Coverage of Tulsa dental clinics’ violations has been cautious

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Health officials in Oklahoma are working to test patients of two dental clinics for hepatitis and HIV, after an inspection turned up lax sanitation practices and other violations of the state’s Dental Act.

Shannon Muchmore

Shannon Muchmore

Shannon Muchmore of The Tulsa World has been covering the story, which has gone on to get worldwide coverage, with a steady stream of stories for the past month.

While getting out the latest news, offering descriptions of the lines of people waiting to get tested and exploring the fears of some of the 7,000 patients who state officials say may have been exposed – including one man who believes he contracted HIV while getting a tooth extracted at one of the clinics – Muchmore also has been careful to sound a cautionary note about the intricacies of tracing the bloodborne diseases back to their source.

“Test results have identified 57 former patients of Tulsa oral surgeon W. Scott Harrington who have hepatitis C, three who have hepatitis B and fewer than three who have HIV, the Tulsa City-County Health Department announced,” she reported in an April 19 piece.

“Health officials stress that a positive test result doesn’t mean the person got the disease from a visit to Harrington’s office, and some of the positive results are likely not related to his practice,” was her second graf. And then, this quote:

“We don’t know yet, so this is just the beginning of a more complex, epidemiologic investigation where we’re going to be interviewing those persons who have positive results and collecting a lot more information from them,” State Epidemiologist Kristy Bradley said.

Officials told reporters covering the story that day they had tested 3,122 patients. But, as Matt Peace of the Los Angeles Times noted, they cautioned that more detective work lies ahead.

“Officials said many of the Hepatitis C cases probably did not stem from Harrington’s practice, as 68,000 Oklahomans probably have the disease,” Pearce wrote.

According to the Centers for Disease Control and prevention, the transmission of such bloodborne pathogens to patients and dental workers in clinics is extremely rare.

The risk is reduced through the practice of “standard precautions” designed to protect workers and patients from pathogens that can be spread by blood or other body fluids. The precautions include thorough hand-washing, the use of protective equipment such as gloves, gowns and face masks, safe injection practices, and the mindful handling of potentially contaminated equipment or surfaces in the clinic.

Still, last year, similar fears were stirred, and stories written, after Colorado state health officials said dentist Steven Stein had been reusing sedation syringes on his patients. They asked thousands of them to get tested for HIV and hepatitis.

After all was said and done, Colorado officials did not find a link between any illnesses and Stein’s practice. But then again, that was never their goal, said Mark Salley, communications director at the Colorado Department of Health and Environment in an April 22 email.

“Colorado’s investigation of Dr. Stein is complete. The department’s role was to notify patients who might have been put at risk…to get tested. As we advised everyone – including local media who covered the story – even if a former patient were to get tested as a result of the notification…a positive test result DID NOT mean a positive link to having acquired the infection in the course of the dental visit. There are other means of transmission for HIV and hepatitis, and a positive test result would not identify how an individual become infected,” Salley noted.

“As I recall, fewer than a handful individuals who were tested as a result of the notification to past patients, did have positive results. But no, the state COULD NOT confirm any cases resulted from his lax practices because the source of their infection was not determined by a positive sample result.”

Here is some information from the Centers for Disease Control and Prevention about bloodborne pathogens in dental offices.

New investigation looks at state board

This weekend, an investigation by The Tulsa World‘s Casey Smith and Ziva Branstetter revealed the state’s board of dentistry “took disciplinary action against 68 licensed dentists in the state during the past 13 years, including 16 dentists whose licenses were revoked or surrendered.”

Violations included “substance abuse, improper prescribing practices and allowing assistants to perform work for which they were not licensed,” and some “involved dentists who violated the terms of their board probations, made improper sexual contact or remarks to patients, had misleading advertisements or took part in Medicaid fraud.”

The paper created a searchable database of board actions between January 2000 and January 2013 that is available on its website.

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