Handpieces

Handpieces

light handles, and plastic over the X-ray unit. It took my staff several m onths to change our routine and get into total dental operatory sterilizati...

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light handles, and plastic over the X-ray unit. It took my staff several m onths to change our routine and get into total dental operatory sterilization. We even hired a new staff m em ber ju st to clean operatories and sterilize instrum ents.

The costs are high initially, but the public should not be fooled th a t dental handpieces cannot be sterilized. They can. I’ll be glad to show anyone my office techniques for steriliz­ ation. I welcome the ADA, MDA, “S treet Stories,” “Prim e

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JADA, Vol. 123, August 1992

Time,” “60 M inutes,” CDC and OSHA to send a representative to see how we sterilize our equipm ent. In my view, my patients deserve th e best, and I would not w ant even the h in t of a patien t getting anything but dental tre a tm e n t from my office. How can a price be put on someone catching a disease like AIDS if it’s preventable by simple office sterilization? My dental office will do everything we can to m ake sure each patien t is safe, and I’m sure all dentists have the ability to do the same. T im oth y J . Z ielinski, D.D.S. M ason, M ich. H A N D P IE C E S

We, as m any others, were distressed by the recent television segm ents on dental handpieces. It seems th a t our profession is under fire on m any fronts, and each day brings more evidence to challenge and reth in k our existing m ethods of practice. We cannot escape the fact th a t HIV was found to have probably been tran sm itted from a d en tist to some of his patients, despite the lack of discovery as to the definitive mode of transm ission. We are certain all of us would agree _ th a t, as educated and com­ passionate h ealth care providers, we would never knowingly p ut our patients a t risk. We would like to believe th a t each of us takes every precaution to protect our

patients and ourselves. Each day we rely on federal and state agencies to require before-m arket testing of m aterials, pharm aceuticals and equipm ent to prevent injury or harm to our patients and ourselves. If scientific evidence exists to show th a t a procedure or a product could be potentially dangerous, it is not m ade available for our use. If it is shown to be harm ful after it has been m arketed, it is either recalled or a m oratorium is placed on it to h a lt its usage, pending fu rth er research to prove its safety. Scientific evidence does exist th a t shows bioburden (th a t is, bacteria, viruses and the like) can and does survive inside conventional dental high speed handpieces, even after the previously ADA-recommended disinfection procedures are followed. This m aterial is a potential vector for patient-top atien t transm ission of a variety of diseases. The possibility for transm ission is elim inated by heat sterilization. So why has our organization essentially sa t on the fence on th is issue by recommending, u ntil recently, "... sterilization of dental handpieces, when possible”? How should we explain to our patients the ignorance displayed by other m em bers of our own profession? And did the position of the ADA change only after being challenged by the m edia on this subject? We complain about intrusion in our lives and practices by th ird parties, governm ent and the like. It is tim e we realize

th a t we m ust be willing to police ourselves if we do not w ant these intrusions. M any of the OSHA requirem ents are burdensom e and could be considered by some to be “radical” or an “overkill,” but w hat are the ultim ate objectives? Won’t our patients and employees ultim ately benefit from these changes? We th ink th a t p a rt of the reason for the upheaval now occurring in our profession is because we have been either lax in acting ourselves, or have resisted positive changes supported by available current scientific research. We realize th a t not all opinions were necessarily given equal tim e. B ut after viewing the program , we felt em bar­ rassed and frustrated. Em barrassed th a t there would even be debate on w hat we consider basic common sense in the face of available evidence—the need for sterilization of dental handpieces. F rustration th a t, as duespaying m em bers of the

ADA, we w atched as our organization appeared to sidestep th is issue on national television and place doubts in the m inds of patients. D entistry is a proud and noble profession and the great m ajority of practitioners place patien t care a t the top of the list of th e ir practice priorities. We m ust learn to act ra th e r th an react and place the welfare of our p atients above all other considerations, even if it m eans w earing protective equipm ent, laundering soiled garm ents and so forth. Yes, th a t even m eans buying additional h a n d ­ pieces. S te v en C. R h od es, D.M.D. L inda K. B ranh am , D.M.D. L on gw ood, FI.

JADA, Vol. 123, August 1992

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