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Focus on Oklahoma oral surgeon puts spotlight on infection control in dentistry

Tulsa, Okla.—In the wake of reports of an alleged breach of standard infection control practices by a Tulsa, Okla., oral surgeon last month, the ADA is reinforcing its ongoing message that dental health professionals take every precaution to protect patients and themselves.

According to the Oklahoma State Department of Health, some 7,000 patients potentially were exposed to bloodborne viruses, including human immunodeficiency virus, hepatitis B and hepatitis C. The Tulsa Health Department, the Oklahoma State Department of Health and the Oklahoma Board of Dentistry are jointly investigating the oral surgeon, as stated in a letter to patients on the OSDH website.

The dental board "so far has found numerous violations of health and safety laws and major violations of the State Dental Act," said a March 28 OSDH news release. "Dental Board investigators have been assisted by agents from the Oklahoma Bureau of Narcotics and the United States Drug Enforcement Administration concerning the maintenance, control and use of drugs on the premises."

Authorities are notifying the thousands of patients who have visited the oral surgeon since 2007, advising them to be tested for potential infection. About 1,700 patients had been tested at press time.

Susan Rogers, Oklahoma Board of Dentistry executive director, and Dr. Brad Hoopes, board president, told the ADA News that the 11-member board has followed the lead of the state's health department in pursuing an investigation. The department of health had spent three months on the investigation before alerting the dental board, they said.

"I feel the board has done exactly what they should have done," Dr. Hoopes said. "We appointed a review panel. We've reviewed it [the allegations]. We did a statement of complaint. We suspended his license initially, and he is set for a hearing the 19th of this month. That is the normal procedure we'd do with any issue like this.  The only difference with this one is obviously the health department went in front of us. They took the ball and did what they felt they had to do."

Dr. Hoopes said that "no portion of the dental board or organized dentistry had control over" any of the information the health department released.

The board ordinarily meets quarterly, and the next regular meeting is in August. The April 19 emergency hearing is the oral surgeon's right, Ms. Rogers said.

"By our state law, he has a right to a hearing for an emergency temporary suspension within 30 days," Ms. Rogers said. "He can waive it, and we will sit for a formal, pending hearing for a final determination on his license."

Ms. Rogers said the hearing is the beginning of due process, and a dentist can appeal a board decision to the district court.

After the story broke in the national media March 28, the ADA distributed two Issues Alerts to members that cited resources on infection control. The Association also addressed the breaking news story in a press release on March 29, and ADA spokespersons have been quoted in national media reports of the case.

ADA President Robert Faiella communicated with dental leadership groups about the evolving story in the April 5 edition of the ADA's Leadership Update.

"When standard infection control practices as recommended by both the CDC and the ADA are followed, dental offices remain an extremely safe place to receive oral health care," noted Dr. Daniel Meyer, senior vice president, ADA Division of Science and Professional Affairs.

Resources are available on the topic of standard precautions for infection control and prevention from the ADA, the Centers for Disease Control and Prevention and the Organization for Safety, Asepsis and Prevention. The CDC is calling particular attention to materials on injection safety and effective sterilization procedures and monitoring.

Some CDC resources include:

•  Guidelines for Infection Control in Dental Health-Care Settings (2003), including a Power Point slide presentation. Find these resources at cdc.gov; search for the title provided here.

• Safe Injection Practices in Dentistry. Visit CDC.gov and search for this title.

• The One and Only Campaign. Visit www.oneandonlycampaign.org for details about this CDC campaign with the goal of raising awareness among patients and health care
providers about safe injection practices.

The ADA is also working with the Organization for Safety, Asepsis and Prevention in reaching out to the dental community.

• OSAP's website at www.osap.org also provides information about proper infection control, and patient and provider safety.

ADA online resources include:

• Policy Statement on Bloodborne Pathogens, Infection Control and the Practice of Dentistry;

• Statement on Infection Control in Dentistry;

• Monitoring Sterilizers;

• ADA Professional Product Review article (December 2012, Volume 7: Issue 3), "Safe Injection Practices: Protecting Dentists, Their Staff and Their Patients." Visit ADA.org/271.aspx and click Archives on the left side to find the 2012 issues.

Another ADA resource, the ADA Practical Guide to Effective Infection Control, is also available as an information resource. (See story, this page.)

A March 29 online ADA News article includes talking points dentists may use if their patients express concerns about safety.