I’m a little late this year in reviewing 2020 from a compliance standpoint. That doesn’t mean it was any less exciting than others.
In reviewing OSHA’s enforcement database for 2020, it was surprisingly light considering we’re in the midst of a pandemic. Dental practices were on the receiving end of “only” 93 inspections. One thing remains constant though: dental practices are continuing to be cited for noncompliance with OSHA’s respiratory standard; and based on feedback I’m receiving from my contacts, inspections are only going to increase until practice owners get the message that this safety program isn’t optional.
Since early fall of 2020, I’ve used the dental practice that was fined over $24,000 for non-compliance with the respiratory standard as my “poster child.” I was hoping that by singing from the mountain top about this unfortunate practice’s penalty, it would get practice owners’ attention. Unfortunately, there appears to be quite a percentage of practice owners who still haven’t gotten the message. According to OSHA’s database, at least five other dental practices were cited and penalized in 2020 for lack of compliance with the respiratory standard. Additionally, based on a recent survey, I’m estimating approximately 45% of dental practices in Texas are still not complying with the respiratory standard. That’s what I’d call a target-rich environment for compliance inspectors.
If you’re a practice owner who has been hunkered down, trying to take care of your patients and struggling to keep your practice afloat to the exclusion of other requirements, I get it. But there is a reason why the Texas State Board of Dental Examiners (TSBDE) has a rule requiring respirators (please note that a surgical mask is not a respirator) and why OSHA is turning into such a bear about non-compliance with the respiratory standard. COVID is extremely contagious, and the easiest way that scientists have found to transmit it is through aerosols. The CDC estimates some of the COVID variants now being discovered are twice as contagious as the original.
It’s time for some practice owners to get their ducks in a row before either an employee or patient gets sick from the practice’s lack of proper planning. Having the practice end up on the receiving end of an inspection by the TSBDE or OSHA isn’t a pleasant thought, either; and is certainly preventable.
Let’s be careful out there!
TBSDE Extends COVID-19 Emergency Rule
On February 19, 2021, the Texas State Board of Dental Examiners (TSBDE) voted unanimously to adopt a new COVID-19 emergency rule—22 Texas Administrative Code §108.7(16). It will remain in effect until June 18th, 2021.
Several previous requirements were removed, including:
- The removal of magazines, reading materials, toys, and other objects that may be touched by others;
- COVID-19 patient screening by phone during scheduling. Patients must still be screened during patient confirmation prior to appointment;
- Prohibition of patient companions. Companions should continue to be screened for COVID-19 during patient check-in;
Additionally, a pre-procedure rinse is no longer recommended.
The most important requirement was left intact: N95, KN95 masks, or their substantial equivalent are still required for all dental health care personnel (DHCP) who will be within six feet of any and all procedures likely to involve aerosols.
I can’t say often enough that dental practices using N95 and/or KN95s are required to have a written respiratory protection program (RPP) in place. The program must include a designated plan administrator, a written plan document, documented training, medical evaluations, and fit testing. None of these are optional.
The reason I’ve been a broken record regarding the use of respirators is we’re seeing a less than 50% compliance rate in Texas, to the detriment of a dental practice’s employees, patients, and the practice. Dental practices are being heavily fined for ignoring these requirements; including a single-location practice fined over $24,000.
Misinformation surrounding the requirement is robust. Dental Facebook groups are awash with comments from clinicians who work in offices not using respirators, much less that are concerned with having an RPP in place. If you think your staff or patients don’t notice, think again. In January and February, OSHA opened 15 investigations of dental practices. 12 (80%) of those investigations were the result of complaints, which typically come from employees or ex-employees but also come from patients.
Pleading ignorance when a TSBDE or OSHA investigator calls or shows up at your door is not a viable option.
Need help with your Respiratory Protection Program?
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