All posts by Kev

Dentists Loose $39,000 During (1) OSHA Inspection Visit! How Will Your Practice Stand Up to The Same Measures…?

It can happen so unsuspectingly:  A quick-to-boil, disgruntled employee; An impulsive, disenchanted patient; And a simple phone call to OSHA.   One overlooked OSHA protocol– that leads to another– and then a third (as in this case).  The loose ends added up quickly when the OSHA Inspector began measuring this tally!

A Compliance Audit, like this one,… can quickly precipitate  disaster for the dental office, unaware of new changes in:  Infection Control , Required Waste & Recycling Containers & Dental Chair Unit Water Quality Regulations.  Oversights may be seemingly innocent: “We didn’t know that rules had changed”, “We are only a few months past-due for our OSHA Training Course” & “We just were not paying attention.”  Comments like these, should never be uttered by dental personnel nor touch an OSHA Inspectors ears.

Yet this incident, unassuming, well-intentioned dental office received (3) costly OSHA violations due to:  admitted negligence and obliviousness.  OSHA takes non-compliance seriously!  A major win for the OSHA Inspector; A $39,780 mistake for the (practice owner), Dentist.  Read on to discover how to avoid this plight and get your office on the road to comprehensive OSHA success!…

Did you know, that every January,  & the Department of Labor Agencies, publish their new Penalty Increases.  Take a look at the 2019 “price-you’ll-pay” for ignoring to the 100+ Safety Protocols currently required to be operational in your dental office:

Type of Violation Penalty
Serious &

$13,260 per violation
Failure to Abate $13,260 per day beyond the abatement date
Willful or Repeated $132,598 per violation

The Penalties Inflation Adjustment Improvement Act of 2015 established an “Allowable Increase Rule” that lets these agencies adjust their assessed penalty levels, upward, every year.  And they do just that!  Since 2015, it seems OSHA & the DOL slap-on an average 10% increase to exceed the prior year’s average penalty rates. 

This year, the OSHA penalties will start at $13,260 per violation.  In addition, the maximum penalty allowed for “failure-to-abate” violations are $13,260 – that’s for every day that an employer fails to abate (1) specific violation!  Finally, the maximum penalty allowed for “willful or repeated” violations is $132,598!   This is 10 times the maximum permitted for “serious” & other-than-serious” violations.  These fees, undeniably, would be astounding and threatening to any dental practice.

What’s the cure?…

Get “in-the-know”!  Stay “in-the-know”, about current & evolving OSHA laws.  Make sure to include (3) components to build a truly comprehensive OSHA Program within your office: Annual Employee Compliance Training, All Required Paperwork & Up-to-Date Facility Protocols

Incorporate Annual OSHA Employee Training for all employees. Be sure to include full-timers & part-timers; clinical as well as non-clinical employees.   Currently there are (45) Required OSHA Learning Point that should be covered in this year’s Annual OSHA Training.

Apply what you learn in your facility!  There are over 100 protocols to set up within your facility. Set your plan into action!  Its best to work with compliance trainers that provide a “recap” of your training in report format.  Then make sure you can reach your Trainers for additional guidance, clarification and support as you set up your protocols.  Getting the assistance during your set-up phase will be a critical key to your success.

Don’t forget the paperwork!  OSHA inspectors will check for required OSHA documents first!  When entering your office, they will want to see required documents, that are up-to-date.  Be sure to include:   Employee Forms & Acknowledgements, OSHA Manual written to GHS & Current CDC Infection Control Standards & new OSHA / GHS SDS Sheets in (2) varying formats.     

What do you do now?:  Get compressively compliant–then stay comprehensively compliant!   How?  Align with a compliance resource that provides “a relationship” along with your training, manuals, forms & protocol checklists.  One that you can reach out to 24/7 for guidance, clarification and updates.  We suggest this ALL IN ONE DXL Program.  It provides everything, plus, 24/7 access to Dental OSHA & HIPAA Coaches that become part of your team’s success.  It the relationship package.  And one of the best rated in the industry.

Need more guidance?  Contact an OSHA / HIPAA Coach for a confidential Discovery Meeting by calling 941-587-2864 or email us, anytime.  We are happy to help!

Annual HIPAA Requirements – What Every Dentist Must Do!

HIPAA Un-Riddled!

What happened to the day when you unlocked the office, turned on the suction, picked up a handpiece and straight-up—practiced dentistry? 

Electronic Communication (E/C) has taken the innocence of practicing dentistry right out of our hands!  While it provides instant information and keeps us “in-the-know”, the double edge to E/C now obligates us, and healthcare practitioners, to insulate and protect our patient “Protected Health Information” to the Max!  Read on— you’ll be glad you did…

What Does This Mean to Your Dental Office?

By now you know that you must protect your Patient’s “PHI” (Protected Health Information) to very strict HIPAA Privacy & Security Standards.   This applies especially to your facilities paper communication, electronic communication (computers) and internet activities.   Since 2010, The Us Department of Health and Human Service ( has required “hi-tech policies” be observed within all healthcare settings in the USA.   But every year, as technology and identity theft evolves, you must keep up with the curve!  

To ensure that your facility standards can stand up to a HIPAA Audit (and yes, they are visiting dental offices in full force) and that you are implementing all of the current  HIPAA Privacy & Security Standards for Conversations, Texts, Copies, Emails & Faxes.  Yes, all of those daily office function has specific HIPAA Privacy & Security Standards.   To understand “how you must behave”, its best to establish a comprehensive HIPAA Program within your office that your review continually and update at least annually.


You can take the long road or the short-road to successful HIPAA compliance.  The following are “short-road /best practices” and provide the least time-consuming remedies for implementing compliant HIPAA protocols:

ConversationsHIPAA has protocols for “regulatory language”.  This means you should refrain from using the patients “full name” and avoid using the patients “the last name” in spoken conversation.  If you want to be more respectful to elderly patients or Doctors who may frequent your office, make sure you have permission a permission statement on your HIPAA Patient Acknowledgement Form that allows the patient to give your team permission to call them by their SurName. 

Texts:  Texting is definitely convenient, but under HIPAA Regulations, you cannot text Patient Protected Health Information (PHI).  A “patient name” is considered PHI.  When texting either do not text a patient’s full name— or download a HIPAA compliant text APP to all cell phones. 

Copies:  Copy Machines need to be located in a low traffic area, under Management Control & specific logs even need to be kept for specific types of copying.  Be sure you have written protocols for “filing or shredding” paper documents. Make sure that all employees are aware of these protocols and follow them to current HIPAA law.  Paper documents containing PHI that is not going to be securely filed, need to be shredded  ASAP.  This protocol needs to be I written format within your HIPAA manual.

Emails:  It is not required that you have an Out-Going Email Encryption Service, but it will sure be a lot less complicated!  If you do not sign-up for an  Out-Going Email Encryption Service, you will have to create a written procedure for:  testing emails, logging the test, sending an announcement that you are not sending your emails with encryption, getting permission—only then can you send an email.  (Wow!  That’s exhausting!  Get the Out-Going Email Encryption Service.  It’s only $15 / month in most instances.)

Faxes: Practice owners are now responsible for where facsimiles end up on the other end!  To be HIPAA compliant either: retire your fax machine, do not fax out or convert your faxes to email encryption.

HIPAA Standards are constantly evolving.  Make sure your office completes a comprehensive update in 2019. If you find yourself a bit overwhelmed with all of this, don’t stay confused.  Call our team for guidance should you need clarification on the aforementioned protocols.  It’s our pleasure to help!

Created by Jill Obrochta RDH BS

Call us for a copy of our:  2019 HIPAA FACILITY COMPLIANCE CHECKLIST  or

ASK TO GET COACHED by JILL:   941-587-2864

Yankee Dental Meeting in Boston, MA in JAN 2019

Yankee Dental Meeting in Boston, MA in JAN 2019

Friday, February 1, 2019, 2-4pm.

Speaker Jill Obrochta, RDA

Course description and objectives:
With a Focus on new CDC Infection/Prevention Requirements to establish Hospital-Grade Level of Infection Control in the Dental Office.

You’re a seasoned dental professional; And you must feel like you have a firm understanding of your dental office’s OSHA & HIPAA Protocols, Right? But did you know: That recently, OSHA & HIPAA requirements have massively changed? Currently, OSHA Inspectors & HIPAA Auditors have received government funding, to conduct detailed audits to ensure that all of these new requirements are enforced! Are you prepared?…

Spend an insightful afternoon with a Dental OSHA & HIPAA Expert. You will learn “what the Inspectors are looking for” and “why it is important to set up your compliance programs—comprehensively.” Ask questions or simply listen & learn. Take away expert tips– so that you can have streamlined success with OSHA & HIPAA compliance at your dental office.


Upon completion of this course you will be able to :

Distinguish what OSHA & HIPAA Modules are required for your State—and when you have to renew them?
Understand what (3) components are critical for setting up comprehensive compliance programs within your dental facility.
Review the different components and make savvy distinctions about the new: CDC Summary of Infection Prevention Practices in the Dental Setting.
Realize that CDC Guidelines are the “Basic Expectations” & OSHA Inspectors can fine for not having them implemented.
Adopt a “Maximum Efforts” mentality to protect your employees + patients by integrating “on-trend” OSHA & HIPAA Protocols.
Realize that OSHA & HIPAA Inspections are getting more detailed and sophisticated and how to stay ahead of the curve.


Attendees will have the opportunity to get a PDF copy of the CDC Summary of Infection Prevention Practices in the Dental Setting & Schedule a 30-Minute Free Phone Consultation on how to navigate and implement these protocols. PLUS a private consultation about your current OSHA & HIPAA status.
Speaker will provide details.

Looking forward to seeing you there.

Jill Obrochta, RDH BS



941-587-2864 office

941-302-2110 cell



Top 5 Things Your Dental Office Should Have in Place to get an A+ rating from an OSHA Inspector

Did you know?   This year, OSHA Inspectors are out in full force and they’re scrutinizing dental offices more than ever!  Why?  Well in recent months it seems the media has targeted several dentists, nationwide, that have had “less than ideal” Infection Control Protocols.    Now let’s focus on the positive:  What should your dental office have in place for Mr. OSHA Inspector:

  1. Employee Paperwork:  Make sure all employees have HEP B Vaccination Records, Proof-of-Annual OSHA Employee Training, Proof-of-Global Harmonization System Training, Occupational Exposures Document and Medical History on file for all employees. 
  2. New Global Harmonization System (GHS) Protocols & Paperwork:  GHS was mandated to be in place in all dental offices since December 1, 2013.  This means you need:  Proof-of-GHS Employee Training, a New OSHA Manual written to GHS Standards, Conversion of your USA–MSDS Sheets to the new International SDS Sheets and a diagram of the new Pictograms posted within your office dwelling.  If you don’t have your act together with regards to GHS, consider a comprehensive GHS Solution.
  3. Required Labels & Stickers: You will need both:  Hazard Rating Labels at the point-of-use to represent all of your dental products, as well a,s Bio Hazard Labels at all biohazardous areas within your office. (i.e.:  at radiation buttons, on soiled laundry bins, at suction traps)
  4. Proper number of Sharps Containers and Red Bags within your office: Now required at the point-of-use are small sharps disposals and red bags for soft soiled waste.  It is not prudent or safe to walk with or re-handle soiled waste.  Make sure you place “point-of-use” disposal containers in all of your operatories.
  5. Sterilization & Disinfection Logs and Receipts: Keep all of these documents together in an organized binder in chronological order. Inspectors will want:  Biomedical Waste Pick-Up Receipts, Spore Test Results and Cold Sterile Changing Logs for the past 3 years.  

So does your office make the grade? Seriously, many dental offices do not know where unsafe behavior starts and where compliance begins!  Don’t be caught unprepared or looking uneducated.  Saying that you are unaware of the OSHA requirements will only infuriate most OSHA Inspectors.  Make sure you choose an OSHA Compliance Training Company that will assist you in getting all requirements in place.  Choose one that will help you with understanding and implementing all of the requirements and that will help direct you when putting your protocols in place.

Written by Jill Obrochta & Heather Whitt of Dental Enhancements.

Got Compliance Questions?  Call us:  941-587-2864

New Hampshire Ortho:

Oklahoma Oral Surgeon


HIPAA Audits – How To Prepare

With the new wave of HIPAA PHASE 1 & PHASE 2 Audits, (that began in November 2016 and will be still running strong in 2019), most dental offices don’t know where to start to streamline their efforts.  Turning the other cheek to this big, bold requirement won’t make it go away. And burying your head-in-the-sand will only make the requirements seem uglier when you surface.  The sinister HIPAA Auditor may ominously creep into your office, like a grim reaper, ready to rip your HIPAA protocols to shreds. 

Protecting your practice is an essential step in setting up your HIPAA compliance protocols.  Did you know there are 89 risks you face in private practice every day?  Eighty-nine!  This is based on research released from noted Dental Financial Prosperity Coach, P. Christopher Music.  Christopher elaborates, “Think about it—Did you ever hire the wrong person?  What did it cost you?  The National Average Cost is $30,000!  Let alone the time, effort and headache that it cost to correct that error.  Building a system around everything you do within your dental office saves you time, money and mistakes.  HIPAA & OSHA compliance protocol systems are no exception.  Especially these days with the deep fines and lengthy inspections that come with governmental intervention.”  (Listen to an enlightening podcast on How to Set Up HIPAA Systems within your office by clicking here).  

We all know, “Knowledge is power”. Discovering and implanting streamlined HIPAA systems is like adding steroids to that power.   Results-based HIPAA Compliance is what you want. Applying a tried-and-true system to almost anything we do in dentistry saves us time money and the pain of the misstep.       

Results Based HIPAA Compliance is the result of implementing a 3-pronged approach to compliance.  Every dental practice owner must be sure to include: 

Employee Training: Remember, every employee must be trained to these new HIPAA Omnibus Rules Standards of 2013.  This includes full-time and part-time employees, as well as, clinical and non-clinical employees.  Rest assured that “Proof-of-Training” will be requested by the HIPAA Auditor typically within the first 5-minutes of his visit.  All employees must have this HIPAA Omnibus Rule training prior to handling any Patient Protected Health Information (PHI).

Required Paperwork:  Currently, this includes (8) HIPAA forms that should be in-use and functioning within your dental office.  These HIPAA forms include: patient, employee, office and business vendor forms that inform and protect your patient’s rights to privacy vs. access of their Protected Health Information (PHI).  And a HIPAA Manual—written to the new HIPAA Omnibus Rule standard is required as a Federal Document in every USA healthcare facility. 

Facility Protocols: …will be the next stop on “the HIPAA Hitman’s” tour of your dental office.  It is not enough to just implement HIPAA Employee Training and the Required Paperwork.  You must make sure that you connect-the-dots of your training and paperwork by implementing all of the required HIPAA Facility Protocols.  This gets to be challenging because technology is constantly changing and growing.  The best way to get your dental office fully HIPAA compliant is to utilize a checklist.  HIPAA Facility Protocols include everything from your patient check-in procedures to how you text patient info after hours.  To keep current with these changing protocols, align with a trusted HIPAA resource.  One that offers expertise and keeps you informed.      


Get informed.  Power Up!  HIPAA AUDITS:  BRING IT!!!  Townies got this!                                                    

Call us for a copy of our:  2017 HIPAA FACILITY COMPLIANCE CHECKLIST  941-587-2864


The risk of Non-Compliance with these new HIPAA Rules

Building a system will help protect you.



Below are (16)  HIPAA Facility Protocols that all HIPAA Auditors will check.

Make sure your facility is HIPAA Compliant in these areas.   If you need additional guidance—feel free to give us a call.  

The HIPAA made EASY Team


□  Patient Check-in / Check-Out Procedures ensure Privacy: ensure that there is no “overhear” or visual intrusions. (No overhear or visual intrusions)

□  Office Server is Secure:  If on-site, place in a secure well ventilated room or lock down with a “server cage” or “server locker”.

Office Wi-Fi is partitioned or separate so that patients cannot access business Wi-Fi.

□  Copy Machine is Secure:  Placed in a secured location, monitored by management, shredder in use & HIPAA Compliant Copy Policies in Place

□  Our Out Going Emails are HIPAA Compliant:  Either an Email Encryption Software Bridge is in use or  a Written Email Use Program with Testing Protocol (tested on every email) is in place.

□  Use A HIPAA Compliant Text-App is in use on all Cell Phones that share Patient PHI so that patient information is sent securely over text.  (Alternatively, if you do not want to load in a Phone APP then, do not text patient PHI)

□  Fax Machine is operating to current HIPAA Standards.  Convert Facsimile to Fax-to Email to ensure facsimiles are encrypted when sent.  Or, traditional faxing will require that you write a detailed Fax Safeguard Plan and implement it to the current HIPAA standards!  

□  Do away with take-along data back-up drives and go fully cloud-based. Lost or stolen take-along drives prove to be a major risk to healthcare facility owners.   Theft of a device risks a $150K HIPAA fine + 18-month audit! Automatic, encrypted, cloud back-up is Best Practices.  Research & choose a reputable cloud hosting service.

Get a HIPAA Manual written to HIPAA Omnibus Rule Standards:  Make sure your manual is up-to-date, customized per office location with HIPAA Officer and Compliance Committee listed.  Hi-tech Law, physical, technical & administrative aspects of HIPAA protocols are all clearly defined for your office (included in HIPAA Manual).  Areas for updates to written policies with notable periodic reviews are evident.

□ Have detailed HIPAA Reports—Up-to-Date: Risk Assessment Report & Data Back-Up & Contingency Report Up-to-date, detailed, customized per office location.

All Employees are trained to HIPAA Omnibus Rule Standard. All Employees must be trained to current HIPAA standards, prior to handling patient PHI.  Update employees on HIPAA rules to keep up with evolving HIPAA laws and technology updates that concern PHI.

All Employees have signed all HIPAA Required Employee Forms:  Up-to-date, signed and readily available for HIPAA Auditor.   All employees must complete HIPAA Omnibus Rule Training by watching HIPAA Omnibus Rule Video:


Appropriate Business Vendors have signed Business Associate Agreements with your office.  Have all applicable Business Vendors sign (then retain on-file), a HIPAA Omnibus Rule—Business Associates Agreement (BAA).  This is a Vendor Confidentiality Agreement, that is required for all vendors who “see or use” your patient PHI.

□  Update and use other required in-office HIPAA Forms written to Omnibus Rule Standards.  These would include, but may not be limited to:  Patient Acknowledgement Agreement, Notice of Privacy Practices, Third Party Release Form, etc.

□  Align your office with a reliable HIPAA Resource.  Search out a reliable HIPAA Trainer or join a HIPAA Web-Group that will provide support, updates and tutorials on these ever-evolving HIPAA laws.

□  Have HIPAA Practice Drills with your team:  HIPAA requirements will always be evolving and changing in relation to our advances in technology.  Be sure to practice with your team, how you should handle various scenarios with regards to patient PHI, internet use, etc.  Establish and update your HIPAA office protocols periodically or at least annually.

Call us if you have questions on this checklist.  Many healthcare professionals feel overwhelmed when they have to tackle an update to their current HIPAA program. If you have questions about your current HIPAA Protocol set up, or if you would like information on our HIPAA COMPLETE PKG or ALL-IN-ONE OSHA & HIPAA TRAINING PKG, please feel free to contact us at any time for a confidential, complimentary consultation.  We love this stuff!  And are here to support your success with HIPAA protocols.  

The HIPAA made EASY Team 







Video Demonstrates A Common US Dental Office HIPAA PHI Violation

The above is a common scenario…

One that could creep up on your team innocently.

If you are curious about how to best protect your team against unsuspecting HIPAA violations – plan a staff meeting and update your current HIPAA standards to include:

  • A review of common practices with patient PHI: Pt Check In/Check Out
  • What papers need to be shred When & Why?
  • What I the proper form to use before sharing patient PHI with a 3rd party?
  • What steps should we take to better safeguard our Patient’s PHI from being seen or used?
  • How are we protecting PHI in Texts, Faxes, Copy Machine & Outgoing Emails?

If you need help with updating your HIPAA protocols for 2019, feel free to call one of our HIPAA Coaches on:


To see what is required.

Ready for TN OSHA Dental Office Inspections?


If you are a Tennessee Dental Professional listen up!  There is a new buzz in town and it may be headed your way.  It’s “a sting” of sorts—but you can get fully prepared:

Launched in October 2017, Tennessee is enforcing their meticulous “Local Emphasis Program” (LEP).  The campaign will subject all Tennessee Licensed Dentists to a random and detailed OSHA inspection.  Why?   LEP is a result of concern that arose after authorities compared a decade of healthcare data.  The results revealed 90% of TN dental offices surveyed had more than double the amount of OSHA violations when compared to combined workplaces during that same time period.  Authorities also discovered that 319 various hazards were involved, thus the push to implement the current Local Emphasis Program to improve overall safety within the Tennessee dental workplace. 

TN OSHA will pair their new appraisal checklist with the recently revised CDC Update for Infection Control within the Dental Office Setting & International Chemical Safety Updates OSHA/GHS , in an effort to accelerate OSHA compliance throughout the State. 

If you are interested in updating all of these standards without the direct scrutiny of TN OSHA Auditors, we can help.  Call or email us anytime.


How Can you best Prepare?  If you are chosen for the random audit, make sure you have the following up-to-date within your dental practice:



CDC Infection Control Update for Dental Offices

Make sure to fill-out Appendix A & B.

Blood Bourne Pathogens

This needs to be updated frequently; All employees must be trained in BBP—even non-clinical.

OSHA/ GHS                    Hazard Communications

Global harmonization Standards –Training & Protocols have been due to be in place since 2013.

Personal Protective Equipment

Know what to wear when to wear it, when to replace it & how to maintain it!

Exposure Control Plan

TN OSHA may ask any team member to access this; Be sure all MSDS & SDS are in alpha-order & updated—and that they coordinate with proper labelling requirements.  Include Beryllium & Silica Safety.

Proper use, location, handling and disposal of Prohibited Materials Containers

This would include BMW Red Bags, Sharps, Rx Waste, Amalgam Waste.

Maintenance & Safety Logs  Engineering & Work Practice Controls


TN OSHA will check these in detail; Make sure to have Annual, Quarterly, Monthly, Weekly & Daily Task listed and monitored. 

TN requires that clinical employees provide input on Safety Devices at least annually. 

Recapping Device 

TN requires that a Re-capping device is tested for use.

Vaccine Documentation & Injury Reporting

Include:  HEP B Series, MMR, TDAP and follow proper reporting protocol depending on the number of employees.

OSHA Required Forms & Proof-of-Training Updates

Keep OSHA Training Records for (3) consecutive years—for all employees.

General Duty Standard

Include also:  Water Quality, Laser//Radiation Standards, Fire Safety, Posters, Sterilization / Disinfection Monitors, Ergonomics, etc.

This is a query provided by

It will help you to understand specific codes in case you have to research violation codes.

The TOSHA-Department of Labor & Workforce Development will help you accomplish what is required, but you may be subject to go through their audits. 

If you are interested in updating all of these standards without the direct scrutiny of TN OSHA Auditors, we can help.  Call or email us anytime. 

Dental Enhancements, Inc.


Team of Compliance Coaches


Beryllium & Silica additives in your lab products!


Take notice: Recently, OSHA updated their requirements for dental offices and laboratories with regards to Silica and Beryllium dust. Both are common ingredients of dental materials.  The greatest take away from this article is making sure you check your labels and SDS sheets for Beryllium & Silica additives in your lab products.  Switch to non-Beryllium & non-Silica containing products and take proper precautions for a throughout clean up.  Now, let’s dig deeper into this topic…

Why the concern over these (2) elements? 

Over multiple year studies, dental labs have been found to have a higher occurrence of lung cancers and heavy metal poisoning, not only in the employees but also their family members at home. The tasks that are associated with this increased risk of beryllium and silicate exposure are casting, sandblasting, grinding porcelain, and cleaning/maintenance processes. The main culprit is the tasks is the materials used, they contain beryllium and silica dust. The particles are 1000x smaller than a grain of sand, allowing for them to become airborne and inhaled very easily.  Poor ventilation, respiratory protection, and barrier PPE increase the risk of inhalation. This fine particulate dust also settles on our uniforms, which if brought home, is then inhaled by family members. This significantly increases our family member’s potential to develop respiratory issues, cancers, and chronic health issues. OSHA has implemented regulations that are aimed at protecting dental lab employees and the secondary exposure victims. These regulations are coming under stricter enforcement measures within dental labs and adjacent dental practices. For more information on this please visit, this outlines the OSHA findings to include how family members are affected by respirable silica and beryllium dust.

The final rule was published in June of 2017 after a few months delay by the current presidential administration. However, compliance is mandatory and will be rolled out for enforcement in the very near future. The timeline is as follows:

General Industry and Maritime

Comply with all obligations of the standard, except the action level trigger for medical surveillance

June 23, 2018

Offer medical examinations to employees exposed above the PEL for 30 or more days a year

June 23, 2018

Offer medical examinations to employees exposed at or above the action level for 30 or more days a year

June 23, 2020

The time is NOW, to begin implementing programs to reduce or eliminate exposures! You can be sure that dental practices and labs (that have exposure potential) will be audited very heavily. Primarily because these issues not only affect those directly involved but also second-hand exposures are very likely as well. An excellent resource that breaks this down even further is at

Risk Factors

Without proper respiratory protection, the particles are inhaled into the lungs where they cause scar tissue to build up, reducing the lung’s ability to function. This is a condition known as Silicosis and along with chronic heavy metal exposure and poisoning (from the beryllium used in the materials). This condition can lead to kidney damage, lung cancer, and tuberculosis. Silicosis is an incurable disease that will cause chronic respiratory issues for life. Even if the exposure is stopped, Silicosis can, and usually does get worse. Silicosis is a preventable condition through the use of exposure controls, ventilation systems, and appropriate PPE.

Precautions & Exposure Controls

How do we protect ourselves in regards to silicates and beryllium? The most effective method of control is through substitution. If we can eliminate materials that contain crystalline silicates and beryllium for sandblasting, then the main source of silicosis will no longer be present. A common replacement is aluminum oxide, however, there are many acceptable replacements available. If substitution is an option or not, focusing on ventilation at the production source of grinding is always a good idea.  And this is a Best Practice when crystalline silicates and beryllium are in use With an effective ventilation system in place, any dust that becomes airborne is evacuated before it is inhaled or caught on surfaces. In addition to appropriate ventilation, respirators are also required in case any stray dust is not captured. Respirators require proper FIT testing programs to be in place, either by a qualified member of the team or outsourced to a third party (approved testing methods are outlined by OSHA at ). At a minimum, the filters on properly fitting air-purifying respirators must be N-100 type as defined in CFR 42 Part 84.179.

Proper Clean-Up, Disposal & Housekeeping Procedures

In addition to the above control methods, some specific housekeeping procedures will help reduce the chances of exposure. Wet mopping ( with disposable mop-heads), wet wiping, or vacuuming with a HEPA filter is highly recommended to keep dust from becoming airborne. DO NOT use a compressed air duster, this will significantly increase the airborne particulates in both quantity and trajectory. Always be sure to double-bag disposable-mop heads and wet wipes into sealed plastic zip-lock bags and dispose of this waste in an exterior trash container.  When these items dry, the particulate matter can be reintroduced into the air.  Best to get them isolated and taken outside of the workplace.

Awareness & Action

With the increased awareness of respirable silicate dangers in regards to dental settings, we can develop protocols and programs to decrease the exposure. Make sure to:

  • Check your lab products, replace all crystalline silicates and beryllium continuing products
  • Replace with non-Beryllium & non-Silica containing ingredients
  • Purchase proper ventilation safety stations
  • Wear proper personal protective equipment (especially respirators)
  • Never eat or drink in the dental lab area
  • Implement proper wet- clean-up with disposable wipes, zip-lock bag and isolate these items into exterior trash immediately

Most importantly, we can help to ensure all members of our dental teams, and their families, have a safe work environment and continued quality of life.

Provided by Dental Enhancements, Inc: 

Gabriel Muller USAF TSgt (Ret.), BA, NREMT, COHC

Heidi Muller  SSgt USAF, EFDA BS 

Jill Obrochta RDH BS 

For more information contact us at:


Some additional sources of information pertaining to silicates and beryllium:

GET IN “THE KNOW”: Dentistry goes to a Hospital-Grade Level of Disinfection 2019

Hey–Pay attention!  This is important…

It’s not often that we have a radical Infection Control Update in Dentistry—but we are in the midst of one now—

It seems that the Centers for Disease Control has been observing the Infection Control and Disease Prevention practices of dental professionals for over a decade.

They have now teamed up with OSHA and long-overdue update to a “Hospital-Grade Level of Sterilization & Disinfection” within the dental office environment is now a mainstay and a mandate!

Even if you are a seasoned dental professional with years of experience, you will want to take a look at the New  CDC Infection Control Guidelines for Dental Offices.

Because—– OSHA Inspectors will be focusing intently on these new Infection Control Guidelines when they visit your office!

This new CDC Infection Control Update provides specific changes that will be important for your entire team to know. 

If you would like a better approach for understanding these changes, fill in the form below to request a Free 30-Minute Guided-Help Phone Consultation with an OSHA Expert to navigate the CDC Summary.

Below is a bullet-point / cliff notes version of the update.  It will be important that review this document—in a staff meeting.

Since you will have to supply an OSHA Inspector with “written protocols” for the CDC Infection Prevention, printing the 44-page document is super smart and efficient.  You can review the information with your team, then fill-in-the-blanks by customizing appendix A & B.  Then save with your other Important OSHA documents.  (PSSSSSSSSSST:  If you do not want to tackle this project alone, skip to the bottom of this article.  We are offering a free 30-minute guided-help phone consult to help you understand how to navigate this 44-page document & tips for easy implementation!  It’s awesome!)

Make sure you understand in detail, these specifics for:

Universal / Standard Precautions:  You already implement these practices with all patients.  These protocols protect the patient and employee from cross- contamination and include the following… Practice these virulently:

Hand Hygiene:  Use soap & water when hands are visibly soiled.  Use Antimicrobial Soaps when a blood-borne path may be exposed. Always wash hands thoroughly, after touching bare-handed objects, before & after treating patients or after taking off gloves.  That is a lot of hand washing!  Use of sanitizing hand gel is not a substitute for hand washing and should only be used when there is no visible soil on hands.

Personal Protective Equipment:  These items must be provided to all employees and worn during clinical and clean up procedures:  Safety Glasses with Side Protection or Face Shields, Surgical Masks (changed—at least one per patient), Well-Fitting / Non-Allergic Clinical Gloves, Puncture Proof Gloves (for all employees who handle soiled instruments), Ear Protection (for employees exposed to more than 2 hours / day of Turbine or Ultrasonic Handpieces ), & Lab Coats or Surgical Gowns.

Respiratory Hygiene / Cough Etiquette: This Practice will aid in preventing the spread of undiagnosed transmissible respiratory infections. Respiratory Hygiene will safeguard both employees and patients. Post signs for patients to understand proper Respiratory Hygiene.  Have touchless Tissue Receptacles, Masks & Sanitizer Gels available for patients.  Determine an Office Policy for treating or dismissing sick or contagious Patients & Employees. And—Stick to your plan!   Make sure your policy is written down.  (Use Appendix A & B at the back of the new CDC Infection Control Guidelines for Dental Offices).

Sharps Safety & Safe Injection Practices:  Be sure to toss all disposable Sharps into POINT-OF-USE Containers.  Do not walk around with disposable sharp— this lends for more chance of injury with that sharp object.  The clinician administering injections must re-load and re-cap anaesthetic syringes.  Do not hand back in-use syringes to another employee.  Recap with an approved recapping device or scoop-one-handed technique —in a direction that points away from your body.

Sterilization and Disinfection of Patient-Care Items and Devices: Sterilization & Disinfection of Patient-Care Items requires multiple steps.  Your team must meet-and-discuss the differences between Critical, Semi-Critical & Non – Critical Items to be processed.   Each dental practice must have written policies and procedures in place for containing, transporting, and handling instruments and equipment that may be contaminated with blood or saliva.  (Use Appendix A & B for this too!) If you have the Dental Enhancements OSHA Manual, you will find (2) customizable sections for your Infection Control Written Obligations. 

Environmental Infection Prevention and Control

Written Policies & Procedures for routine cleaning and disinfection of environmental surfaces should also be included in your infection prevention plan.

Cleaning removes large numbers of microorganisms from surfaces and should always precede disinfection.

Disinfection uses chemicals to eliminate microbes—but is not as virulent as sterilization. 

Both Cleaning & Disinfection need to be understood & in a constant process in your clinical areas.

Dental Unit Water Quality

Your Dental unit waterlines promote bacterial growth and development of harmful bacterial biofilm.  These water lines include plastic tubing that carries water to the high-speed handpiece, air/water syringe and ultrasonic scaler.  Employees and patients can be placed at risk of adverse health effects if water is not appropriately treated.  All dental units should use systems that treat water to meet drinking water standards which is LESS THAN 500 CFU/of heterotrophic water bacteria). Independent water-bottle systems—alone are not sufficient. Neither is distilled water use.  Make sure to treat all dental chair water with commercial-grade products or devices meet current regulations for quality water.

Remember to download and print the New CDC Infection Summary of Infection Prevention for the Dental Office Setting.

There is, undoubtedly a lot to review!  We understand that these new changes can be daunting, overwhelming and confusing!  Many dental professionals have loved our streamlined approach for implementing the CDC updates!  If you would like a better approach for understanding these changes, >>Click Here<< to request a Free 30-Minute Guided-Help Phone Consultation with an OSHA Expert to navigate the CDC Summary.

This session is so insightful!  It will take the guesswork and confusion out of understanding these new mandatory protocols.  We can provide peace-of-mind and help you get these requirements implemented into your day-to-day routines—easily!  Give us a call or click the link above to reserve your free 30-Minute Phone Session.   

Got More Questions?  Don’t hesitate to reach out to me or my team.  We are happy to provide clarification for any or your OSHA or HIPAA Compliance needs.

Written by: Jill Obrochta RDH BS

Dental Enhancements, Founder

Compliance Researcher & Trainer