Checking up on your dentist: Are the instruments they use clean?

Checking up on your dentist: Are the instruments they use clean?

When you go to the dentist, there's a level of uncertainty about whether it's going to hurt, but you trust that certain things are a given. For example, you probably trust that the instruments dentists and hygienists are using in your mouth are clean.

For added assurance, the Centers for Disease Control has recommended since 2003 that dentists do what's called spore testing every week, rather than every month. The testing is done to make sure the machine that sterilizes instruments, the autoclave, is working properly. 
 
The testing involved dental offices running a package of live bacterial spores through the autoclave. That package is sent to a lab that tests it then reports back to the dental office whether its sterilization efforts passed or failed.
 
Dr. Ben Kang with Pedatric Dentistry at Bridgeport Village showed KATU the binder in which he keeps records of his spore test results dating back several years.
 
"It’s one of those things if it has to do with safety for the family patients and the kids that come here, I think that’s a good way to make sure that’s being done properly," Dr. Kang said.
 
The focus on sterilization became a much bigger deal after the HIV and hepatitis outbreak at a dentist's office in Oklahoma last year. Sixty patients tested positive for the diseases after being treated with instruments that weren't properly sterilized.
 
During an inspection at a dental office in Lake Oswego, the Oregon Board of Dentistry realized it had a serious problem. 
 
"We found a lot of things that were wrong," said the board's executive director Patrick Braatz.
 
Braatz said the board discovered Dr. Hamid Zehtab had been breaking the rules when it came to spore testing and certainly had not been testing every week. KATU has previously reported on sterilization issues involving Dr. Zehtab. It was so alarming, they started asking other dentists they were investigating about spore testing too.
 
"There were some people that weren't even doing tests monthly. We have some people that, in a 52-week period, only did five tests or did no tests," said Braatz.
 
The board issued fines upwards of three or 6-thousand dollars per dentist. The highest fined levied was against Dr. James Savage in the amount of $12,000.
 
But here's where things get interesting.
 
Enter Oregon state Sen. Fred Girod, R-Stayton, a retired dentist. He co-sponsored a bill this session that not only stops current investigations into dentists about spore testing; it refunds money to those who've already paid their fines.
 
Dr. Girod's bill also removes from the board of dentistry's website the record that a dentist was disciplined and fined about spore testing failures. 
 
"You are freshly retired as a dentist but sponsoring a bill that in essence helps the people that were your colleagues?" asked KATU investigative reporter Anna Canzano.
 
"Well, I think it gives me a special viewpoint as to what the problem was," said Dr. Girod. "I'm sorry as a dentist, I know darn good and well they have not done due diligence in making sure the average dentist on the street knows that's part of their code."
 
Dr. Girod insisted the board didn't do enough despite notices, newsletters and emails it sent to Oregon dentists over the last decade about the weekly spore testing protocol. 
 
He also asserted that since part of the bill he wrote requires dentists to do weekly testing, the new law will help Oregon lead the way in patient safety.
 
"You can say in good conscience you sponsored this bill and it ensures patient safety in a greater way and it ensures accountability for dentists in a greater way?" asked Canzano.
 
"Absolutely it does because instead of administrative rule, it locks into statutes that you must spore test every week," answered Dr. Girod.
 
"But why refund the money that's already been paid?" asked Canzano.
 
"Because I think it was bogus! I honestly truly do," said Dr. Girod.
 
Three dentists interviewed by Canzano disagree and take issue with aspects of the Senate Bill 1519.
 
"For a dentist to say 'I didn't know, don't fine me' I don't think that's fair for all of us who do follow the line and make it our priority to make sure patients are safe by doing spore tests," said Dr. Kang with Pediatric Dental in Bridgeport Village.
 
Dr. Justin Marostica with Tendercare Dental in Tigard said he believes in forgiveness, but "I think the Oregon Board of Dentistry's sole purpose is to protect the patient and I think that's wonderful. I think they're doing a great job of doing that and I would expect nothing less from them."
 
Like Dr. Kang, he showed Canzano a binder of the lab results his practice has received over several years. And he showed her the certificates he receives from a lab in Michigan verifying that the autoclaves in his practice are properly sterilizing instruments.
 
Dr. Rodney Nichols is a retired dentist who submitted written testimony to Oregon legislators opposing Senate Bill 1519.
 
"This is an example of an extremely small group -- less than 1-100th of the dentists licensed in Oregon -- who are trying to control the entire dental world in Oregon for their own benefit, for their own reputation," expressed Dr. Nichols.
 
He continued: "It's actually disgusting that such a small group can have such power over our legislators. And unfortunately, it's somewhat disappointing our legislators are not able to see the true intent behind this legislation."
 
Last week, Dr. Girod's bill passed unanimously in both the state Senate and House. Not a single lawmaker voted against it. 
 
Canzano heard from Gov. John Kitzhaber's spokesperson Rachel Wray Thursday afternoon. Wray confirms the governor's staff members helped craft this bill and he intends to sign it into law. 
 
Special protection for Oregon Health and Science University
 
Many dental offices comply with the Oregon Board of Dentistry's spore testing protocol by paying an outside lab to do their testing. Oregon Health and Science University (OHSU) offers the lab testing service and issues certificates like this to dental offices:
 
 
Section 4 of Senate Bill 1519 protects OHSU from lawsuits over spore testing:
 
(1) If a person who is licensed to practice dentistry under ORS chapter 679 has been disciplined prior to the effective date of this 2014 Act by the Oregon Board of Dentistry for testing an autoclave or other heat sterilization device less frequently than once per week, the licensee may not bring a cause of action against an entity that tested for the licensee the autoclave or other heat sterilization device on grounds related to that testing. 
(2) For purposes of this section, “entity” includes Oregon Health and Science University. 
 
Sen. Fred Girod explained that some dentists who'd been fined by the board of dentistry thought they were in compliance because of the certificates they were receiving from OHSU. In reality, they were not in compliance because they weren't doing weekly spore testing, and thought the testing was only required once a month.
 
Dr. Girod said he saw the bill as a way to bring "together three groups (dentists, the board of dentistry, and OHSU) to resolve this problem."
 
Canzano has reached out to a spokeswoman for OHSU. She's awaiting comment from the university about its inclusion in SB 1519 and will update this report when she hears back.