North Carolina Family Dentist Talks Sanitation in a Family Practice Setting

“It is scary to make the transition from working in a community health center to owning your own practice,” Bagley said. “You go from having a solid income where your family is comfortable, to making projections and hoping you can keep them. At one point, we were a million dollars in the hole; it was terrifying.”

Bagley said the nice thing about working in a community health center is that there was always a compliance officer whose full-time job was to make sure the center was following rules for health safety.

“As a small business owner, I am that compliance officer, along with all the other roles I am trying to fill,” Bagley said. “I don’t have someone who can dedicate all their time to make sure all those boxes are checked, so that falls on me. I think that is one of the reasons small businesses in the health profession fields are disappearing.”

In comparison to medical professions, dental malpractice costs are minimal. Bagley said he probably spends a few thousand dollars in malpractice insurance every year.

“Even if something goes wrong, it is usually not too bad,” Bagley said. “What is the worst that can happen? If something doesn’t work, I just take responsibility for it and replace it at no cost to the patient. There are very few large dollar law suits in dentistry.”

“Mouths are horribly dirty,” Bagley said. “That’s probably why oral infections are so rare.”

Bagley said it is still crucial for him and his staff to keep the office clean to protect their patients from dangerous viruses and blood-borne pathogens.

One of Bagley’s employees is an OSHA compliance officer who oversees safe practices. In addition, an auditor comes to the office once a year to make sure the dentistry is up-to-date compliance-wise.

Bagley and his staff take what are called “universal precautions.” These include not touching surfaces with a glove, wiping down surfaces, using barriers and using hand sanitizer or washing hands regularly.

In a dental office, there are certain vectors that staff members must be especially careful about. For example, Bagley said his office provides TVs for patients to watch during their appointment. The remotes are passed from patient to patient and must be cleaned thoroughly between appointments.

Every tool that is used in a patient’s mouth goes through a two-step sterilization process or is disposable. Plastic, disposable barriers go over the chairs to prevent germs or bacteria from adhering to the stitching and other crevices. Even keyboards are covered with plastic, disposable covers.

“The same assistant who has been working with a patient in a room cleans the room when that patient is done,” Bagley said. “That way, she knows the areas of concern and cleans the room in a pattern to ensure she doesn’t miss anything.”

Bagley’s practice has nine total keyboards, five of which are used directly next to patients. There are only four people who use them. He said he likes the idea of the Vioguard keyboard because it is an extra layer of protection.

“You can’t clean every nook and cranny of a keyboard no matter what you do,” Bagley said. “It would be nice to have the peace of mind that any germs that have made their way onto that surface are killed.”