Eye Protection with Leslie Canham

Today, we're going to be tackling eye protection. I think. Probably for both the provider and the patient. I think it's a topic that's so important in creating those safer dental visits. And I'm thrilled to be joined by Leslie Canham, who brings a wealth of knowledge and practical insights to the, to this audience today. So welcome so much, Leslie, for coming on.

For team members who are performing clinical tasks, and that's everything from providing patient care to, processing instruments, and it concerns me a great deal because I have, some information that I received from, A person who has actually had an eye injury, a dentist, Dr. Peter Arsenault, his studies revealed that 70 percent of dentists experience some degree of ocular trauma throughout their entire career. And many times it's because they're not wearing appropriate protective eyewear.

So when I see people working with patients who are wearing eyewear, but maybe not necessarily appropriate protective eyewear, it's concerning to me.

As you know, we have two eyes, and when you lose your sight in one eye, it makes your depth perception, in a way that you may not be able to deliver dental care or do other things that you're used to doing because you simply can't focus and do what you need to do to be able to deliver dentistry or again, other things that you might enjoy doing in your life.

one of the concerns that I have is that it's, the not wearing appropriate protective eyewear, but then it's up to the employer to provide that appropriate protective eyewear. The right message comes from the top, and we have buy in from the leaders of the practice when it comes to personal protective equipment. Everyone else will follow in line.

And the new ANSI standard actually brings into the language appropriate protective eyewear and deals with something called the bottom gap. And the bottom gap is the space where the safety glasses and the user's cheek is. and today what we're finding is that bottom gap allows debris, blood, or other potentially infectious material to get to the wearer's eyes.

With appropriate protective eyewear, many of us are wearing face shields because during COVID, we found that face shields were providing us a better protection and allowing us to extend the use of an N95 respirator by keeping it cleaner from splashes and spatters.

And when I talk with folks who have switched from protective eyewear to a face shield, they tell me that It's amazing what collects on the outside of a face shield and that they had never realized how much they had been pummeled with everything with that close proximity. you think about it, your face is the biggest piece of real estate besides your hands that are right up there.

there next to a patient's mouth and when you add rotary instruments and aerosols and debris, it can be for hygienists, it can be prophy paste or, chunks of calculus or tartar, for dentists and dental assistants, it might be restorative materials and, oh gosh, I had one client who was wearing loops. He mentioned loops. He was wearing loops and he was sectioning a bridge and a piece of porcelain managed to get past his loops and embed in his eyes.

And he said that was just the scariest thing that ever happened to him as a dentist. And he remembers being in the emergency room thinking that, Oh, he hopes he doesn't have, Permanent damage as a result of this.

I, it was the best thing that came to me because of the silver lining, if you will.

I remember a hygienist telling me about an experience where she had a little bit of a prophy paste that behind her brow shield or brow guard on her safety eyewear and actually landed on her eyelash. And I remember her saying that if I had not linked at that particular moment, that might have gone into my eye. So it's not just dentists, it's hygienists and then dental assistants.

If you can think about the position where a dental assistant sits next to a dentist, when a dentist is Prepping a tooth. You can see how we could have all sorts of debris that was, could fly at us from the side as well. So appropriate protective eyewear that, that wraps around well.

I like the kind of eyewear where there's a gasket where you actually, and again, and other innovations that we have seen that sort of transferred over from, I, I want to say, those guys that wear skydiving glasses where they have the gasket around it and how it sits firmly. But I've also seen bicycle riders who are out on the road and they come across everything from gravel to bees and other things on the road where they have a gasket all the way around.

and so, you know, what better protection could that be than having that type of availability to cover your eyes?

So any way that we can look at making it safer and then getting the word out there, and as consultants, we are constantly talking about protective eyewear, not only for ourselves, but for our patients as well. And, I remember you and I both belong to an association called the Association for Dental Safety, formerly called OSAP, Organization for Safety, Asepsis, and Prevention. And several years ago, we had a guest speaker who was a young lady who had an experience in a dental chair.

She was not wearing protective eyewear and she had a very severe eye injury that cost her eyesight. and for those listeners that are in this podcast, her name. It was Jen Morone, and she actually has a couple of YouTube stories that you can Google her.

Her name, Jen, is J E N, and I believe the last name is M A R O N E. And she spoke to our group describing her Typical visit at a dental practice where she had gone to have a routine root canal and she was anesthetized and she described the, assistant and the doctor were, handling the syringe. The doctor apparently was passing the syringe over her face, somebody fumbled and the syringe. fell out of the hands of the dental worker, landed needle first in her eye.

Well, she suffered a very severe eye infection. And as she described it, it was not necessarily, an infection from just a needle. Any infectious agents you might find in a dental office. It was a staph bacteria, so it was from her own mouth to her own eye. And, she later after the dental visit had to be admitted to the emergency hospital where she, suffered all sorts of eye wash procedures to try to eliminate the infection in her eye.

And apparently the infection was so bad that it required removal. So her, today she has a prosthetic eye or a prosthetic plate on her eye, something that, that actually looks very normal and very real. And you can't tell which is actually her natural eye and which isn't. And great advocate for patient safety when it comes to protective eyewear. How many times do we have patients that sit in the chair and decline to accept the protective eyewear that we offer them?

And then, it even just the roughness of perhaps prophytase that, is there anyone can think of how it might feel if it had a grain of sand gets you in the eye and how uncomfortable that would be for a patient and how that could scratch their cornea.

And it's flying off and like that, your eyelid, I guess, will give you some protection, but like, why do we chance it? Why are we chasing any of that?

Now, you said that there was, like, some standards, that OSHA follows. One of the things that I thought was interesting in one of the ADS courses was that, we can't just use the plasticky type of, eyewear as our preferred eyewear because it might not actually hold up to some of those, things that ricochet out from a handpiece or something.

And then, there were different types of facials that were designed to provide a little bit more room for the loops. I've also heard that sometimes facials can create sometimes a glare and that may be difficult for the provider to be able to really see well. As we go along, looking at the different types of eyewear that we could wear to protect ourselves, looking at the type of eyewear maybe that our team members are wearing, looking closely at, for example, eyewear prescription glasses.

And when I see people wearing prescription glasses, again, unless they're designed as safety eyewear, impact resistant lenses, solid side shields, brow guard, and then consideration for the bottom gap. They're really not appropriate protective eyewear. So something has to be done to protect individuals. And OSHA holds the employer responsible for providing this. So there's a great deal of liability that rests on the employer's shoulders when it comes to eye injuries.

And again, in dentistry, it could cost us our career. If we lose the sight of one eye.

You trained me, you provided it, can I even make a claim? And she was like, potentially not, because you were trained and you made those decisions. But then my other thought is like, Should I even allow if I'm the employer and my team is just making choices to not do that? is my liability even higher on that because they could get injured and now I gotta pay for that? Like I'd be upset if I was an employer.

Working in a safe environment is a choice. And when someone chooses to cross the threshold of a dental office and work for a dental practice, they need to agree to abide by the rules and the standards of the office. We have certain policies, maybe somebody says, I'm always late. tardiness is not an option. sometimes things happen, but on a routine basis, I choose not to wear protective attire, or I don't want to wear a clinical jacket. It makes me too warm.

if you choose to work for a dental practice. us. you choose to abide by our safety standards. These are those standards. We require this in our offices of the policies and you're welcome to find an office that suits you better if you want to work somewhere where they're not going to enforce safety. When we protect ourselves, we protect our practice and you're right about the individual that says, I just want to wear my prescription glasses. I don't want to wear, safety eyewear or a face shield.

it's lumpy, it's bulky. in that case, they're not protecting themselves and. I think from the patient's perspective, for those patients who know a lot about PPE, thanks to COVID, they know all about protective eyewear, they know all about how to wear a mask, how not to wear a mask. If they look at us and say, if they can't protect themselves, how can they protect me when I'm in this chair?

And, as far as liability goes, again, the employer certainly has an obligation to enforce the safety standards or the safety policies of a dental practice. So I think OSHA would be very concerned if an employer let employees choose what they want to do.

Like it really, I know that sometimes the perspective of infection prevention and, safety and the things that we're required to do is a burden. It feels frustrating, feels annoying. But really, if you like just adjusted that perception, like you'd see that it's because you matter, like you matter, your sight matters, your body matters, and you really can't pour into other people in a healthcare profession unless you're filled up yourself. And so take care of y'all. Take care of you.

It's so important.

And if you think about something hitting you in the eye, causing an infection, how uncomfortable that would be for you and the potential other bad, And that, that could come to any other, sometimes infections can, are difficult to, knock down and sometimes an infection in one eye can travel to the other eye. And of course, certainly, pinkeye or conjuctivitis is contagious. So there's, a lot of opportunity to infect others within your family and patient population.

And according to the CDC guidelines, that's one of the conditions that would prohibit us from being at work. It's called a work.

And now the office is not producing or they had to bring in a temp. And now I'm not making the money that I need to make. And like how many days until that clears up? Usually it's not too bad with antibiotics, but like you never know. And I think that's a sensitive subject for a lot of us that are working. Maybe not exactly paycheck to paycheck, but you got to work. And if you're not working, you're not getting paid.

So my dad's a dentist and we worked together again. I was 16. I started working for him. It was a funny story, Michelle, because my mother told my dad that if he didn't take me to the office, that she was going to kill me. So

but I also remember hearing a lot about, there was sometimes there would be splashes and spatters that would occur for dental workers, and they would suffer from something like ocular herpes. from oral cavity to, to the eyes. I remember myself when I was working chair side, and we were standing, mind you. We hadn't discovered four handed sit down dentistry yet, so I'm really dating myself here.

But, I remember it was warm, and we were on the third floor of a five story building in the San Fernando Valley, California, which is going to get over a hundred in the summertime. and I used to lean into the cool mist of the hand. It would fall my forehead. and, I remember being pummeled with just different. pieces of either tooth or amalgam or whatever, and I'd have to blink my eyes against it. And my dad finally said, he finally agreed that maybe I should go get some safety glasses.

And I went and got some safety glasses. They were clear glass, because I had forfeit vision back then when I was a teenager, but they were impact resistant. And so I got through that. days. And then my dad finally had to tell me, he said, now that we've got your eyes covered, Leslie, you got to stop licking your lips when you're working on patients. That was one of my nervous tendencies.

Like it's, I think we can all be like, we haven't done it. Perfect. But I suffered a ton of upper respiratory infections. for whatever reason, I always covered my eyes cause it's probably the only thing that actually works well on me is my sight organs, so I like to keep those as healthy as possible, but I think we just, we know. better and we should do better. I know that's not everybody's motto just because they know better doesn't mean they always do better.

But I think if we can make these steps to protecting ourselves and our patient and going back to pink guy, how angry I would be as a patient. If I got pink eye from my dental office. Are you, I'd be so upset, especially if I had kids and stuff, like I'm now this highly contagious thing. protect your patients, protect yourself, it is so critical, we create so many spatter sprays, aerosols, debris, chemicals that we use, it's so important.

Team members are, aware of the hazards that could occur to their own eyes and to their own wellbeing.

And so we can, you can hear our podcasts from your favorite podcast channel or from our website. ComplianceDivas.com.