FYI

Dentist blog from Delta Dental

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Infection control best practices

In light of recent global health emergencies such as the COVID-19 pandemic and monkeypox, and with flu season fast approaching, infection control is more crucial now than it’s ever been before.

Infection control prevents or stops the spread of infections in dental settings and is vital for the safety of your patients and dental team. It’s a process that involves continuing education, engineering protocols, vigilance and a commitment to follow proven step-by-step measures.

The following steps, from dental consultant Dr. Michael Tarighati, take into consideration the latest knowledge gained from the pandemic, particularly concerning aerosol spread, to help you achieve infection control best practices and ensure that your facility is clean and safe.

Patient treatment areas

Start of the day

  1. Wash your hands thoroughly with antibacterial soap and water before appointments and after any interruptions. Keep your fingernails trimmed and make sure they have smooth, filed edges to allow thorough cleaning and prevent glove tears.
  2. Wear personal protective equipment (PPE), including gloves, masks (level 1, 2, 3, N-95 respirators), protective eyewear with side shields, reusable water repellant lab coats or disposable gowns, head bouffant and face shields.
  3. Flush your high-speed handpiece hose for at least three minutes to clear any residual water in the tubing before connecting the handpiece. The CDC recommends using a dental unit water that meets the regulatory standards set by the Environmental Protective Agency (EPA) for drinking water, which must have fewer than 500 colony-forming units (CFU/mL) of heterotrophic water bacteria.
  4. Inspect the anti-retractive valve in each air-water syringe to prevent backflow of water.
  5. Fill each dental unit water container with distilled water.
  6. Flush water from the air-water syringe for one minute, and for at least 30 seconds between patients.
  7. Disinfect environmental surfaces with the “wipe-discard-wipe” technique. Wipe the surface with a disinfectant wipe to clean it, discard the wipe and then use another wipe to disinfect it. Do not spray disinfectant directly on surfaces, and limit spraying to procedures such as disinfecting dental impressions. Disinfect any surface with which you, your staff or your patients might come into contact, including:
    • Doctor and dental assistant chairs
    • Dental chair switches and arms
    • Lamp switches and handles
    • Hose ends
    • Bracket table handle edges
    • Handpiece holders and levers
    • Air-water syringe tip
    • Evacuator/ejection couplings
    • Drawer handles
    • Top of mobile unit
    • Countertops
    • Digital radiograph unit
    • Intraoral camera
    • Digital intraoral scanner
    • Composite applicator
    • Impression mixing cartridge dispenser gun
    • Reusable dental materials
  8. Cover the bracket table and countertop with a polyvinyl or cover and place a paper tray liner on the patient tray to minimize surface contact with contaminated disposables.
  9. Place disposable barrier sleeves on light curing units, digital radiograph sensors and other dental material syringes.
  10. Leave instruments unopened in their pouch or cassette.
  11. Calibrate the dental ultrasonic cleaner unit in the sterilization area with distilled water and enzymatic ultrasonic solution.
  12. Have your patient rinse with an antibacterial mouthwash before starting the procedure.
  13. Remove your gloves and wash your hands thoroughly before leaving the operatory.
  14. Discard reusable gowns in a dedicated hamper.

During each dental appointment

  1. Adhere to good work practices. Wash your hands if you leave the operatory, replace gloves that are torn, cut or punctured, and discard gloves before leaving the operatories.
  2. Clean and wipe down clinical contact surfaces between patient visits with an EPA-registered low-level or intermediate-level surface disinfectant. The benchmark organism used to assess intermediate (or higher) level disinfectants is Mycobacterium tuberculosis (TB), because it’s comparatively difficult to destroy. Tuberculocidal action ensures that the product will destroy all important pathogens found in medical and dental environments, referred to as “TB kill.”
  3. Avoid injury with sharp instruments and needles. Manage sharp instruments carefully and use a needle shield. Use the one-handed scoop technique to recap needles.
  4. Place all sharp items, such as needles, ends of sutures, burs and broken instruments, in appropriate red puncture-resistant containers mounted to the wall, and ensure that the container doesn’t reach its full capacity. Ideally, use Isolyzer in each dental operatory, ensuring that it’s within its six months of use.
  5. Place soiled gauze and cotton rolls in biohazard bags.
  6. Flush water from your high-speed handpiece hose and air-water syringe for at least 20 to 30 seconds between patient visits to clear any residual water in the tubing.
  7. Put on heavy utility gloves when transferring dirty instruments to the sterilization center. Each dental assistant team member must have dedicated utility gloves.
  8. Transfer contaminated instruments in a cassette.
  9. Remove gloves when you open cabinets and drawers to minimize cross contamination.
  10. Discard dirty reusable lab coats in a dedicated hamper.

End of the day

  1. Remove gloves and wash your hands. Put on heavy utility gloves when transferring a dirty instrument via cassette to the sterilization center.
  2. Discard reusable gowns in a dedicated hamper.
  3. Clean up disposables in the operatory. Wipe countertops, mobile cabinets and sinks with antibacterial soap and water.
  4. Disinfect each dental unit with disinfecting wipes, including the chair, operating doctor and dental assistant chairs, hoses and the bracket tabletop.
  5. For surgical procedures, remove and replace the screen in the saliva ejector and insert a new waterline cleansing tablet.
  6. Shock both the high-volume evacuation (HVE) line and slow-speed evacuation line with a gallon of water mixed with shocking agent.
  7. Shock the dental HVE system in each dental operatory with dental evacuation system agents.
  8. Drain the dental ultrasonic cleaner unit in the sterilization area. Don’t leave instruments out overnight and place them in sterilization pouches or cassettes.
  9. Housekeeping surfaces such as cabinets, walls, and floors must be cleaned and disinfected regularly with a low-level disinfectant with detergent, especially when spills occur or these surfaces are visibly soiled. Vacuum and mop the floors with a low-level disinfectant, such as bleach and water. Avoid sweeping the floor to prevent creating aerosol.

At the beginning of each week

  1. Disinfect each dental operatory with disinfecting wipes, including the chair, operating doctor and dental assistant chairs, hoses and the bracket tabletop.
  2. Run a spore test for the autoclave. Repeat the spore test if the first test is positive. If positive results continue, contact your dental supply company for maintenance.
  3. Maintain autoclave weekly cleaning protocols.
  4. Vacuum and mop the floors with a low-level disinfectant, such as bleach and water. Avoid sweeping the floor to prevent creating aerosol.

At the beginning of each month

  1. Maintain autoclave monthly cleaning protocols.
  2. Evaluate your eyewash station to ensure it’s functioning properly.
  3. Inspect the anti-retractive valve in each air-water syringe.
  4. Inspect your compressor unit.
  5. Inspect your amalgam separator unit.
  6. Inspect the water from each dental unit in each operatory, especially if you use tap water rather than distilled water.
  7. Inspect the air conditioner and heater air filters throughout the office.

Dental laboratory areas

  1. Change the lathe after polishing a removable denture, complete denture, nightguard, sports guard or snore guard appliance. Transfer the dirty lathe to the sterilization area to be sterilized.
  2. Change the acrylic or diamond bur after each adjustment of fixed or removable prosthodontic appliances, such as crowns, and transfer the dirty bur in a bur block to the sterilization area to be sterilized.
  3. Disinfect the countertops, the dental laboratory lathe machine, sandblaster unit and dental laboratory handpiece.
  4. Vacuum and mop the floors with a low-level disinfectant, such as bleach and water.
  5. Use your office washing machine to clean all dirty lab coats with bleach and detergent, and then put them in the dryer. Don’t wash patient blankets with lab coats.

Front office areas

  1. Ensure that dental team members who leave dental operatory areas discard their gowns or gloves to avoid cross-contamination to the front office and patient reception areas.
  2. Provide hand sanitizer, and ask patients to apply it when they check in.
  3. Reschedule patients who appear to be sick.
  4. Use gloves when using disinfecting wipes to disinfect the areas, including countertops, computer monitors, pens, the front door handle and the payment terminal machine.
  5. Vacuum and mop the floors with a low-level disinfectant, such as bleach and water.

By taking these measures, you’ll continue to keep your patients and team member’s health and wellbeing a priority, ensuring that they’re safe from spread of infection and illness. Remember, always adhere to Standard Precautions, which are the minimum infection prevention practices for all patient care, regardless of the status of their health, in any health care setting, including dentistry. For more information, review the infection control guidelines set forth by the CDC.

Dentists and hearing loss

Dentist offices often try to bring a level of comfort and relaxation to patients, with easy-listening music playing in the background. But in reality, your office is never quiet. Throughout the day, you and your staff are using ultrasonic scalers, high-speed drills, air compressors and instrument cleaners in addition to other tools.

That noise can take its toll on your hearing. Noise levels in a dentist’s office routinely reach 90 decibels, with some machines topping 100 dB. Noises above 70 dB over a long period may damage your hearing, according to the Centers for Disease Control and Prevention.

As a result, dentists are twice as likely to suffer from hearing loss as the general population, and 21% of dental professionals have some type of hearing-related condition.

Learn the signs of hearing loss

So what can you do to avoid hearing loss? Start by establishing a baseline for your hearing. Get your hearing checked by an audiologist, and then periodically get it re-tested to see if there are any changes.

Hearing loss is irreversible but preventable. Learn how to recognize the symptoms of hearing loss, which include:

  • Trouble understanding conversations
  • Not being able to hear people when there is background noise
  • Keeping the radio or TV at a high level
  • Asking people to repeat themselves
  • Complaining that others don’t speak clearly

Protecting your ears in the office

You can take steps to reduce the amount of noise that gets into your ears. Some dentists and hygienists wear earplugs, but this can get in the way of good communication with your patient.

“Going to the dentist is such a vulnerable experience for patients,” said Dr. Jessica Buehler, Delta Dental’s director of dental affairs. “Dentists need to stay in touch with them, and it’s very hard to maintain that level of communication with earplugs in. They need to be able to hear physical responses.”

Luckily, technology is catching up. New earpieces with custom electronic circuitry compress sound when it reaches dangerous levels. When the noise decreases, it allows normal sounds back into the ear. These can cost anywhere from $35 to $600, depending on the technology and the noise compression you want to achieve.

Reducing the noise in your office can also help. Keeping your tools in good repair can lower the volume of sound they emit. You can also upgrade your cleaning and drilling equipment to the latest technology, which tends to be less noisy. Adding acoustic treatments to the walls of your room can help absorb the sound. Also, consider adding doors and soundproofing walls in rooms where the noise gets high, especially those that have your cleaning equipment and are generally empty.

You can also try to scale teeth manually instead of using the ultrasound scaler, one of the biggest culprits of noise in the office. But manual scaling can take a toll on your hands and wrists, especially if you have multiple clients in a day.

It’s impossible to get away from all noise while you’re in the office, but reducing your exposure to the louder sounds will help preserve your hearing and prevent permanent damage in the future.

Dentist spotlight: Dr. Alan Bui

Selling hot dogs may not sound like the most logical starting point for a career in dentistry. But Alan Bui, DDS, who grew up helping out with his family’s hot dog truck in Washington, D.C., says he loved befriending the truck’s regular customers. Cultivating relationships that could sometimes last for years made him realize that a career in dentistry — with its close, long-lasting interpersonal relationships between doctor and patients — would be the perfect fit for him.

Dr. Bui graduated from the University of Maryland School of Dentistry in 2020. We reached out to him at his office Simply Beautiful Smiles in Abington, Pennsylvania, to discuss his first few years as a dentist, his advice for others just starting out in the field and what he sees as the biggest challenge for dentistry today.

You grew up in northern Virginia and the D.C. area. Why did you decide to practice in Abington, Pennsylvania?

I went to dental school at University of Maryland. I got a position for my residency at Jefferson Abington Hospital in Pennsylvania. It’s about five minutes from where I work right now. My girlfriend and I liked it a lot, so we decided to stay and make this our new home. I love it here.

How and when did you decide to become a dentist?

I grew up in a working-class family that owned a hot dog truck in D.C. When I was selling hot dogs, I would see a lot of the same faces. I could catch up with them every day, and I really saw them throughout their lives. I knew I wanted to do something very personal. I knew I wanted to see people on a continual basis. I also loved science. Dentistry was the culmination of both those things. I can treat patients, get to know the story of their life, their family. I can see them throughout the years and really take care of them. I’m also able to apply a love of science to that. Dentistry was just the perfect fit.

Can you tell me about your work providing free dental care through Mission of Mercy events? Why do you think it’s important to give back to the community that way?

Dr. Bui works with Mission of Mercy in Pennsylvania, a free dental clinic for underserved Pennsylvanians.

Mission of Mercy is a group of dentists who organize events that offer two days of free dental care. A bunch of people line up at 4 in the morning, and we just volunteer our time doing procedures like extractions, fillings, even root canals. We’re there pretty much the whole day, starting at 6 am and finishing maybe 6 pm.

When I was growing up, my family wasn’t exactly poor, but we didn’t have health insurance and we didn’t have the money for things like dental care. I don’t remember having regular dental visits growing up. Luckily, I had good oral hygiene, but I can imagine many people in similar or worse circumstances where they don’t have insurance and can’t afford the dental care. Having a set day where they can access free care makes a big difference in their lives.

What advice would you give to other young dentists just starting out?

Some personal advice: Be honest. Patients know when you’re being honest with them. They can see it. The stress of dentistry goes away when you’re honest with yourself and honest with your patients. Being honest makes a big difference in having a good career.

A consistent challenge for dentists that’s becoming particularly thorny at this time is staffing. Do you have any advice or insight to give other dentists on the issue?

My advice would be: Take the time to check in with your team. Just now, I was having lunch with my team, and we were talking about our days, about life. Make sure everything’s OK with them, and always ask if they have any concerns or questions.

What do you love most about being a dentist?

Talking to patients. Addressing their nerves and anxiety. For me the best feeling is when a patient comes in nervous — you can tell by the way they talk and their body language. But once you take the time to gain their trust, to be honest with them, and have all that nervousness go away, it’s a really good feeling. It’s a great thing to have as a dentist.

What do you see as the biggest challenge for dentistry today?

I’m still a relatively young dentist, but from what I’ve experienced so far, it’s finances — whether or not a patient can afford things out of pocket. When I try to tell a patient they need something for the best long-term prognosis and the best outcome, it’s usually the thing they can’t afford. The biggest challenge is financial access to care.

What do you like to do in your free time?

I like physical activity. A lot of dentists can develop back problems, so I’m always at the gym or playing basketball. It’s almost always something physical. I hike a lot with my girlfriend. I like to be active.


Congratulations to Dr. Bui of Simply Beautiful Smiles for being our Dental Health Partner of the Month, and a big thank-you for taking the time to share his thoughts with us!

The dental office and mental health: what you need to know

Dentistry can be a stressful and challenging profession. Teams like yours can often face depression, anxiety and other mental health issues. For Mental Health Awareness Month this May, take some time to get a closer look at why many dentists and their staff face mental health problems and what you can do to improve overall well-being in your office.

Dentistry and mental health

The percent of dentists diagnosed with anxiety more than tripled in 2021 compared to 2003, according to the 2021 Dentist Health and Well-Being Survey Report from the American Dental Association (ADA). The ADA also found 13% of the dentists reported that they suffered from depression, while it’s estimated that only 3.8% of the general population is affected.

The challenging, demanding work of a dentist’s office can affect the well-being not just of dentists but of office staff, as well. Dentistry can be an especially stressful profession because dentists and their staff often:

  • Work in isolation in confined, small, sometimes windowless spaces
  • Deal with time constraints, economic challenges and other business-related pressures, many of which have only worsened with the advent of COVID-19
  • Perform stressful procedures on a sensitive part of the body with no room for error
  • Deal with long working hours and a heavy workload
  • Face an unfavorable public perception of dentists and dentistry
  • Work with patients who may loathe or resent visiting the office
  • Provide care for others on a day-to-day basis and may not be as accustomed to caring for themselves
  • Are often high achievers who may view reaching out for help as a sign of weakness or failure

Know the signs

As a dentist, you’re trained to identify oral pathology by clinical evidence, diagnostic testing and a patient’s own account. But identifying mental health problems can be very different. Signs related to mental health issues are most often manifested as behavioral changes or they’re experienced internally by the affected individual in the way he or she thinks and feels.

Common signs and symptoms of someone dealing with depression, anxiety or other common mental health issues include:

  • Behavior that is uncharacteristically sad, irritable, critical, indecisive or disorganized
  • Reduced productivity or frequent absence from work
  • Loss of interest in hobbies and other pleasurable activities
  • Withdrawal from friends, family and other social activities
  • Expressions of negativity or feeling “helpless,” “burned out,” “lost” or “hopeless”
  • Frequent complaints of tiredness, headaches, stomach problems, back pain or other aches and pains
  • Changes in sleep, such as insomnia or oversleeping
  • Changes in weight or diet, such as eating more or less than usual
  • Abuse of alcohol or drugs, including prescription medications

These symptoms may increase in severity and frequency over time. In advanced cases, affected individuals may lose their ability to support the team and function in the office.

What you can do

Raise awareness and reduce the stigma

Make sure you and your staff can talk openly about problems and reach out for help without negative judgment. As an office leader, you can model this behavior by talking openly and honestly about stress and problems you may be experiencing. Remember that your colleagues and staff could be experiencing similar issues, so openly sharing can be comforting and encouraging. If you don’t suffer from mental health problems, work to be empathic and supportive of those who do.

Resources and assistance should be available and accessible, and using them should never threaten someone’s job or reputation. Consider adding an employee assistance program (EAP) to the offered benefits at your practice if you haven’t already.

Take care of your emotional health

Here are some tips for self-care during stressful times:

  • Take care of your body. Try to exercise regularly, eat well-balanced meals and get enough sleep. Limit your alcohol intake and avoid tobacco and other drugs.
  • Connect with others. Share your concerns about how you’re feeling with a friend or family member. It’s important to maintain a strong social support system and to build healthy relationships during difficult times.
  • Take breaks and vacations. Allow yourself time to unwind and engage in activities you enjoy.
  • Seek help. If stress is impacting your life and work, don’t be afraid to seek out help from others when you need it.

Know where to turn for help

The following free resources can help promote mental health in the dental office:

Other mental health resources include:

  • The National Suicide Prevention Lifeline (800-273-8255). Provides 24/7 free, confidential support for people in distress as well as best practices for professionals and resources to aid in prevention and crisis situations.
  • NAMI. The National Alliance on Mental Illness provides advocacy, education, support and public awareness to individuals and families affected by mental illness.  
  • SAMHSA. The Substance Abuse and Mental Health Services Administration is an agency within the U.S. Department of Health and Human Services that leads public health efforts to reduce the impact of substance abuse and mental illness on America’s communities. Their resources include a helpline at 800-985-5990.

The mind, just like the mouth, requires constant care. Optimal mental health is a crucial part of your practice success and your overall well-being. Don’t neglect mental well-being in your office or feel shame or stigma about needing to reach out for help.

Meet Dr. Jessica Buehler, Director of Dental Affairs

Whether she’s motorcycling through the Alps or hiking through Southeast Asia to bring aid where it’s needed most, Dr. Jessica Buehler approaches what she does with passion, courage and commitment. That includes her work rewriting Delta Dental’s Quality Improvement Plan and bettering the oral health of members through her wellness webinars as Delta Dental’s Director of Dental Affairs.

We recently caught up with Dr. Buehler to discuss her work at Delta Dental, her time as a frontline provider during the early days of COVID and her dual passions for traveling and musical theater.

I think a lot of people, including even some dentists, might be surprised to learn that a dental insurance company like Delta Dental has dentists on staff. Can you tell us about the work you do for Delta Dental?

My work is to support our quality program. Insurance plans are regulated by the Department of Insurance and other regulatory bodies to ensure that the care is appropriate. It takes clinicians to be a part of that process so that key decisions about care and quality aren’t made by laypeople. They’re made by clinicians who have practiced and treated patients just like our dentists.

What initially led you to dentistry as a career?

I was overseas on the San Blas Islands off the coast of Panama working with an indigenous tribe on a summer mission trip. I volunteered to help a Panamanian dentist who was assigned by the government  to do health work on the island. I saw severe infections — people who had no access to care. It opened up my heart to this way to impact the world; it showed me how much dentists can improve people’s lives, not only in the U.S. but also overseas where people don’t have access to care.

What are the biggest rewards of your work now?

I feel my ability to impact oral health in this country is much bigger working for a plan. When you’re working as a chairside dentist, your impact is limited to only those patients you touch or the community events you volunteer at. Right now, I’m giving enrollee wellness webinars that are live-cast across the country to hundreds of enrollees at once. Having an impact on a stage that’s much bigger is really fun for me.

What do you miss most about being a chairside dentist? What do you miss least?

I miss the connection with my patients. You don’t realize when you go into dental school as a young person that your patients follow you for years and years. I saw couples get married and have babies. I saw babies grow into high schoolers. I saw couples get divorced and people pass. You are an intimate part of people’s lives over time. It feels like you’re checking in with old friends every time you see these patients. And when I went through those big life events like getting married and having a baby, my patients were there for me. I’m separated from that now, and I miss that.

In terms of what I miss the least: staffing. Staffing is impossible right now. Overall, dentistry is one of the hardest jobs in the world. It’s not for the faint of heart. 

I was so impressed to learn that you were a frontline provider during the early days of the COVID pandemic. It’s only been a couple years since then, but many of us have forgotten (or blocked out!) how very scary that time was, how many unknowns there were. Can you tell me about your work during that time?

When COVID hit, I was a regional clinical director supervising over 80 clinicians and specialists in Seattle. We were the epicenter of when it was first blowing up. Things were happening very fast, and there was very little guidance at that time, but we knew we had to do something to help. We had to make tough decisions about closing our offices: We had around 30 offices, and we went down to four.

The government was coming into dental offices and taking PPE, but we were expected to care for patients. My husband’s in construction, so he got a welding face shield for me and a construction and painting P100 respirator with a mask over the end. It wasn’t just about keeping myself safe. I was dealing with a lot of anxiety trying to keep my team safe. Some of my colleagues who worked for me had at-risk relatives at home. Some of them had health conditions. I was driving around the state to gather whatever supplies I could find in the construction world to provide to my doctors who were working those frontlines. It was a really scary time.

What do you think are some of the most important things Delta Dental can do to help maintain strong, positive relationships with dentists?

I think being empathetic to how hard dentistry is. It’s easy to go into a dental office and think a dentist is just a “tooth-counter.” I’ve had people say to me, “You make way too much money for what you do.” But a lot of people have no idea what dentists do! It’s a really hard job. It’s even hard on your body, too. You have to manage the emotions of your patients; you have to manage your staff. It’s challenging to be a business leader and a clinician and everything else.

Speaking of playing multiple roles, I was interested to learn that you have a background in musical theater. Can you tell me a little bit about that? Do you feel that your work in theater and performance helped inform your daily work as a dentist at all? Do the two pursuits have anything in common?

My parents always said, “Do whatever you want. We know you’ll succeed at whatever you decide.” So, I got really involved in musical theater and lighting design when I was in college. I loved the theater, but I realized I was a bit too organized and Type A to hang forever in that world…

I still love and appreciate the theater, but I come from a science family, and I almost felt dentistry was a calling. Once I got it into my brain, I couldn’t get it out. But, the things I learned in the theater — to ground yourself, to speak and perform with confidence — are really important and have helped me grow a lot as a provider.

What do you like to do in your free time?

I’m an avid reader. I run a book club for a community inclusion group at Delta Dental, Women@Delta. I love everything outdoors: stand-up paddleboarding, snow skiing, camping, hiking, wakeboarding, all of it. Just put me outdoors and I’m a happy girl! I love to travel. I did a motorcycle tour through the Alps, hitting seven countries in Europe with my dad. He’s passed now, so that’s one of my favorite memories… I love Thailand. I love Australia. I’ve done work in Southeast Asia in countries that aren’t even open to Western aid. I backpacked in and brought dental tools and taken teeth out, all sorts of crazy stuff. I have a family now, so I don’t do as many risky things now, but I still love to travel!

What to know about sexual harassment by patients

Approximately 86% of dental hygienists in the U.S. reported experiencing inappropriate patient sexual behavior at some point in their careers, according to a study published in the August 2021 issue of the Journal of Dental Hygiene. About 63% of hygienists experienced harassment within the past 12 months, including patients staring at their bodies, grabbing them or making overtly sexual remarks.

This study looked specifically at dental hygienists, but harassment can affect any role in the dental office. Here’s what all office staff should know to handle cases of harassment, and what practice owners should know to support their team.

What staff should know: How to handle patient misconduct

If a patient behaves inappropriately, it’s important to address the behavior promptly and directly.

Before harassment occurs

Familiarize yourself with your office’s policy on harassment. If your office does not have a written policy (some states may not require it for smaller offices), review federal and state laws on the topic. 

In the moment

Using strong body language and a firm voice, tell (don’t ask) the patient to stop their behavior. There is no need to be apologetic.

Try language like:

  • “I don’t appreciate your advances and would like you to stop right now”; or
  • “What you are doing/saying is making me uncomfortable. Please stop immediately.” 

After the incident

Immediately report what happened to your immediate supervisor (or HR representative, if your office is large enough to have one). Be sure to keep your own notes documenting the incident, including details, such as date, time and description of the behavior. It’s critical to document every instance of inappropriate behavior. Remember that retaliation against you for reporting sexual harassment is illegal. 

What dentists need to know: How to support your staff

Know the rules

Federal law (specifically, Title VII of the Civil Rights Act of 1964, or “Title VII”) makes it illegal for employers to allow anyone to be sexually harassed at work by anyone else, regardless of sex, gender or sexual orientation. Sexual harassment can happen to a person of any gender, and the harasser can be of the same or different gender.

While federal laws may be limited in scope, such as only requiring written policies for workplaces with more than 15 employees, state laws may be more stringent.  Be sure to know and adhere to the requirements for your office location, and consider having a policy regarding harassment even if the law does not strictly require you to do so.

Support your team

If hygienists or other staff members report misconduct by a patient, always take them seriously. Listen to their description of the incident and assure them that the issue will be addressed with the patient. Encourage them to report and document any other incidents and thank them for coming forward.

Address the issue with the patient

While it is a difficult conversation to have, discussing the incident with the patient and making it clear that the behavior will not be tolerated and must cease is a critical step. Depending on their response, you may need to take steps to manage the situation, up to and including termination of the patient relationship. 


Having preventive strategies in place including a clear policy and open communication addressing sexual harassment helps you maintain a healthy, respectful and supportive work culture.

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