Q: We get children who have problems with keeping the x-ray sensor in their mouth because of gagging or discomfort. A staff member  is required to stay in the room with the patient and hold the sensor in place while another staff member presses the button to take the x-ray. The staff has discussed concerns about radiation exposure with the employer, the employer suggest that we wear a radiation apron when in the room while holding the sensor. Is this safe?

A: NO it is not safe and it is a violation of OSHA, Department of Health Services and Consumers Affairs regulations. I would advise your employer to purchase the proper sensor for children, the cost would be cheap compared to the citations, fine and potential lawsuit by employees!

It is amazing how often I am asked “What’s new with OSHA?  When the question should be “What’s new with Dental Compliance?”

Why?  its simple; Dental Offices are regulated by more than OSHA, depending on the county and city your practice is located in; it can be as many as seven agencies!

However, if you look beyond your OSHA training and gain an understanding of the compliance makeup you will also gain an appreciation that compliance regulation is an essential part of your business operations, both in growing your practice and maintaining your practice, not to mention reducing financial risk. Today compliance has taken on a whole new meaning, it is no longer a back office issue; it is a “total” practice philosophy.  Compliance is good – good for the staff, good for the patient and good for the practice.  So think “Dental Compliance” and not just OSHA.

Five things you should do during inspections,

1. Ask questions
2. Take notes and photos
3. Don’t argue with the inspector
4. Walk around with the inspector
5. Ask the inspector for their suggestions

Q: What governmental agencies are most likely to inspect our office?

A: Although there are about seven agencies that are responsible for regulating dental offices, the top three and most active are,

1. OSHA
2. Consumer Affairs (Dental Board)
3. Department of Health Services

Q. Recently my office was inspected by OSHA as a result I received several fines; two were regarding my compliance manual.  The OSHA inspector said my manual was missing several written plans, was outdated and too general. I had purchased the manual a month ago from the company who picks up my hazardous waste.  I contacted the company and told them what the inspector had said, their reply was they did not have manuals specifically for a dental office.  Can we purchase the right compliance manual from your company?

A. YES – I only write compliance manuals for dental offices, email me and I will provide you with the details – tom@tomterryseminars.com

I am very busy working with new clients who had requested my services because their practice was inspected by OSHA or the Dental Board and the results were not favorable.  In the process of bringing these dental offices into compliance I discovered something they all had in common, they all had some type of compliance services or product which they relied on but apparently failed.  Here is the list,

1. Online OSHA training
2. OSHA training videos
3. OSHA monthly newsletter service
4. Attend dental associations seminars & conventions
5. OSHA training provided by a dental supply representative
6. OSHA training provided by their waste management company
7. Compliance Manuals which they download from a dental association
8. Compliance Manuals provided by their waste management company
9. Service from compliance service companies who guaranteed to pay any fines

Dental compliance training is a hands-on, show me learning process that should be conducted in your office by an expert.

97% of the people who have been put in charge of OSHA compliance for their dental office feel they do not have the knowledge and experience to do the job. Doctors are you expecting any results?

Your Compliance Manual should contain current, site-specific policies and procedures for establishing and maintaining a safe working environment.  In addition, training documents, rosters, and audits/inspections reports should be filed within the manual. Your Compliance Manual should never be a “junk collector” for seminar handouts, advertisements, and unrelated documents, if your manual is a confusing mess don’t except anyone to read it and use it. All employees must be familiar with the policies & procedures of the office therefore they must review the Compliance Manual and postings.

Management must keep policies & procedures current and enforced, during an inspection the inspector will review the Compliance Manual, Posters, and postings to determine if policies & procedures for compliance are established and enforced.  The inspector will interview employees, if simple questions get answers like “I think we do”, “I’m not sure”, or “I don’t know”, the inspector will come to a quick conclusion that compliance doesn’t exist; this is not a good thing!

Passing a Delta Dental inspection is a good thing but not a gauge for an inspection by OSHA or the Dental Board.  I get calls everyday from Dental Offices that passed Delta Dental inspections with flying colors but didn’t pass OSHA or Dental Board inspections.  They call me for advice and direction wanting to know what went wrong and how-to correct the problem. The answer is quite simple – set the right standard and do the things to achieve it.  Example – if you set a standard to pass a Delta Dental inspection you will not pass inspections that require a higher standard.  This is why 9 out of 10 Dental Offices fail inspections, their standards are too low.

My advise – establish a standard that every patient will receive the highest quality of care and the highest level of safety, then do the things to achieve it  in other words make your office “Patient Compliant”, your office will pass every inspection every time. Remember it isn’t government regulations that makes a dental office safe it’s the people who work in it!

The fact is that 9 out of 10 Dental Offices fail OSHA inspections and receive huge fines, how will your office do? If you answer “NO” to any of theses questions, prepare yourself for the OSHA inspection from hell!

• Has your compliance manual been revised for 2010?
• Do you have a written Exposure Management Plan that is current?
• Do you have a written Injury and Illness Prevention Plan that is current?
• Do you have a written Hazard Communications Plan that is current?
• All employees both part-time and fulltime received in-office training on Bloodborne Pathogens Standard every year?
• All employees both part-time and fulltime received in-office training on Injury and Illness Prevention every year?
• All both part-time and fulltime received in-office training on Hazard Communications every year?
• Do you have documentation for all employee meetings and trainings?
• All employees are following office policies & procedures?
• Management enforcing office policies & procedures?