and a Department of Labor-authorized OSHA outreach trainer. You can find the podcast at Dentaltown.com/blogs/infectioncontrol.

On Dentaltown.com we also have excellent online CE courses for infection control. One example is the course, “Disinfection and Sterilization: A Primer,” by Margaret I. Scarlett, DMD, and “The New OSHA Hazard Communication Standard,” by Leslie Canham, CDA, RDA.

Some dentists don’t consider infection control sexy—it’s not as exciting as CAD/CAM or making a same-day crown, but we need to learn about it and adhere to the best infection-control practices anyway. This topic isn’t sexy, but it is lethal. People die when they get bugs at hospitals, and they die when they get bugs at dental practices.

In all likelihood, it’s not going to be long before some good-old-boy dentist has to spend the last 20 to 30 years of his life behind bars because he didn’t have an OSHA policy. It’s time to get serious about infection control. It’s time to appoint someone in your office. If you’re not interested in this topic, you have dental assistants, you have hygienists, you have practice managers, and any one of them could be champion for this. One person needs to be in charge and to own the topic of infection control and get everyone else on board and hold them accountable. It’s your job to empower that person and to check in on him or her.

It’s time to write the check, get the policy, get the consultant, do whatever you need to do, because that guy who used to provide people with peanut butter, he’s spending his golden years behind bars and I do not want that to happen to you.

People aren’t looking the other way on Cecil the lion. They’re not looking the other way on irresponsibility regarding salmonella. And the next dentist who accidentally kills someone because he’s not dotting the i’s and crossing the t’s may go to jail for a long time.

The legal system is going to make a huge example of him or her. Be a different kind of example. Be an example to your staff and the rest of our industry by taking infection control as seriously as a life-and-death matter, because it is.