Never make assumptions during your dental career

The people we work with, the materials, instruments and equipment we use and the dental laboratories with whom we work, and professional colleagues to whom we refer patients or who refer patients to us, are all part of our clinical routine and ‘comfort zone’.

But over time this familiarity can create risks of its own because we might assume that other people are doing things when in fact they are not, or that certain aspects of a process will take place in a particular way when in fact it won't.

Assumptions are as dangerous in clinical dentistry as they are in aviation and other fields, and we need to guard against them and the risks that they can create.
Examples might include the safety features on certain types of equipment, or an automatic timer on an x-ray machine, curing light or other device. In these and other instances there is no room for assumption - for example:

• Assuming that someone else is following agreed procedures in the area of decontamination and infection control.
  Assuming that a dental nurse is adequately protected against Hepatitis B, having appropriately sero-converted following immunisation.
• Assuming that a sedated patient is accompanied by a responsible adult who fully understands their role and responsibilities.
• Assuming that a new dental nurse if familiar with how to mix a particular dental material or to use a particular piece of dental equipment safely and effectively.
• Assuming that someone else has explained the nature and purpose, risks, limitation and benefits of a procedure as part of the consent process.
• Assuming that someone else will take responsibility for keeping an adequate and appropriate record of some aspect of a patient's care and treatment.
• Assuming that a particular piece of equipment (such as a washer-disinfector, or autoclave or eye protection) is doing the job for which it is designed. Are we, for example, regularly auditing the consistency and effectiveness of these procedures?
• Assuming that someone else is ensuring that equipment is regularly serviced and maintained, and operating properly.
• Assuming that patients are actually taking medication that has been prescribed for them.

It will be seen from this list of examples that we might take many things for granted in our professional lives. Nine times out of ten, our complacency does not lead to an adverse outcome, but it's essential that assumptions are not made and thereby reduce the risk to both our patient and our dental career.