Dental hygiene and infection prevention has been a major issue in recent UK practise but the management of clinical and sharps waste from dental surgeries has never really hit the headlines except as a ‘filler’ issue when regulators act on other non-compliance issues.
In these circumstances, it seems that there are almost always clinical waste issues that act as supplementary regulatory issues to plump up the charge sheet! But not so in the US, where at least one dentist has faced a formal suspension and censure from the Board of Registration In Dentistry in the Supreme Judicial Court of Massachusetts.
In an action for judicial review of a final decision and order of the Board of Registration in Dentistry suspending Stephen Chadwick’s license to practice dentistry in Massachusetts, the decision was subject to further review. However, in its decision, the board found that Chadwick failed to comply with Occupational Health and Safety Administration (OSHA) standards; Centers for Disease Control and Prevention (CDC) guidelines; and Department of Public Health (department) regulations “with respect to spore testing, annual office training, the proper handling and disposal of medical waste, proper maintenance and disposal of sharps [i.e., sharp items, such as needles, scalers, burs, laboratory knives, and wires], the maintenance of complete and accurate records with respect to hepatitis B inoculations, and basic exposure control protocols.”
The board concluded that this conduct “constituted deceit, malpractice and gross misconduct in the practice of the profession in violation of G.L. c. 112, § 61,” and “seriously undermined the integrity of the profession of dentistry and the public’s confidence in the practice of dentistry.” It suspended Chadwick’s license to practice dentistry in Massachusetts for six months and imposed a five-year probationary period to follow the suspension.
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In this case, the violations are clear and unambiguous, and the penalty is quite rightly severe. What is perhaps surprising is the clarity of the citations that must account for deficiencies in some part in so many dental surgeries. What is special about this case, and why such a punitive regulatory response?
Perhaps the failures were just too great, and that regulators had evidence of a failure to comply despite repeated attempts at regulatory intervention and improvement. Perhaps also this was something of a showcase, to send a message to others to smarten up their act. Either way, are the floodgates now opened for others to be similarly punished or will others improve as a result? Or maybe, however unlikely, this was a single and well-isolated case.