Professionalism and the Foundations of Dental Practice

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Professionalism is one of the most important fundamental aspects for a healthcare practitioner. It embodies the very essence of how a private practice should be operated properly. This is because it encompasses not one particular aspect of a practice, but all aspects.

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Without it, not only would the practice ultimately fail, but also everyone associated with the practice (patients, doctor, and staff) may be affected in such a way that his or her very well being, health, and safety may be put at risk. Professionalism does not strictly apply to private practice though. Professionalism applies to other healthcare facilities including educational institutions like Nova Southeastern University.

One of the fundamental aspects of professionalism in the dental practice is infection control. The same protocols apply to the orthodontic practice as well. This is because dental patients and dental healthcare providers have the potential for exposure to a vast array of microorganisms including HBV, HCV, HIV, CMV, HSV1, HSV2, Mycobacterium tuberculosis, staphylocci, streptococci and others.

Infection control is broken down into two tiers of recommended precautions within the healthcare setting: transmission-based and standard precautions. The less common transmission-based precautions are added level of precautions to standard precautions that are used when patients may be infected or colonized with certain infectious agents. These precautions are more often used in a hospital-based setting with added precautions like ensuring the patient is placed in an airborne infection isolation room (AIIR) in the case the patient is known or suspected to be infected with Tuberculosis and limiting transport and movement of the patient outside of the room for solely purposes that warrant medical necessities.

The more common tier of infection control within an orthodontic practice is standard precautions. These are used on every patient. Standard precautions are divided into sub-categories that include: hand hygiene, use of personal protective equipment (PPE), respiratory hygiene/cough recommendations, proper patient placement, proper handling of clean and disinfected instruments, handling of laundry, injection safety, and proper handling of sharps.

The recommended protocol for hand hygiene will vary depending on the procedure done, the amount of contamination present, and the desired persistence of antimicrobial action on the skin. Hand washing with soap and water is indicated when there is visual evidence of contamination of the hands with proteinaceous material or when they are visibly soiled with body fluids like blood. If the hands are not visibly soiled, then an alcohol-based hand disinfectant is suitable to decontaminate the hands. It is important for the healthcare provider to understand that gloves do not preclude the need for hand washing. The hands must be decontaminated before direct patient contact. Kalra et al. recommend hand washing for one minute under cold water to minimize the amount of skin pores that open and then use a hand disinfectant afterwards.

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