A South Carolina lawmaker says the state should consider routine inspections of dental offices, as is done in 15 other states. But another legislator who's also a dentist questions the need for such inspections, saying several state agencies already oversee the facilities and respond to complaints.
State Sen. Harvey Peeler, who heads the state's Medical Affairs Committee, recently said the Legislature should consider the idea of routine inspections that could be expanded to medical offices.
Some 15 states conduct regular inspections of dental offices; South Carolina currently only does routine inspections of barbershops and hair salons.
But state Sen. Ray Cleary, DDS, a dentist on Peeler's committee, noted that three agencies already have some part in regulating dental offices: the state's Department of Health and Environmental Control (DHEC); the Department of Labor, Licensing and Regulation (which houses the state dental board); and the Occupational Safety and Health Administration.
He also argued that requiring routine inspections should extend to physicians and other medical offices.
"If you have mandatory inspection of dental offices, wouldn't you have to inspect medical and chiropractic offices since they're under the same regulations as we are?" Dr. Cleary said in an interview with DrBicuspid.com.
He also questioned the need for such a requirement.
"If DHEC showed the need, then it should be mandatory, but it's my assumption that it's not mandatory because there's no need," Dr. Cleary said.
The issue arose after a reporter asked Sen. Peeler if South Carolina should start routine inspections in the wake of an infection-control scandal at the dental clinic at an Ohio Veterans Affairs (VA) medical center last year, Dr. Cleary said.
The VA notified 535 veterans that they may have been exposed to hepatitis B, hepatitis C, and HIV by Dwight Pemberton, DDS, the dentist who allegedly failed to properly sterilize dental instruments between patients between 1992 and 2010. Officials are continuing to determine whether three veterans who tested positive for hepatitis contracted the disease at the clinic.
Step in the right direction
However, Don Marianos, DDS, MPH, chairman of the Organization for Safety, Asepsis and Prevention (OSAP) Foundation and former oral health director at the U.S. Centers for Disease Control and Prevention, finds merit in the proposal.
"This could be a very meaningful component of a comprehensive program to enhance safety," he told DrBicuspid.com. "This is a step in improving dentistry. There's now a strong global effort to improve the safety of care delivery and lower existing risks. We support the idea and encourage all states to take a look at this situation and do what they can to make dentistry even safer."
OSAP Director Therese Long said her group could provide South Carolina with checklists for dental practices that practitioners could use to self-evaluate whether they were being inspected or not. She also advised that inspectors should be calibrated to understand dental procedures and dental infection control guidelines before doing inspections.
"Anything we can do to make healthcare better is laudable, but you have to consider cost benefits," Dr. Marianos said.
Regulatory agencies are already struggling to do existing inspection requirements in the face of budget cutbacks, Dr. Cleary pointed out.
"My conversations with DHEC indicate there's not an issue, and they don't have enough funds to keep up with inspections of residential centers where they know there are problems, so they should focus where they know there's a problem," he observed.
Dr. Cleary said the issue could be revisited in the future if problems arise.
"If there're issues out there, the public is pretty intelligent, and I'm sure they'll complain and DHEC will investigate and things will be taken care of," he said. "But I think it's a solution in search of a problem, and at what level do we stop?"