Infection Control

A few days ago, I received an email titled: “Every dentist should know.” I opened the attachment and there it was: the story of Dr. Wayne Harrington of Tulsa, Oklahoma, being investigated by the state dental board, the state bureau of narcotics, and the federal drug enforcement agency. The Tulsa Health Department has warned 7,000 patients of his that they may have contracted HIV, hep B or hep C from his procedures due to poor sterilization practices. During the investigation, they found numerous issues in that practice that had to be addressed. (ABC News, Mar. 29, 2013)

Another email followed with the same title, this time with an article speaking about an incident in the St. Louis area in 2010 where 1,800 veterans were put at risk of HIV and other diseases form dental tools that had not been properly sterilized between patients.

My whole body shivered for a moment. All I could think of was where my own limits would be on this issue. Sometimes, I think all human beings are capable of the same actions and what separates us is our limits, our tolerances, and our control levels. I wondered what situation I would have to be where I decide that the value of practicing with poor sterilization would be greater than putting 7,000 patients at risk of contracting a lifelong infection. I couldn’t find where that limit would be for me or for anyone. This was some of the most disturbing news I have ever read about in my field (it was quite a shocker to read the responses to it, as well).

As a way to prevent this, some suggest patients ask their providers what their sterilization practices are and demand explanation. Have we really come to the point where we need our patients to keep an eye on us so we can “do no harm?” Is it not the very essence of every healthcare professional to do no harm? This is not the responsibility of the patient. Patients shouldn’t be going around interviewing dentists to find the ones who practice good infection control! It upsets me to see how one person’s madness has created a situation where distrusting your dentist is being advertised and normalized.

I wondered how this issue could be dealt with in-house. Maybe there should be higher restrictions on licensing renewals and more stringent training required. This episode was unbelievably large in scale, and I doubt that there are any more like it. However, not everyone practices very strict infection control fully; it is assumed that if the bulk of it is practiced, attention to detail is not necessary. I disagree. I think it’s the details that make the bulk work properly.

This is an incredibly sad situation. My heart goes out to every person who was exposed because of one person’s lack of responsibility. This is a good time to reflect on the issue and evaluate our own personal commitment to our patients and make adjustments if we need to. However small, these adjustments will make a big difference in one person’s life and that makes them worth doing.

Mona Goodarzi, DDS