Tag Archives | dental office

How to Address a Patient who Had an Interrupted Treatment Plan

An interesting article titled “Following up with a patient whose treatment has been interrupted” appears in the November 2014, JADA, and written by Michael H. Halasz. The article discusses a patient who received a complex treatment from a military dentist. The treatment started but because of deployment of a large number of troops in Iraq the treatment was interrupted so that the dentists could attend to other troops. The article addresses if the patient was abandoned during this time. The American Dental Association Principles of Ethics and Code of Professional Conduct states “Once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken that the patient’s oral health is not jeopardized in the process.” The article states that if the dentist felt he was going to resume the treatment of the patient after handling the deployed troops, then he acted reasonably. However, one could also argue that since the dentist did not know how long he would be tied up with the other troops, he had an ethical obligation to inform the patient to have […]

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The Ethics of a Dentist Leaving a Practice

An interesting article written by William Walton, appears in JADA December 2014, titled “Addressing the ethics of leaving a dental practice.” In the article, a discussion of what a dentist should ethically do when they are at a current dental practice and are moving to a different dental practice. It is stated that the American Dental Association Principles of Ethics and Code of Professional Conduct provide guidance on what should be done in such a situation. It is suggested that once a dentist knows they are moving to a different practice they notify their patients of this and the departure date. Further, if a patient is in the midst of a treatment plan, then discussions should take place regarding if the treatment can be finished and if this is unlikely then other options for completing the treatment should be discussed. This will allow the patients to be involved in their treatment decisions. Another issue at stake is that of patient abandonment. The dentist should not discontinue the treatment without giving the patient adequate notice and the opportunity to seek the services of another dentist. If needed interim dentists can be used. The article addresses a few issues in regards to […]

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Infection Control Lapse in Hawaii at VA Dental Clinic

The U.S. department of Veteran Affairs (VA) has said that 20 patients treated on May 23 and May 27 in Hawaii may have been exposed to viruses due to instruments that were not sterilized. The dental instruments used were believed to be clean, but the VA monitors said they were not sterilized. Only a single load of dental equipment, which was typically sent from one medical center with a dental clinic to a different medical center for sterilization was not performed. It is believed that the risk of contracting anything like HIV or hepatitis is low but patients at risk are recommend to be tested for viruses. The source of the story is over at khon2 titled Veterans Affairs apologizes to dental patients for unsterilized instruments written by Nestor Garcia on June 27, 2014, and located over at  http://khon2.com/2014/06/27/veterans-affairs-apologizes-to-dental-patients-for-unsterilized-instruments/. Staff at khon2 observed the sterilization procedure followed at the VA. They said in their article “First, they scrubbed the instruments, then placed them into an ultrasonic machine to rid the instruments of debris. Next, the instruments were blown dry, placed in a bag and put into an autoclave. The machine steamed them clean for 45 minutes at a temperature of […]

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More Dental Patients Warned of Potential HIV and Hepatitis Exposure in Pennsylvania

Back in July, 2014, I discussed a case in Pennsylvania where dental patients where made aware of possible HIV and hepatitis exposure due to infection control lapses by a dentist. This led to a 74 year old dentist having his license suspended. A video interview of several students who were treated by the dentist said that sometimes the dentist didn’t wear gloves and didn’t wash his hands between patients. See the blog post located over at http://blog.teethremoval.com/dental-patients-warned-of-possible-hiv-and-hepatitis-exposure-in-pennsylvania/. An additional case of infection control lapses has also occurred in Pennsylvania. The dentist had his license temporarily suspended due to an investigation by Pennsylvania’s department of health. A press release issued said the dentist “…did not follow appropriate procedures to properly clean, disinfect, or sterilize dental tools used at his…office.” The investigation showed the dentist admitted that he and his staff do not send out samples for biological spore testing which to make sure that sterilization is occuring. Furthermore it is not clear when the dental instruments were last sterilized including metal impression trays and dental tools. As such the health officials have encouraged former and current patients of the practice to get tested for potential hepatitis and HIV. A few of the […]

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Propofol-Remifentanil Versus Propofol-Ketamine for Third Molar Surgery

A study titled “Comparison of Propofol-Remifentanil Versus Propofol-Ketamine Deep Sedation for Third Molar Surgery” appears in the 2012 Anesthesia Progress journal. The authors of the study set out to better determine what anesthetic to provide during third molar (aka wisdom teeth) surgery. In the study, two drug combinations for use as deep sedation during oral surgery were evaluated. Patients in a control group received a continuous intravenous infusion of propofol-remifentanil,  and patients in an experimental group received a continuous intravenous infusion of propofol-ketamine. This study was double blind in that neither patients nor surgeons were aware of which treatment was given. In this study, 37 patients  were monitored while sedated for respiratory, heart rate, and blood pressure stability. Emergence from the effects of anesthesia and total recovery time were recorded. In addition, patients and surgeons were both asked to rate their satisfaction with the anesthetic given. It was found that those patients who received the ketamine treatment took longer to emerge from the effects of the anesthesia. For those who received ketamine, the average emergence time was 13.6 minutes while those who received remifentanil  had an average emergence time of  7.1 minutes. The recovery period for ketamine patients was an […]

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