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What do you do when the dentist makes you still see patients who come in sick or with herpetic lesions?

When a patient calls in to reschedule their cleaning appointment because they have a cold or have a fever blister, the front desk staff have been instructed to tell the patient that we can still see them. I know this is not safe and is putting us at risk. When I bring up my concerns, I’m told there is nothing to worry about and that I’m safe. There is a reason why we were taught in school to NOT see these patients. Since we are expected to still see these patients, are there any extra precautions we can take to protect ourselves? Also, two of our back staff members are pregnant and I worry about the safety of their unborn babies.



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2 Answers

It sounds to me whoever is telling you, “You are safe,” needs to be educated. Treating patients for elective procedures who have active herpes or who are sick not only puts you and the rest of the dental team at risk, but other patients who enter the practice. Especially immunocompromised patients; children, the geriatric population, patients taking immunosuppressants for autoimmune disorders, etc. Further, the production gained by treating these patients can be lost if you, as a producing clinician, are out sick. Going further, imagine if the entire office came down with the flu! There goes treating any patients! So while it seems like a boost in production in the short-term, it can mean a loss of production over the long-term.
 
As clinicians, we practice standard precautions, however, there’s no way to “clean the air.” Some bacterial and viral aerosols can linger in the air for hours and not all offices have an HVAC system that’s up to par. For an immunocompromised patient, a simple cold can be deadly. Herpes is present in saliva for 3 weeks and ocular (eye) herpes is the leading cause of blindness. Herpes can even be deadly to an infant.
 
Though we disinfect operatory surfaces, after a sick patient enters the practice is the entry door cleaned? The magazines, front desk, chairs, or anything they came into contact with in the reception area disinfected? This might seem extreme, however, to an immunocompromised patient it matters. No one comes to a dental office hoping to get sick and exposing patients and staff for production reasons is not ethical in my opinion. Is this a practice your core values are aligned with?
 
I’ve written two versions of an article on why a hygienist should never treat a patient with an active herpetic lesion, which perhaps you should show the person giving the okay to treat. Here are the links (References to studies are at the end of the articles):
 
http://www.dentalproductsreport.com/hygiene/article/why-dental-hygienists-should-not-treat-patients-active-herpetic-lesions
 
https://www.todaysrdh.com/why-hygienists-should-never-treat-patients-with-active-oral-herpes/
 
I’m sorry and downright disappointed for your situation! I would encourage you to try and educate this person. Print as many resources and share them as you can find. I applaud you for looking out and being an advocate for yourself and your co-workers!

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I am curious to see how you confronted them with this info & situation. Please do an update on how it went & what you did!

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