Talking with the Toothcop

In this episode of Talking with the Toothcop, I share some sobering news that recently happened in Kansas. I'll also share some important updates that dentists need to be aware of that were highlighted in the Texas State Board of Dental Examiners Newsletter. Stay up-to-date on the latest dentistry compliance issues—don't miss it.

Outline of This Episode

• [0:21] 3-year-old boy dies during dental procedure
• [3:13] Get your dental unit waterlines tested through ProEdge!
• [4:30] Electronic Prescribing Waiver
• [6:03] Texas administrative code Rule 108.7 sub-section 16
• [7:44] Tele-dentistry rule (HB2056) passed
• [12:50] Questions about Rule 108.7 sub-section 16
• [14:33] Do dentists prescribe anxiety medication frequently?
• [15:26] Learn more about protectIt dental's emergency medical kit
• [16:43] The Professional Recovery Network

3-year-old Boy Dies During Dental Procedure

A 3-year-old boy in Wichita, Kansas went in for a simple procedure. He was sedated to have some teeth removed after a gum infection. Unfortunately, something went awry during the procedure and the boy passed away after being transported to a nearby hospital. The incident is currently under investigation though it appears there was no wrongdoing.

However, incidents like these are a sobering reminder to have your dental office prepared in case of emergencies. You need a written protocol in place, your team needs to be aware of their role, and it needs to be referenced as often as possible.

Electronic Prescribing Waiver

As of January 1, 2021, the Texas Health and Safety Code 481.0755 dictates that

"Prescriptions for controlled substances be issued electronically, except in limited

circumstances, or unless a waiver has been granted by the appropriate agency."

The waiver applies to dentists that issue prescriptions for controlled substances—but don't prescribe many at all. They can apply for a waiver to avoid setting up electronic prescribing. If granted, the waiver allows dentists to write up to 25 prescriptions for controlled substances per year. You can re-apply for your waiver up to 30 days before it expires (it lasts a year from when it's issued).

Please Note: Many drugs that you may not consider are classified as controlled substances. Do your research and don't let yourself get caught off guard by this.

Texas administrative code Rule 108.7 sub-section 16

Rule 108.7 sub-section 16 was the COVID rule. It's now been replaced with what was sub-section 17: You must "Hold a Level 1 permit (Minimal Sedation permit) issued by the Board before prescribing and/or administering Halcion (triazolam), and should administer Halcion (triazolam) in an in-office setting." Basically, if you want to treat patients with these meds, you must hold a Level 1 permit.

In the newsletter, the featured a question a reader asked, "Can I prescribe or dispense a drug for sedation without a sedation permit?" The answer is no. You have to have a minimal sedation permit to prescribe sedation medications to patients (dosage recommendations in board rules 110.1 and 110.4).

Texas Legislative House Bill 2056 Passes

The bill passed on June 16th, 2021. But on August 11th at 1 pm, the Texas State Board of Dental Examiners will host a stakeholder meeting to address the specific rules for teledentistry. This is your opportunity to make your voice heard and shape these rules on the front end. What can you do? Look at other state's regulations and see what they're doing and what their recommendations are. Too often dentists don't get involved when they have the opportunity. If you're not involved, you can't complain about it! I think we will see rules formed by March.

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• Get your dental unit waterlines tested through ProEdge!
• 3-year-old Boy Dies During Dental Procedure
• The Texas State Board of Dental Examiners Newsletter
• TWT Episode: Electronic Prescribing of Controlled Substances
• Texas administrative code Rule 108.7 sub-section 16
• https://tsbde.texas.gov/
• The Professional Recovery Network

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

A lot of people get the Treatment, Payment, and Healthcare Operations (TPO) Exception wrong. So in this episode of Talking with the Toothcop, Andrea and I dissect what it is. We also talk about what to do if you need patient authorization and the importance of informed consent for treatment. Don't miss it!

Outline of This Episode

• [0:21] Coffee + Rom-Coms
• [4:07] Learn more about ProEdge Dental!
• [5:24] The treatment exception
• [10:00] The payment exception
• [11:01] The operations exception
• [12:14] If you NEED authorization
• [13:25] Informed consent for treatment
• [17:49] Learn more about protectit dental!

The treatment exception

You can communicate with other healthcare providers (i.e. dentists/specialists) to care for a patient (consults, discussions, coordination of care, etc.). Under HIPPA you don't need authorization from your patient to communicate with healthcare providers regarding treatment. Some state laws are more restrictive. For example, in Minnesota, this does not apply and you are required to get authorization. Federal HIPPA laws allow communication if your state does not have more restrictive requirements.

The payment exception

If Grandma stops by to pay a patient's bill, you may have to follow the minimum necessary principle (that a legal guardian is the only one allowed access to patient information). So you may not be able to close the date of service or the procedure but you sure can take payment. If it's necessary to state a balance to get paid, it's perfectly fine.

The operations exception

The operations exception allows dental offices to access and use/disclose their patient's information. You don't need authorization from the patient or legal guardian. How does that look in practice? Duane is allowed to access a patient's records without them being notified because it's for compliance purposes.

If you NEED authorization

If you need authorization from a patient to disclose PHI to a third party, there is a form you need them to complete with specific elements that need to be on it. Most information release forms don't have the necessary information. So what's needed?

• It must clearly identify your entity and who you're allowed to release information to
• What part of the patient's record you're authorized to use or disclose
• The explicit purpose for the disclosure
• A notice that informs the patient they have the right to revoke the authorization at any time (this is what most dental offices are missing)
• A signature on the form by the patient or legal guardian

NOTE: Get familiar with your state's recommendations to make sure they don't have specific requirements for authorizations. If you're from MN hit me up at toothcop(at)dentalcompliance.com for a template for the form you need!

Informed consent for treatment

This seems like an ongoing issue I encounter regularly. Different states have different requirements for informed consent. Common sense dictates—to protect yourself and your practice—you should obtain informed consent from your patients. They should know the potential risks of a procedure and alternative treatments that could be appropriate (including no treatment). They should also be informed of the potential consequences if they choose not to have a procedure done.

If you practice in multiple states, follow the most stringent standard in all of your locations. Then you'll never run the risk of being out of compliance. In Texas, you need consent for everything that comes with a risk. In Texas, Medicare requires consent for every procedure on the date of service it's being completed. If you don't get consent, the insurance companies can recoup what they paid for the services.

Have any good coffee bean recommendations? Send me an email with your suggestions!

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• Movie: New in Town
• HHS Guidance on TPO

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Recently, I've dealt with some level of confusion surrounding the Hepatitis B vaccinations (HBV) and post-vaccination testing requirements. So in this episode of Talking with the Toothcop, I'm going to cover what both OSHA and the CDC require for the HBV and post-vaccination testing.

Outline of This Episode

• [2:03] Hepatitis B vaccination requirements in dentistry
• [5:08] OSHA requirements for post-vaccination testing
• [10:22] Hepatitis B vaccination recap

Hepatitis B Vaccination Requirements

When a dental office hires a new person, they need to determine if that person will have exposure to bloodborne pathogens. Front office staff may have exposure in one dental office and others won't, whereas a clinical staff will have ongoing exposure. It all depends on the activities of your staff and whether or not they're cross-trained. But it's not like a bloodborne pathogen follows the rules and won't cross into an area they're not supposed to.

If a new staff member will likely face exposure throughout their employment, they need to be offered the Hepatitis B vaccination. The employer must:

1. Get a copy of the employee's vaccination record
2. If the employee declines the vaccination, they must sign a declination form. (i.e. they may have already had the vaccination).

Dentists, you must show you offered the vaccination within 10 days of hiring the new staff member. Document your attempt to get the vaccination records. Include all of this in your new hire paperwork.

The vaccination is a three-shot series given over six months. At the conclusion, your staff member's blood needs to be tested to ensure they've developed antibodies for Hepatitis B.

OSHA requirements for post-vaccination testing

In a 2000 OSHA response to Christopher S. Taylor, M.D. (a flight surgeon), OSHA stated that:

"The employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure follow-up to all employees who have had an exposure incident." (Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens, [CPL 2-2.69])

In short, according to OSHA, the employer must pay for post-vaccination evaluation and follow-up at no cost to the employee (2 months after the vaccination series is complete).

In 2015, Richard L. Raimondo, Jr. D.D.S, posed two questions to OSHA.

• Once my employees have completed the 3-dose hepatitis B vaccination series, is there a requirement to obtain a test for hepatitis B antibodies? OSHA responded that, yes, a test is necessary for antibodies (according to the CDC).

Dr. Raimondo also asked if anyone hired before this standard was in effect must be tested for antibodies and offered the vaccination series. OSHA responded that at the time, they didn't recommend further vaccinations or titer testing for anyone vaccinated before December 26, 1997. However, for anyone vaccinated after December 26th, 1997, they did recommend anti-HBs [titer] testing.

Hepatitis B vaccination requirement recap

What does this mean for dentists?

1. Determine who needs to be vaccinated.
2. Offer them the vaccination and prove you've made the offer (i.e. declination form and vaccination record).
3. Document, document, document. If it isn't written, it didn't happen.

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• Check out ProEdge Dental for waterline testing!
• OSHA response to Richard L. Raimondo, Jr., D.D.S
• OSHA response to Christopher S. Taylor, M.D.
• Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

This episode of Talking with the Toothcop is a two-parter! In the first half, you'll get a look behind the curtain and get to know me—Duane Tinker—and my co-host, Andrea Baysinger. In the second half of this episode, we share an important reminder about nitrous oxide compliance rules. Don't miss it!

Outline of This Episode

• [3:01] How Andrea became my co-host
• [6:05] I'm an introvert—until I take the stage
• [8:09] Andrea is an introvert disguised as an extrovert
• [9:29] Country versus city living (who is who?)
• [12:22] Raising Australian Shepherds on a ranch
• [13:05] Dentists that administer nitrous oxide
• [14:31] How dentists get busted for lack of compliance

I'm an introvert—until I take the stage

I am an introvert. I'm like Sylvester Stallone (Hawk) in the Movie "Over the Top." Hawk is a professional arm wrestler preparing for a national event in Las Vegas. At the end of the movie, Hawk is interviewed. He said that before he steps in the ring, he turns his hat backward and it's like he turns his face and becomes a different person. That's how I feel when I'm about to walk on a stage and speak. I'm a shy wallflower until I take the stage.

Andrea is very talkative and is a self-proclaimed social butterfly. But she believes it's just a different version of her. She has a degree in English and loves writing and being introspective. So she's at her best when she's chosen to be alone. She feels at peace. She recharges, then gets back out with people.

Country living versus city living

My wife and I have a ranch and sometimes I'll go weeks without leaving it. We've got everything we need here (including fast internet). Andrea grew up in the country, too, in a small town of 1,500 people. She thought she was going to stay there for life but she followed her brother to Texas. She packed everything in her Maxima, got a part-time job within two weeks, and has been here for almost 8 years. She'd never in a million years thought she'd end up in a field close to healthcare and now she can't imagine anything else (including living in the country again).

My wife and I have 6 Australian Shepherds, five of which are related. We have a lot of livestock (sheep, goats, ducks, and geese) because my wife does competition herding with her dogs. Supporting my wife in training the dogs is my extracurricular activity. Plus, there are always things to do around a ranch.

Dentists that administer nitrous

Switching gears, I've been getting a lot of calls and emails from dentists who are shocked about rules that have been in place for three years now. Many dentists are way out of compliance and don't know where to start.

How are dentists getting busted for lack of compliance? The state only does inspections for those with level 2, 3, and 4 sedation permits. Those who are administering nitrous will never be inspected for that. But let's say a new patient comes to see you for a second opinion. You prepare a treatment plan, make your recommendations, and the patient decides to go with you for treatment.

Six months down the road, you get a letter from the state board. They want to copy the patient's record and the dentist's emergency plan, and the dentist has no idea what they're talking about. Nine times out of ten, it's a complaint against another dentist. That's how dentists get busted for not having emergency plans. It's how the conversation starts with me.

Dentists who administer nitrous: What you should be doing

What do you need to do? You need to have a written emergency plan in place and train your staff on that plan. You need an AED, stethoscope, blood pressure cuff, backup suction unit, and emergency oxygen unit. Most of the dentists that are calling me had no clue. Luckily, it's an easy fix.

The takeaway? Be in the know. Get the newsletter from your state licensing board. Visit their website frequently for important information and updates. Get on our email list. We'll inform you of new rules and regulations. Something is always changing and impacting dental offices.

Need help with compliance? Give me a shout!

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• Over the Top with Sylvester Stallone
• More information on sedation inspections

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

In our last episode, we talked about how the Texas State Board allowed their COVID-19 rules to expire. We think it's a good thing! But a lot of dentists are not happy about it. So in this episode of Talking with the Toothcop, Andrea and I dive a little deeper into the topic. We'll share why we think it's a good thing and what dentists can do moving forward.

Outline of This Episode

• [2:51] The feedback on the COVID-19 rule expiration
• [5:22] You can continue what you were doing
• [8:10] Dentists are encouraged to follow CDC guidelines
• [11:00] Let us know if you have any episode requests!

The feedback on the COVID-19 rule expiration

I'm not entirely surprised dentists aren't happy with the expiration of the rule. Many dentists want to know what they have to do—they like structure. I thought it was a beautiful thing that the state board was allowing dentists to take the reins again.

But a large cross-section of dentists like the comfort of being told what to do. I don't entirely understand. I get that you want to focus your energy elsewhere. But I like to be recognized for my ability to think, reason, and make my own decisions. Not everyone feels the same way as I do.

Oddly enough, there were a lot of gray areas when regulations were first announced last year. Dentists wanted clarity. Now they've taken clarity away again and it can be overwhelming. So what can you do?

Continue what you were doing

We want to be clear. Just because the Texas state board allowed their COVID-19 rules to expire does not mean you have to stop following them. If you—and your patients—were comfortable with the level of safety it afforded you, then by all means stick with it. Work within your comfort level.

However, I believe you need to get comfortable stepping outside of your comfort zone. It's how you grow. You learn to trust your instincts and your ability to trust your own decisions. As a dentist, you've earned respect and you're recognized as someone qualified to make tough decisions beyond the average person (when it comes to oral health). But everything that pertains to your patient's health is your responsibility. Don't be afraid to do your own research and make your own decisions.

Dentists are encouraged to follow CDC guidelines

The state board encouraged dentists to follow CDC guidelines but did not instruct them to. It sounds like this governing body understands it's stressful, so if you want guidance, you can continue to follow the CDC recommendations. But they are giving you room to make your own interpretations. By the tone of the ruling, there is flexibility and forgiveness if you get something wrong.

Any recommendations for requests for our next topic? Let me know at toothcop(at)dentalcompliance.com!

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• The expiration of the COVID-19 Rule
• Texas Dental Board Rule 108.7 Subsection 16
• CDC Guidance for Dental Settings

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

The Texas dental board let the COVID-19 rule expire (rule 108.7 subsection 16). How does that impact dentists moving forward? What rules do some providers still need to follow? What procedures are still recommended by the CDC? We cover it all in this episode of Talking with the Toothcop!

Outline of This Episode

• [3:20] The impact of the expiration of the COVID-19 rule
• [4:41] The OSHA Emergency Temporary Standard
• [9:25] 1910.504: The Mini Respiratory Protection Program
• [16:35] Subscribe to the podcast and sign up for our newsletter!

The impact of the expiration of the COVID-19 rule

How does this impact you? Maybe very little. There is no longer a Texas State Board rule that says you have to follow these specific rules. You don't have to wear N95 masks. You don't have to do twice daily temperature checks. You don't have to screen patients and check their temperature. But many of you have gotten used to the process and feel like it's best to continue. You absolutely can! You get to decide how to care for and keep your patients and staff safe—whatever that looks like for your practice.

The OSHA Emergency Temporary Standard

There is an OSHA standard—the "Emergency Temporary Standard"—that was released a few weeks ago and was effective immediately upon release. That means it is an enforceable federal law. Who is impacted by this law? Those who work with people who are suspected of having or confirmed to have/had had COVID-19. This can include employees at:

• Hospitals
• Nursing homes
• Assisted living facilities
• Emergency responders
• Home healthcare workers
• Employees in ambulatory care facilities

It does not apply to non-hospital care centers where non-employees are screened before entry and those with COVID-19 are not allowed to enter. So if you screen everyone that walks in the door, this rule doesn't apply to you.

If it does apply, you must have a written safety plan, patient screening management, transmission-based precautions, PPE, physical distancing, and more. What qualifies as screening? Listen to find out!

OSHA Standard 1910.504: The Mini Respiratory Protection Program

When respirator use is required, the respiratory protection standard applies. This requires medical evaluations, fit testing, a written safety program, user seal checks, and training. What does the "mini" version require? User seal checks and proper training. 90% of dental offices are already here.

CDC COVID-19 guidelines are still recommended

The state board still recommends finding the CDC guidelines:

• Postpone procedures if they aren't medically necessary
• Implement Teledentistry and Triage Protocols (doesn't apply yet)
• Screen and triage everyone entering for signs and symptoms of COVID-19
• Monitor and Manage Dental Healthcare Professionals (if you're sick, stay home)
• Create a process to respond to COVID-19 exposures among DHCP and others
• Implement universal source control measures
• Encourage physical distancing
• Consider COVID-19 testing for patients and staff who don't exhibit symptoms (we recommend you don't do that)
• Do things to minimize exposure
• Implement universal use of PPE

Familiarize yourself with this stuff!

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• The expiration of the COVID-19 Rule
• Texas Dental Board Rule 108.7 Subsection 16
• COVID-19 Healthcare ETS
• The Mini Respiratory Protection Program
• CDC Guidance for Dental Settings
• Save the date for bootcamp: Nov. 19th and 20th

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Are you doing proper sedation and anesthesia reviews? Are you making sure you don't have drugs sitting in your office that expired pre-COVID? Are you checking with a patient's primary care provider before administering anesthesia? Being busy and overwhelmed isn't an excuse for not doing your due diligence. In this episode of Talking with the Toothcop, Andrea and I touch on the importance of doing a proper review.

Outline of This Episode

• [4:09] Sedation and anesthesia reviews
• [8:49] Upcoming anesthesia course

Check for expired drugs and equipment

I've done a lot of sedation and anesthesia reviews in the last few months, and I can tell that some offices have been quite distracted. Those that have been quite busy aren't staying on top of the things they should, like an annual inspection of the sedation process and equipment reviews. As a result, I'm finding a lot of expired stuff. They're lucky I found it—not the state board. You need to be routinely checking to make sure you're not storing expired drugs.

Sedation and anesthesia reviews

You also need to be diligent in your patient screening and selection for anesthesia. Don't overlook even the slightest detail. Get the proper medical consultations done versus just getting medical clearance. "Medical clearance" is not an absolution of viability for you. You can't just exchange paperwork with their primary care physician. Take the time to document the conversation in your clinical notes (with great detail).

Take your pride out of the equation. Even if you've done something 1,000 times, there may be one time something goes wrong. If you can't prove you've done your due diligence and properly screened your patient, you won't have a leg to stand on. Err on the side of caution. If a conversation happened—but it's not in your records—it didn't happen.

Upcoming anesthesia course

We have an anesthesia CE course coming up on June 5th from 8 am to 12 pm central, but open to anyone across the US. The course is "Principles and Practices of Dental Office Anesthesia," taught by Dr. Justin Bonner and Dr. Garrett Starling. If you've done the same anesthesia course, change it up. Hearing the same thing from a different perspective might impact you in a more meaningful way. Learn more by clicking the link in the resources!

Call to action: When you get to your office, check the expiration dates on your emergency drugs and all of your equipment. Make sure they aren't expired.

Resources & People Mentioned

• Learn more about protectIt dental at https://dentalcompliance.com/drugkit or call them at 888-878-8916 and tell them that the Toothcop sent you!
• Principles and Practices of Dental Office Anesthesia: https://dentalcompliance.com/products/live-anesthesia-principles-and-practices-of-dental-office-anesthesia

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Last week, I read an article about an oral surgeon in North Carolina who got busted after a patient died. So in this episode of Talking with the Toothcop, we're going to talk about what happened, why it happened, and how it could have been prevented. This isn't to shame the dentist or staff involved, but to learn from the mistakes that were made. Tragedies in the dental office should never happen.

Outline of This Episode

• [0:22] Death in the dental office
• [8:50] Get professional help before it's too late
• [13:45] The Professional Recovery Network
• [18:21] Your patients may not trust you anymore
• [20:20] The current action being taken
• [24:15] Upcoming CE courses

Death in the dental office

According to the article Leland oral surgeon suspended by Dental Board, under investigation by SBI for drug misuse, Dr. Mark Austin had his license suspended following an investigation by the State Board of Dental Examiners. The patient in question came in for an appointment to receive a dental implant. The doctor administered sedatives before and during the procedure. Unfortunately, the patient's oxygen saturation dropped significantly, and after attempting to place an endotracheal tube, 911 was called. The patient died a few days later in intensive care.

This prompted an immediate investigation by the dental board. The DEA and state board combed through this dentist's practice. Even worse, in an earlier audit, the doctor couldn't account for substances that were supposed to be maintained at his office, including Fentanyl. The investigation also alleges that he used illicit substances personally for two years while practicing.

The patient was at 60-70% oxygen for 20 minutes. Brain death happens when it's deprived of oxygen for 4–6 minutes. When EMS arrived, the patient didn't have a pulse. The Dr. had not administered CPR prior to their arrival. His brain was deprived of oxygen for far too long, and he suffered irreversible brain injury and died 4 days later.

Get help—or get busted

If you or someone you know is struggling with a drug or alcohol problem, get help. It can be done anonymously before you impact your patient's lives. Because when a dental board gets involved, they'll issue an emergency suspension which creates a public spectacle. This situation is attached to Dr. Austin's license for the rest of his life. Every insurance company he attempts credentialing with will know. Some won't take the risk. If someone had recognized he had a problem it could all have been prevented.

It's hard to get help. But when you do, you go to a special rehab just for doctors. You're there with other dentists or physicians in recovery. You avoid a public stigma while getting acceptance and support. This isn't about shaming dentists, it's about getting them help.

It's sad that a world-renowned cardiologist—someone who devoted his life to helping people—lost his life in a preventable situation.

You have a moral obligation to protect your patients

Someone had to have seen the signs in this doctor and did nothing. You can't hide a drug addiction for over a year. If you work with someone who is struggling, you have an obligation and responsibility to report this behavior. You're either part of the problem or part of the solution. The staff had a moral and ethical obligation to make a decision. They didn't make the right one.

The proper training and preparation for something like this could have prevented someone's death. This is why we're talking about this. Dental offices need to be taught the right way to do things. A reasonable person should ask, "What could I have done to prevent that?" Sadly, these staff members will carry guilt with them for the rest of their lives.

The current action being taken

The dental board received information that Dr. Austin had prescribed controlled substances for staff members—outside the scope of dentistry. The board also received evidence that he was unable to account for controlled substances and had been taking them for two years. In a nutshell, he agreed to a suspension of his license.

Resources & People Mentioned

• Leland oral surgeon suspended by Dental Board
• Professional Recovery Network (Texas)
• Consent Order Suspending License
• Dental Compliance CE Courses

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

I recently realized it's been so long since I've played my guitar that the strings have started to rust. It's sad and embarrassing to realize I've let something I love that's important to me get forgotten. But it made me question: Where do you have rusty strings in your dental practice? Where are you not putting in the energy and effort into things that you should be? Have you let the things that are important to you go to the wayside? In this episode of Talking with the Toothcop, our goal is to bring you back to your current reality.

Outline of This Episode

• [0:22] Where do you have rusty strings?
• [2:23] You have to sweat the little things
• [6:22] Take a moment for self-reflection
• [8:26] Get on my schedule for a chat!

Where are your rusty strings?

We've had a lot of distractions with the pandemic. Because of this, I've seen a lot of "rusty strings" in dental practices. People are forgetting to do a step-wedge test for their x-ray machines. They're forgetting medical emergency training and preparedness. Many people are just going through the motions.

In every sedation inspection that I've done recently, everyone has had grossly expired equipment. These people are filling out their checklists but not really paying attention—which defeats the purpose of the checklist! Some of these things expired pre-pandemic.

You have to sweat the little things

Think about everything that happened in the last year. All of your energy and focus may have gone into keeping your practice afloat. It begs the question—is there something you can do to prepare for the next pandemic?

When a crisis happens you focus on priority #1. With COVID, it was infection control. But you still have to focus on step-wedge testing and check for expired drugs. You still have to do your OSHA and HIPAA training. These things are basic and don't require much effort to do. But all of the focus was on the pandemic.

Maybe this won't happen again in our lifetime, but other things will happen. You need to focus on the things that you still need to be doing and don't forget the little things, or they will morph into bigger problems. It's always the little things that fall through the cracks.

Take a moment for self-reflection: mental checklist

Take a moment to think through where you're at right now. Did you do your HIPAA security risk assessment? Have you done your OSHA training? Have you done emergency training? What are the things you need to be doing regularly? Are you on top of everything? What are the things that you're missing? Figure it out and get back on track.

We aren't bringing this up to shame anyone. But it's easy to get caught up in the moment, and it's important to take a breath and realign. Take a mental inventory, make a list of what you need to catch up on, and execute.

Are you stressed and don't know where to start? Head on over to DentalCompliance.com and get on my schedule for a complimentary consultation. Just fill out a simple form, and Andrea will get you on my schedule for 30 minutes of my undivided attention. Then you can ask all of the questions you want.

Resources & People Mentioned

• FREE 30-minute Consultation

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
• On Facebook
• On Twitter
• On LinkedIn
• On Youtube

Who says compliance training can't be fun—or funny? In this fun episode of Talking with the Toothcop, we take a short break from our scheduled programming to hopefully share some laughs. Plus, we drop some important news about upcoming events. Don't miss it!

Outline of This Episode

• [2:08] Why OSHA training is dangerous
• [6:44] An intentional demonstration
• [12:19] Bootcamp is coming BACK!

Why OSHA training is dangerous

Those who know me know I LOVE public speaking. Recently, I was doing an in-person OSHA/compliance training (which was awesome). I was speaking in a movie theatre and this particular movie theatre had a short stage about one foot off the ground. Toward the end of the presentation, I was talking about medical emergency preparedness.

I like to lean on things and decided to lean on a bar. Turns out, the bar was pretty low—a lot lower than I had anticipated. I ended up awkwardly squatting into a semi-sitting position to learn on the bar. But as I did, I slid back onto the platform and fell on my back. As I'm falling, I'm saying "It's important to be prepared for unexpected emergencies." Splat. The audience was confused and perplexed.

I couldn't figure out how to get back up without looking ridiculous. I managed to sit up and continue my lecture while sitting. I finally figured out a plan to get up and quickly hit the next slide, which said, "We don't rise to the level of our expectations, we fall—HA—to the level of our training."

I walked off the stage and made a beeline for the door. People asked the hostess if I did it on purpose and she was like, "Yeah, he does that stuff all the time."

The takeaway? Come see me speak live! Need a speaker for an upcoming event? Throw my name in the hat!

Bootcamp is coming BACK!

Bootcamp is coming back in 2021! The planning is in motion. It will be a two-day event on the 19th and 20th of November. More details to come.

Resources & People Mentioned

• Dental Compliance Live Training

Connect With Duane

• https://www.dentalcompliance.com/
• toothcop(at)dentalcompliance.com
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