Is this really the dental standard of care?

Monday, November 29, 2010

I have good teeth , so I seldom interact with a dentist. I am also an experienced RN in NY state, so I understand standards of care. My 25 yr old front tooth crowns cracked, so I went to my dentist to have them replaced. He put temporaries on, and after 3 to 4 weeks I returned to have the temps taken off and the new permanent caps put on. In the waiting area was a sign stating to notify office staff if having any flu like symptoms. I happened to have a slight sore throat and headache, so I dutifully reported this when I was called. I expected that my report of sore throat and headache would result in staff donning masks to protect themselves should I indeed be incubating something nasty. I was shocked when my appointment was immediately canceled and I was told I could not reschedule for at least a week! This they said is standard for all patients regardless of Pt. frailty or vigor, age or immune status. I protested that rescheduling would be very difficult with my schedule (their office is only open four days a week) but they stood firm insisting this policy is a dentistry standard. Is automatic rescheduling of symptomatic patients the standard of care? The ADA website linked me to a CDC report on infection control in dental practice, but it was not covered there. Thank You P.S. And yes, I will be switching dentists to one open five days a week -- just as soon as the permanents are finally on.
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There is no definitive set of "standard of care" guidelines on "how contagious" a patient might be. It is whatever is established by a particular office. Obviously that office is being overly cautious. Any slight chance of introducing harmful microbes into the closed office environment is not good. Working in the mouth, especially when using ultrasonic scalers that spray fine water mists , hi pressure air sprays, highspeed drills, etc can get oral bacteria/viruses airborne. It's not only the direct exposure between you and staff member that's a concern, it's the bigger picture of exposing all patients who even walk in the front door to any possible microbes in this flu season. It's unfortunate about the inconvenience to you, but hopefully you appreciate the extra precautionary concerns and high standards. From the office standpoint, it was a loss of production time too. Some offices bring in obviously sick, coughing, feverish patients just so they don't lose the $$ production. In the future, you as a nurse know what might be deemed a concern, so just use your good professional judgment as to whether to "tell" them or not.
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