Michelle Aubé (Simmonds), RDH

As dental professionals have implemented the 2018 AAP periodontal classification of staging and grading there is still some confusion as to some of the rules of what counts and what does not count. One of the ways to make sense of the ‘rules’ is to ask the question Papapanou et al. (2018) pose in the Journal of Clinical Periodontology, “How do we define a patient as a periodontal patient?” (p. 168). Answering this question clarifies the rules of staging and grading, including the need to capture true interdental CAL’s, the requirement for a matching CAL site, searching for the highest CAL’s, why adjacent CAL doesn’t count, when buccal and lingual CAL can be considered, and how periodontitis distribution is assessed across the entire mouth rather than assigning generalized or localized labels to specific stages.

To answer this question, we must consider how we have traditionally approached it and not ask "Does the patient have perio?" instead "How do we define a patient as

Why does sterilization monitoring include both a biological indicator ‘test’ and a ‘control’?  Post incubation is it not clear enough that the user will simply look to see if the vial is purple or yellow?  Seems simple to observe a color change and log the outcomes.  This is all indeed true, however, dental professionals need to remember the structure of scientific testing and validating. Going back to high school science and the science labs in undergrad we were all taught the purpose of following the scientific method. As we get busy in our typ

If my dental regulatory body does not state specifically, that I need to track and trace, then who is telling me to track and trace?

A terrific question for any busy dental office to pose … who is telling me to track and trace?  To answer the ‘who’ one must understand the ‘why’.  Once the ‘why’ is understood through a risk management lens and professional responsibility to keep the public safe, the who loses its debate as you will be the person telling yourself to track and trace! 

Tracking and tracing are linking a sterilized package to the client it was used on.  Why do we label packages with the date, sterilizer #, load #, contents, and initialize? It is not just to label to see when it was sterilized but also where it’s going or in past tense, has gone. The label is the first step of having a recall system in place, it’s the tracking of packa

Infection prevention and control (IPAC) is a fundamental aspect of dental practice, ensuring the safety of both clients and dental professionals. A critical component of these standards is the Point of Care Risk Assessment (PCRA), which helps dental professionals determine the appropriate PPE for various procedures and client interactions.

A PCRA is conducted before any client interaction or procedure. It involves evaluating the potential risks of exposure to infectious pathogens and determining the necessary measures to mitigate these risks. This assessment considers the client’s health status, the type of dental procedure, and the likelihood of exposure to blood, bodily fluids, and other infectious materials. The following are elements to consider during a PCRA:

Client Health Status: Assessing the client’s med

It is no secret that dental clinicians work hours upon hours under the armor of personal protective equipment. For educational facilities and some dental offices, the pandemic PPE layers were not new protocols. For others, it was a novel approach to the safe practice of dentistry.

Are all these layers still required post-pandemic? Why had educational facilities and some offices already expanded their PPE wardrobe before the pandemic?

As dental professionals, it is not new news that enamel falls prey to constant demineralization.  In the Enamel 101 of dentistry, we learned the fact that hydroxyapatite can be attacked by acids and break down if there is not a remineralization balance.  The ideal balance is to stop acid attacks period. 

Does every office need a DUWL program?

This can be answered by the equipment the office has.  There are two types of water delivery systems in a dental office:  direct municipal and closed bottle systems. 

The direct municipal has no bottle and is only required to purge the DUWL on opening, closing, and between clients. 

However, a closed water system as per the MIFU of the manufacturer of the dental chair or bracket table with the attached bottle, states a program is required to include cleaning, disinfecting, and testing. 

At this point, a retrofit from municipal to closed is not mandated.  It is important to note that offices do not get confused with the word municipal … if the office uses tap water in their closed bottle system that is not considered m

Should Leadership be Taught in Dental School Curriculums?

Absolutely!  The dentist running a practice must be the ‘scientist’ in dental sciences and deliver quality care. Also, the dentist has to be a ‘business’ savvy individual to ensure the practice’s financial health. What else does the dentist need to be … the team ‘coach’. 

It is either the dentist’s role or if the office has an office manager, it may fall upon the manager.  Nonetheless, it’s a reality that hand-in-hand with being a practice owner comes leadership.  So where does a practice owner ‘learn’ leadership? 

It would be fantastic along with DENT 3055 there would be a Leadership 101 course that teaches the practice owner how to navigate the various dynamics of a team to develop and strengthen that team. 

July 1976 at the American Legion Convention at the Bellevue Stratford Hotel in Philadelphia, Legionnaires was named and identified as the cause of an outbreak of severe pneumonia with 200 cases and 29 deaths (3) (5).  The outbreak was linked to the inhalation of aerosolized contaminated water (3)(5).  A milder infection caused by the same type of Legionella bacteria is called Pontiac fever. Rewinding in time, in 1968 in Pontiac Michigan, Pontiac Fever was named and identified as an outbreak of influenza-like illness, identified by people who worked at & visited the city’s health department and had inhaled aerosols from contaminated water (3). Legionnaires' disease is an acute bacterial disease, causing death in 5% to 30% of cases (4). The Government of Canada’s Legionella site, states the following:

“Cases of Legionnaire’s disease may be difficult to detect because very few of the people exposed to the bacteria get infecte