We have provided helpful “links” to resource information which can answer most of your questions. If you find your question is not answered here or can suggest other links, please e-mail:
or call Laney at 770-312-6257.
Important Information for Dentistry
Postexposure Prophylaxis (PEP) Hot-line.
(doctors on call 24 hours a day to discuss procedures and
the need for PEP after a needle stick):
(888) 448-4911 or click here.
New Stuff and Alerts:
- Check with your credit card machine company; you may need a new machine that is able to read credit cards with chip technology by October 2015. If not, you may be financially responsible for any fraudulent transactions. Here's an explanation from a credit card fraud specialist that explains the situation pretty well:
The “liability shift” is a big moment in the changeover. Can you explain what it means?
Part of the October 2015 deadline in our road-map is what's known as the ‘liability shift.’ Whenever card fraud happens, we need to determine who is liable for the costs. When the liability shift happens, what will change is that if there is an incidence of card fraud, whichever party has the lesser technology will bear the liability.
So if a merchant is still using the old system, they can still run a transaction with a swipe and a signature. But they will be liable for any fraudulent transactions if the customer has a chip card. And the same goes the other way – if the merchant has a new terminal, but the bank hasn't issued a chip and PIN card to the customer, the bank would be liable.
The key point of a liability shift is not actually to shift liability around the market. It's to create co-ordination in the market, so you have issuers and merchants investing in the migration at the same time. This way, we're not shifting fraud around within the system; we're driving fraud out of the system.
- Click here for information on the new Prescription Drug Monitoring Program Website. This website allows you to check whether a patient has received a controlled substance from another health care provider, but there are VERY strict rules as to how the information can be used… if you're not careful, you could unintentionally commit a felony, so please check out this information!
- For new OSHA and HIPAA manuals, call the ADA catalog people at (800) 947-4746 (make sure you provide your ADA number; the prices listed are much higher for non-members.) For OSHA, you want the “Regulatory Compliance Manual”, which includes the update service and a CD ROM that allows you to customize forms (item #S696B, member price $275). The HIPAA compliance kit has the privacy and security information in one manual, plus a 3 yr update service, and the customizable CD ROM,plus a basic HIPAA training DVD which can be used for new employees and for review purposes. The item # is J598 and the price for members is $300. They also have a package that includes the OSHA and HIPAA manuals and all the stuff listed above for $575 (Item # K017… and yes, there is apparently no discount for buying them together).
- HIPAA penalties can now run as high as $1.5 million per incident! Make sure you have a HIPAA manual that is completely filled out and current. Also, the program must be constantly maintained and updated, so have regular meetings and risk assessments to ensure that your program is current. Here's a short form for monthly meetings:
(click here for HIPAA monthly risk assessment form).
To prevent large breaches, make sure your hard drive and portable devices (smart phones, laptops, etc.) are properly encrypted.
- Here are the requirements for security paper in Georgia. So long as the security paper meets Centers for Medicare & Medicaid Services requirements, it is sufficient. The good news is that you can get this tamper proof security paper at office supply stores instead of having to order it at a ridiculous price from a specified vendor.
- Here is a sample risk assessment and a breach risk assessment to use for your office. The risk assessment should be used periodically, or whenever changes are made in your office, to evaluate your procedures related to patients’ private health information. If a suspected breach occurs, the breach risk assessment can be used to determine whether a reportable breach has occurred:
(click here for risk assessment document)
- You never have to pay for posters in your office. Call the US Department of Labor (1-888-9SB-REFA) or go to the Department of Labor Poster Page and fill out the questionnaire to see which posters you need to print and post!: http://www.dol.gov/elaws/posters.htm
- There has been an overhaul of the Hazard Communication Standard, and there is a new chemical classification system that will be implemented over the next few years. Manufacturers have to use a standard MSDS form (FINALLY!), standard labeling, and standard hazard classification. Training on the new system will be required by December 1, 2013; I will be providing the required training on-line and on-site as part of annual OSHA training.
Check back on the “Online Training” tab as it comes available. Go the the “Dental Guidelines” page and check out the info at the 5th bullet for specific information. Also, here's an article that explains the new requirements. Hope you find it helpful!
(click here for hazard communication article)
- Click here for a great new website designed to help offices with HIPAA compliance, as well as info on Obamacare. It's got some really great information and explanations, plus it's adding state information, as well, so it should be a really great resource!
OSHA Compliance Checklists and Info:
- For a new OSHA manual, call the ADA catalog people at (800) 947-4746
(make sure you provide your ADA number; the prices listed are much higher for non-members). For OSHA, you want the “Regulatory Compliance Manual”, which includes the update service and a CD ROM that allows you to customize forms (item #S696, member price $180).
- For the latest and greatest information on infection control in dentistry,
check out www.osap.org (Organization for Safety and Asepsis Procedures).
They also have a fantastic OSHA checklist (click here) and are a great organization to join for the latest updates in infection control.
- From OSAP, the dental infection control gurus of the universe, here's some fantastic guidance on becoming your office's office compliance queen (or king, as case may be!):
click here for guide
- For a quick overview of what OSHA requires for dental offices and some recommended publications, check out this link:
- For a list to help you get your Hazard Communication Plan in order:
( Hazard Communication Plan Checklist )
- Here's some information from the ADA about what to do in the event of an OSHA inspection: click here for info sheet
- Stick Injuries and Sharps Info:
- If someone in your office is stuck, DO NOT CALL ME!!! I often can't be reached within 24 hours and you need to react quickly. If you have any questions about stick injuries, call the Postexposure Prophylaxis (PEP) Hot-line. (doctors on call 24 hours a day to discuss the need for PEP after a needle stick): (888) 448-4911 or click here for web site.
- Here are the Steps after a Stick. Put this on the fridge in the lounge so you’ll have it handy if someone gets stuck: (click here for steps after a stick handout ). Also here is more info explaining what needs to be done after a stick and why: (click here for “stick injuries: management of exposures…” form)
- Here's an interesting article about stick injuries in hospital-based dentistry (where needlesticks may be more common than in regular dental practices because of the use of IV needles and different types of procedures); the article reiterates the importance of making all procedures as safe as possible. click here for article
- Here is a great checklist from OSAP about what to do after a stick: click here
- In the event of a stick injury , fill out this exposure report form and give it to the doctor when you and the source patient go for testing: click here
- Review of Rapid HIV Tests: click here
Click link below for more info on rapid HIV antibody tests,
how they work and how you can use them for your office:
- For free sample forms to evaluate safer sharps devices,
go to: http://www.cdc.gov/OralHealth/infection_control/forms.htm
- Here is a completed evaluation of a safety syringe that you can print out, go over with your office staff, and if you agree with the findings, place it in your OSHA notebook:
(click here for evaluation)
- Here's a study discussing dental safety needle effectiveness:
Dental Safety Needle Effectiveness, results of a one year study.
click here to view / print this article.
- Here is a sample OSHA needle safety plan to help you design a plan for your office, if you need one. It's in a “Word” format so you can change it however you want:
click here for OSHA needle safety plan
Disinfection/Sterilization and MSDS/SDS info:
- Here are two articles from infection control experts about the effectiveness of wipes:
OSHA Disinfectant Surface Wipes
OSHA Wipes Effectiveness
- Here's some help when selecting approved disinfectants in dentistry:
Here's a list of surface disinfectants from OSAP, the dental infection control experts:
(OSAP Surface Disinfectant Reference Chart - click here)
Gordon Christensen, the dental products expert, evaluated several disinfectants for effectiveness: (click here)
For a list of EPA approved disinfectants, directly from the EPA, click here
- Here's an article about the nastiness found in water lines: (click here)
- Here are instructions and information on how to clean and process your instruments, directly from OSAP, the infection control experts for dentistry:
How to clean your instruments - OSAP.
How to process your instruments - OSAP.
- Not sure about your waterlines? Here are some test kits that are less than $5 /each and offer a simple test for bacterial growth (it is one of the tests that are mentioned in the ADA statement below): https://www.millipore.com/catalogue/item/mhpc10025
Order the Sampler kit, item number MHPC10025, and it's $122 for 25 test kits.
Here are some great articles about cost effective and easy methods of treating your waterlines, (please note that Listerine has also been found effective when used in the same manner as the Scope and peroxide mixtures described in these articles), view or print articles using Adobe Reader
Article 1 - Waterline Contamination Strategy
Article 2 - Waterline ADA Statement
Article 3 - Waterline Basic Information
Article 4 - Waterline Hydrogen Peroxide Disinfectant
- The bib chain may be a source of cross contamination, so it’s important to disinfect or sterilize it. Here's some information you might find helpful:
OSHA Bib Chain Contamination
- For information on how to test your ultrasonic cleaner to make sure it’s functioning properly, check out this article from Dental Economics: (click here)
- MSDS forms: For a great way to access and store MSDS forms for your office check this out: http://www.msdsxchange.com/english/index.cfm
If you're missing some MSDS forms, here's a great place to find them and print them out: http://www.ehso.com/msds.php
HIPAA Info, Forms and Checklists:
- Go to the Handouts and Forms page for a complete list of available HIPAA forms.
- Go to Laney's Article page for articles summarizing the requirements for HIPAA
- Here is a HIPAA risk assessment and a HIPAA Breach risk assessment. The HIPAA risk assessment will allow you to analyze your office for possible vulnerabilities and document the results, which should be done regularly to maintain your program. The HIPAA Breach risk assessment allows you to analyze a potential breach to determine if a breach has actually occurred: ((click here to view or print assessment document)
- For a new HIPAA manual, call the ADA catalog people at (800) 947-4746 (make sure you provide your ADA number; the prices listed are much higher for non-members. Also, call for the HIPAA manual because the cheap package isn’t visible on the website, but is available if you ask). The HIPAA compliance kit has the privacy and security information in one manual, plus an update service, and the customizable CD ROM. The item # is J594 and the price for members is $225.
They also have a package that includes the OSHA and HIPAA manuals, but it also includes a bunch of extra stuff, and the member price on that is $575.
- For specific questions and answers about HIPAA, click here for the US Dept of Health & Human Services web link. This is an AWESOME resource! You can search for a term and they will show questions and answers related to that topic: ( click here )
- Here's information about encryption and smart-phones and laptops: ( click here )
- Click here for a new website designed to help offices with HIPAA compliance. It's got some really great information and explanations, plus it's adding state information, as well, so it should be a really great resource! http://www.healthinfolaw.org/home
- For general information about HIPAA in dentistry go to the following websites:
- Here's free HIPAA Privacy training from the HIPAA folks at the
Dept. of Health and Human Services: ( click here )
- Here's information about how to perform and document a risk assessment in your office (they need to be done regularly to ensure compliance with the Security Rule):
Risk Assessment Document - click here
- Here's a general checklist for HIPAA privacy:
HIPAA readiness checklist and
HIPAA checklist for HIPAA privacy
- ADA commentary on HIPAA regulations and how it affects dentistry.
Here's a great "HIPAA Questions" link that you can print to answer a lot of questions that affect us specifically. (American Dental Association)
- For a quick reference sheet directly from the HIPAA folks, check this out:
HIPAA Fast Facts for Covered Entities
HIPAA Security Standard Information:
- Why encryption is necessary: Here's information from the HIPAA folks about what's required to comply with encryption. This explains why encryption is the only security precaution that will stop a breach in the event that your computer, backup, or a laptop or unencrypted phone (with access to your patients’ information) is lost or stolen.
Here is a short summary from HHS (the HIPAA folks): click here
- Here is some other info for more specifics about what's required (the actual encryption requirements can be obtained from this page so you can give it to your computer guy): click here
- Also, here is the Security FAQ section, directly from HIPAA: click here
- Here is a summary of the security requirements from HHS: click here
- And here's a general page about security: click here
- click here to view / print the HIPAA Security Standard handout.
Here's 5 great hints on keeping your computer system secure:
- Security Breach: A new section of the HIPAA rules were put into effect as of September 2009. In the event of a security breach of your computer system, you are supposed to follow certain procedures to ensure that patients are notified that their information may have been compromised. Here's are links to the ADA’s website that explains the procedures that need to be followed:
SECURITY BREACH NOTIFICATION FLOW CHART
GUIDANCE FOR COMPLYING WITH THE HIPAA/HITECH BREACH NOTIFICATION RULE
In the event of a breach of unsecured personal health information, we are supposed to maintain a log of all breaches, and report it to the Department of Health and Human Services (HHS). If the breach involves more than 500 individuals in a single geographic area, we are supposed to notify our patients, the local media, and HHS as soon as possible (absolutely within 60 days of the breach); if it's less than 500 individuals, we are to log it and notify HHS on an annual basis, (within 60 days of the end of the calendar year in which the breach occurred). Here is the site to fill out the HHS notification:
If there is a possible breach, it is assumed that a breach has occurred unless you analyze the situation and determine that the patients’ information was not compromised. If a reasonable person would determine that the information was compromised and a breach occurred, you have to follow the notification requirements; if there is no breach, file this completed form in your HIPAA notebook: (click here for “HIPAA breach assessment”).
- Avoiding a breach: If your patients’ information is compromised (your computers are stolen, you lose a backup drive, someone hacks into your system) you have to report this breach unless your information is properly secured. Click here for information about the importance of securing your information and the importance of encrypting your hard drive: (HIPPA Encryption Guidence)
- One of the biggest problems we have is securing our computer's information from a potential breach. Dealing with a breach has huge implications for a dental practice, so encryption is a great preventative measure. If someone steals your computers or hacks into your computer system and more than 500 patients are involved, you have to notify the patients AND the local media! If the information is encrypted, the information is not considered usable and no breach has occurred. Mr. Justin Hahn installs and maintains computer systems for dentistry, and he has put together different packages that encrypt your information so it is protected from potential breaches.
Mention that I sent you and get 10% off! (click here)
General Risk Management and Office Safety Info:
- Here's a sample of a dental office emergency plan you might find helpful!
(dental ofc emergency plan)
- For information about Emergency Kits in the dental office, check out these articles for recommendations:
Office Emergencies - ADA Article
Emergency drug kit article from Dental Economics
- Here's a great article from JADA that helps dental offices deal with medical emergencies: (Dental Emergency Article - JADA)
- We should all be prepared in the event of a natural disaster or emergency; some states require a written plan. Here's a great publication from the ADA that will help you formulate a plan: (Emergency ADA Disaster Manual)
- For information on how often to update a medical history form,
click here to view this article:
- For information about mold in the office, check out the following link from the CDC:
- Here is information about tamper-resistant prescription pads
(as required by Medicaid): Click here for fact sheet.
- For information about dental records
What is included in the record, copying costs, privacy requirements, etc.
check out these links:
American Dental Association - Dental Records, click here:
Georgia Laws Relating to Patient Records, click here:
or click here for
Unprofessional Conduct Defined (Maintenance of records)
- Here's a great resource for information about the laws regarding HIV testing in your state:
- For information on legislative and regulatory issues, go to:
- For information on legal issues:
- For information on ADA guidelines, information on ADA positions and ADA statements, go to the following link and click on any topic that interests you:
- It's official: We're out! Congress has passed a law that exempts dental and medical offices from the Red Flag Identity Theft Rules. No policies, no procedures, no fines, no worries! Woo-Hoo!
(The only exception may be if your office accesses credit bureaus before extending credit to a patient; if you do, these rules may apply to your office, so check with your attorney to make sure you're in compliance.)
Dental X-rays and Radiation Safety
- Here's a great reference about radiation exposure levels. If your patients want to know how much radiation they receive from dental x-rays versus other sources of radiation, here's something you can show them that's very interesting (and reassuring!): (click here for dose chart)
- X-Ray Badge Information: X-ray badges are only required for pregnant employees, as a general rule, but check with your local board to make sure it's not required by your state.
Click here for more information
The Georgia Department of Community Health also recognizes that dental health care workers rarely receive enough radiation to require the use of dosimetry badges.
To check out the Georgia laws, there are two links.
Click the first link: http://rules.sos.state.ga.us/docs/290/5/22/03.pdf
and look at section (3) under "Personnel Monitoring" and you’ll see that we rarely meet the minimum requirements to necessitate the use of x-ray dosimetry badges.
And click here http://rules.sos.state.ga.us/docs/290/5/22/04.pdf
for general rules under “X-rays in the Healing Arts”.
- Leave it to OSAP to give a great summary of radiation safety guidelines in the dental office:
Radiation Safety Guide for the Dental Office
They also have great information about infection control procedures and preventing cross contamination while developing xrays: (q a xray infection control)
- Check out the recommendations from the FDA and ADA regarding the
frequency and types of dental x-rays for various classes of patients:
click here for - Radiation Recommendationw ADA 2012
- Here is an information sheet from the ADA about dental x-rays and safety. Please note they recommend the use of a lead apron with a thyroid collar when taking x-rays, so long as it does not interfere with the procedure.
Here is an information sheet.
Disease, Health and Infection Control Info:
- The diseases we worry about most in dentistry are HIV, Hepatitis B and Hepatitis C.
Here are some great links for information on these diseases.
- The Human Papilloma Virus (HPV) is at epidemic proportions in North America, and it turns out that chronic HPV infection has huge implications for dentistry. Studies show that a significant amount of oropharyngeal cancer can be attributed to the human papilloma virus. Here's great information on how to perform an extremely thorough oral cancer exam:
(click here - Oral Cancer Screening Protocols)
Check out these websites for more great information!
http://oralcancerfoundation.org/ (This is an incredibly helpful website on oral cancer;
it has a specific dental section and a separate section on HPV-related cancers)
- For questions involving infection control, amalgam, blood borne pathogens, waterlines, etc. go to the following link, (“Oral health Topics A to Z”) and click on topics of interest. http://www.ada.org/public/topics/index.asp
- For information about “H1N1” flu in the dental office, check out the
recommendations from the infection control gurus at OSAP:
- It's important for health care workers to receive vaccinations for the flu and for any childhood diseases for which they don't have immunity. Here's the CDC's vaccination schedule for health care workers: http://www.immunize.org/catg.d/p2017.pdf
- “For a great overview on MRSA in dentistry,
check out this articleﾔ: (click here to view or print)
- For tuberculosis information, check out the following websites:
(for state TB agencies) ;
For Georgia TB info and forms, try the following web site:
General Info Related to Dentistry:
Stacey totally rocks her ‘dew rag’ and face shield!
Other Dental Information Links:
- American Dental Association:
- Center for Disease Control (CDC):
- Health Insurance Portability and Accountability Act (HIPAA):
www.hhs.gov/ocr/hipaa/ (US Dept. of Health and Human Services)
- For a great web site with information about the link between systemic disease and oral health, check out www.ZT4BG.com (which stands for zero tolerance for bleeding gums). There's a section for the public and one for professionals, and it's a great educational tool for patients who just don't get the fact that oral health can determine the state of your entire health.
- For information about latex allergies in dentistry,
go to http://www.latexallergylinks.org/dental.html
- ADA commentary on HIPAA regulations and how it affects dentistry.
A great "HIPAA Questions" link that you can print to answer a lot of questions that affect us specifically. (American Dental Association)
- Morbidity and Mortality Weekly Report:
www.cdc.gov/mmwr/ (CDC publication)
- Occupational Safety and Health Administration (OSHA):
- For info on Hepatitis, call the Hepatitis Hot-line: (888) 443-7232 or
Okay, so none of this has anything to do with infection control or regulatory compliance, but my motto is, if you're going to be doing OSHA and HIPAA, you may as well be drinkin’!!
One quick reminder from your favorite safety girl…
Lots of alcohol here, so DO NOT do dentistry, drive, operative heavy machinery or accompany strange people to strange places while using these recipes…
For the very best recipe in the world for sangria, click here!
(Okay, so it's not really infection control related, but come on, how fun is sangria!)
And how about MARGARITAS?
Click here for killer margaritas…
Or maybe a BOURBON MASHER?
Click at your own risk!!