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OSHA Guidelines
w ithout m uch thought: driving, overeating, smoking and firearm s to nam e a few. These | are activities th a t kill hundreds of thousands of individuals each year. By comparison, the risks encountered in the dental office are minor. I am not suggesting th a t we ignore infection control or X-ray exposure. B ut I am suggesting the following: ■■ We should evaluate the real risks in the dental office. If we strive to modify behavior so as to m inimize risk, we need to j have a clear understanding of j the relative risks we face. I suspect th a t if we were to ran k the various risks to our patients and to ourselves, AIDS would be very low on the list. Indeed, the risk of AIDS being con tracted in the dental office m ust be on the sam e order as the risk j of being struck by lightning. ■■ We should evaluate the benefits of new program s along w ith th eir associated costs (both j economic and otherwise). For exam ple, th e costs of infection control are driving up dental j fees, and hence lim iting the availability of dental care. We ! m ight w ant to m oderate our I desire to m ake the dental environm ent as safe as possible w ith our desire to m ake quality dental care available. The consum er is paying for our infection control procedures. We should know how much safety they have bought, and a t w hat cost. M arc A lexan d er, D.D.S. H ealdsburg, Calif. O S H A G U ID E L IN E S
Like m ost practicing dentists, we are constantly working at our offices to keep up w ith the 16
JADA, Vol. 123, Ju ly 1992
late st changing infection control I inappropriate, I applaud your guidelines from OSHA. We are M arch editorial. also concerned about how we Tw enty years ago, Dr. Louis can possibly absorb the addi Rose of th e U niversity of tional costs and procedures into Pennsylvania suggested th at our daily dental practice. the dental office of the future m ight likely be the prim ary Could it be th a t the various dental associations are non-invasive diagnostic center approaching the OSHA issue of medicine. In consideration of from the wrong angle? Maybe th a t, for five years I have had a we all should be promoting the blood analyzer in my office. OSHA policies: W ith it we have performed concerning screening tests for glucose, saliva and all cholesterol and triglycerides. A th a t it touches fasting glucose test, we believe, being treated and is justified for brittle peri being disposed of odontal patients. Cholesterol like nuclear waste; and triglyceride are tests we m aintaining employee offer w ith no diagnosis, simply records for 30 years. ... a referral to th eir private B ut I suggest th a t if we do it physician, if the counts are we m ust dem and th a t it be done elevated above the standard. rig h t for each and every The tests are an offered service, not m andatory. business in America. Why should dental and medical These tests can be ru n on facilities be singled out? After blood obtained from a fingerstick, which is less blood th an all, shouldn’t people be we could obtain from oral protected equally everywhere surgery or a sub-gingival they m ay go? We m ust insist scaling. The blood analyzer is a th a t OSHA rules of every kind desktop model and is capable of and natu re be developed to ru n n in g any desired presurgical cover public w ater fountains, chemical analysis. Blood tests dishes in re sta u ra n ts and bars, are stan d ard a t hospital sanitary disposable napkins adm ission, w hether for a hang and diapers, school cafeterias, nail or open-heart surgery. I napkins and partially eaten doubt th a t any of our food in the trash. invasive procedures Maybe when Congress finally should be treated less realizes th a t OSHA’s actions seriously. have escalated the cost of a Ironically, ham burger, fries and a Coke physicians to $20 they will force OSHA appreciate our to develop a more concern for our appropriate infection p atien ts’ health while control guideline. some dentists have misgivings T im oth y C. C anty, D.D.S., M .Ph. about th e service. T hank you for opening R ou nd Lake B each, 111. discussion on our role as health B L O O D A N A L Y S IS care providers. M.R. L ew is, D.M.D. As a practitioner whose local R och ester, N.Y. dental society years ago told me th a t taking blood pressure was
Like m ost practicing dentists, we are constantly working at our offices to keep up w ith the 16
JADA, Vol. 123, Ju ly 1992
late st changing infection control I inappropriate, I applaud your guidelines from OSHA. We are M arch editorial. also concerned about how we Tw enty years ago, Dr. Louis can possibly absorb the addi Rose of th e U niversity of tional costs and procedures into Pennsylvania suggested th at our daily dental practice. the dental office of the future m ight likely be the prim ary Could it be th a t the various dental associations are non-invasive diagnostic center approaching the OSHA issue of medicine. In consideration of from the wrong angle? Maybe th a t, for five years I have had a we all should be promoting the blood analyzer in my office. OSHA policies: W ith it we have performed concerning screening tests for glucose, saliva and all cholesterol and triglycerides. A th a t it touches fasting glucose test, we believe, being treated and is justified for brittle peri being disposed of odontal patients. Cholesterol like nuclear waste; and triglyceride are tests we m aintaining employee offer w ith no diagnosis, simply records for 30 years. ... a referral to th eir private B ut I suggest th a t if we do it physician, if the counts are we m ust dem and th a t it be done elevated above the standard. rig h t for each and every The tests are an offered service, not m andatory. business in America. Why should dental and medical These tests can be ru n on facilities be singled out? After blood obtained from a fingerstick, which is less blood th an all, shouldn’t people be we could obtain from oral protected equally everywhere surgery or a sub-gingival they m ay go? We m ust insist scaling. The blood analyzer is a th a t OSHA rules of every kind desktop model and is capable of and natu re be developed to ru n n in g any desired presurgical cover public w ater fountains, chemical analysis. Blood tests dishes in re sta u ra n ts and bars, are stan d ard a t hospital sanitary disposable napkins adm ission, w hether for a hang and diapers, school cafeterias, nail or open-heart surgery. I napkins and partially eaten doubt th a t any of our food in the trash. invasive procedures Maybe when Congress finally should be treated less realizes th a t OSHA’s actions seriously. have escalated the cost of a Ironically, ham burger, fries and a Coke physicians to $20 they will force OSHA appreciate our to develop a more concern for our appropriate infection p atien ts’ health while control guideline. some dentists have misgivings T im oth y C. C anty, D.D.S., M .Ph. about th e service. T hank you for opening R ou nd Lake B each, 111. discussion on our role as health B L O O D A N A L Y S IS care providers. M.R. L ew is, D.M.D. As a practitioner whose local R och ester, N.Y. dental society years ago told me th a t taking blood pressure was