BAD headlines, BAD news for dentistry

“Court orders dentist to pay $85,000 to employee fired for safety complaint.”

“Fears for more than 11,000 dental patients who could have been exposed to HIV and Hepatitis due to poor cleaning and sterilization”

“Dentist accused of being a menace to the public health faces 17 OSHA violations and a revocation of his license.”

When it comes to headlines like these, it can be bad news for dentistry. Patients become concerned, and may choose not to visit their dentist out of fear. The number of cases where OSHA fines are issued and action is taken against dentists may be relatively small when compared with how many dentists there are. The reality is though, that the idea that even bad publicity can be good does not apply here.

Let’s discuss the first case that came about by a dentist trying to cut overhead. He determined that the protective caps should be removed from needles prior to being placed in the sharps container. The idea was that the containers would fill at a slower pace, saving the practice money as they would not need to be disposed of as often. A dental assistant was concerned about the increased risk of infection and possible needle stick injuries. The assistant raised these concerns with the doctor who dismissed her concerns, and she filed a complaint with the US Department of Labor’s OSHA Administration. The doctor was fined $11,000 for the violation. After all, the CDC estimates that 600,000 needle sticks occur every year, placing employees at risk for a variety of serious health issues.

The real expensive part of the story occurred the same day the OSHA inspector visited the practice. In retaliation the dentist fired the assistant who filed the complaint. The $85,000 judgement was for $51,641 in back wages, as well as $33,450 in compensatory damages.

You might be surprised at the lengths some practitioners take to save costs. A dental hygienist recently posed this question on an online Hygiene forum, “My dentist told me today that in order to cut down on electricity usage from the autoclave and to save money on sterilization bags, he wants me to put my instruments in the cold sterile only. What should I do?” Another posted, “I temped today in a practice where I was told that to save money, we are only to change the barriers once per day. Is this legal?”

Not only are these decisions putting patients at risk, they are also placing the practice at risk for OSHA fines as well as other disciplinary actions. How bad can it be? The most frequent OSHA violation for dental offices is 1910.1200 (e) (1) Hazard Communication: no written hazard communication maintained in the workplace. This violation carries an average initial fine of $303. The most expensive OSHA violation for dental offices is 1910.1030 (c) (1) (iv) (A) Bloodborne Pathogens. Exposure control plan update does not reflect changes in technology that eliminate or reduce exposure to bloodborne pathogens. Initial amounts for OSHA violations of the Bloodborne Pathogens Standard can be as high as $40,000! Proposed OSHA fines for nongovernment healthcare facilities can be as much as $89,000. Yikes.

Consider the Oklahoma Oral Surgeon whose office was visited after the health department was alerted about a possible Hepatitis C infection from the office. The office was found to be a “perfect storm” of violations. A few of the problems discovered? The autoclave had not been tested for effectiveness in more than 6 years. the instruments coming from the autoclave were not fit to be used. Drugs in the practice were expired, and not properly stored. Basic universal precautions for Blood-borne pathogens were not being followed at all.

As a result, the dentist was accused of more than 17 violations and risks losing his license. His reaction to the situation, “My staff takes care of that. I don’t.”   This reasoning didn’t hold much weight with OSHA, or the Dental board.

As the owner of the practice, you are held responsible for training your staff, and making sure that they are all following the necessary standards for minimizing risks to patients. Consider another post on a hygiene forum, “An assistant told me that another hygienist in our practice is saving Oraqix carpules that are not completely empty and is re-using them on multiple patients. What are your thoughts on this, and what should we do?”

Knowing what your hygienists and assistants are doing is critical to exceptional patient care and avoiding OSHA violations and fines.

When is the last time you had an OSHA training meeting in your practice? Did you know that your updated Hazard Communication standard was to be in place by December 1, 2013?

Do you have systems in place to train and hold accountable new team members? Many practices are sorely lacking in systems for training new hires. The good news is that you don’t have to re-invent the wheel. We have 75 complete systems that we teach and help our clients implement. Standards for office sterilization is just one of those.

Check out all 75 systems in our new book “The Ultimate Guide To Doubling and Tripling Your Dental Practice Production” – For a limited time you can grab one of our 100 free copies at

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