A few months after I graduated from dental school in 1981, I heard the terms HIV and AIDS for the first time. The next few years were very scary. Over those years many things happened to make it less scary and by the end of the 80’s we had a new normal and a sense that transmission of this horrible disease could be prevented in the dental office.
First, the global scientific community got busy. Research was done all over the world. Facts came to light. The unfiltered truth came to light. Empowered with knowledge, dentistry changed. The need to prevent the transmission of blood borne pathogens became our #1 priority. By following new guidelines, we moved forward safely. Perfect safety was never guaranteed, but with careful adherence to the protocols that were now known to work, we did not have a problem protecting ourselves, our staff and our patients.
This chart shows some of the key changes I recall from my experience, it is by no means a complete list, but if you wonder what may change now, just look at some of the things that changed in the 80’s and imagine.
|Before AIDS||New Normal once AIDS was understood|
|Worked in “street clothes” & jacket||Scrubs and Jacket|
|Dental handpieces could not be sterilized (destroyed by autoclave)||Handpieces were reinvented. Autoclaving became the new normal. Throw away the old ones.|
|Plastic covers were not common||Everything covered|
|Surface disinfection of countertops was more for cleaning than asepsiptic standards||Surface disinfection became standardized Chemicals known to work best were identified.|
|Cold “sterilization” was used for certain instruments under certain conditions||Never, Never, Never|
|Instruments kept in drawers unbagged||All instruments bagged, autoclaved and stored sterile|
|Gloves used only when contact with blood was anticipated||Always, Always, Always!|
|Masks were frequently, not always used||Always, Always, Always!|
|Eye protection not always used||Always, Always, Always!|
Second, we began to manage fear. The facts about this disease caused everyone to be fearful. But, layered on top of that was the fear from the unfounded and the misleading stories that circulated. These get a tremendous foothold in the beginning, when little is known for sure about a new virus. Then it becomes a challenge to change those beliefs once we know more facts and more about managing the reality of our world. The fear lives on long after we figure out the science of the problem. It is the biggest obstacle to achieving a new normal.
Now we are facing the biggest global pandemic spread by respiratory borne pathogens. Another very scary time for dentists, hygienists and clinical assistants who work in the “breath zone”. Its scary for the rest of our staff and for all of our patients.
But we do know what to do. It’s the same game plan as before. To quote Matt Damon in “The Martian” “we are going to have to science the shit out of this”. This will lead to the next new normal. And, just as before, we will be safer because we raised the bar on infection control.
Knowing that the right answers will come from science, we can be assured that we will once again be safe and provide safe dental care to our patients.
Knowing that the fear will need to be addressed, we need to wait on our recommendations for patient care until we know in our hearts that the correct path has been provided. Then we can speak with confidence to our patients about safety.
The right way to the future will soon come to light. Between now and then we must be careful not to over-react and we must never under-react. These are uncertain times, but with diligent study, working together, we will come through this with new knowledge, new skills, new tools and the safest protocols the world has ever seen. We’ve done it before!
– Michael R. Thompson, DDS