CDA Essentials 2017 • Volume 4 • Issue 7

9 Issue 7 | 2017 | CDA at W ork T he only thing that is constant is change.” This adage, when applied to the rapid pace of change we are experiencing in our society and profession, can leave us with an uneasy sense that the ground is constantly shifting beneath our feet. The need to keep up with changing regulations, best practices, and innovative technologies can keep dentists scrambling to stay informed and in compliance. Take infection control and prevention as a recent example. Dentists are professionally obligated to be knowledgeable about current standards in infection control and prevention and apply them in their practices. In Ontario, two dental offices were found to be below these standards and were temporarily closed this summer after local public health units reported lapses in infection prevention and control practices. A statement from the public health unit that inspected and closed one of the clinics suggests that although sterilization procedures were in place, they didn’t strictly adhere to best practices. In general, I see the potential for confusion about what the best practices are, if (1) requirements changed but were not well- publicized, or (2) best practices, as defined by different professional bodies, public health units, and equipment manufacturers, are not harmonized. Adapting to new guidelines that call for changes to long-standing behaviours can be a particularly challenging and slow-moving process. To illustrate, consider that in 2014 CDA revised its guidance on prophylactic antibiotics for prevention of infective endocarditis, supporting guidelines of the American Heart Association. The change was this: prophylactic antibiotics, which in the past were routinely administered to patients with mitral valve prolapse (and other specific conditions), were no longer needed. Yet a recent CDA-commissioned report based on a survey of dentists (as yet unpublished) shows that three years after the guidelines on antibiotic prophylaxis for preventing infective endocarditis were revised, some dentists were not aware of the changes. Over 20% of dentists who responded to the survey wrongly reported that patients with mitral valve prolapse required antibiotic prophylaxis for prevention of infective endocarditis. The report also notes that over- prescribing for these patients can happen if dentists’ prescribing decisions are influenced by cardiologists and medical practitioners who, in not keeping up with changing guidelines, continue to do things the old way. Dentists are constantly bombarded with information and need support to stay informed in all areas that could affect their practice. CDA, and other organizations like the provincial dental associations and regulatory bodies, are there to help dentists prepare for and manage change. CDA takes its responsibility to keep dentists informed seriously and is constantly striving to provide up-to-date, user-friendly information. Reading CDA Essentials and the Oasis Discussions website will help keep you current. Providing our patients with optimal care demands continuous learning. We must all be constant students and lifelong learners. When the ground is shifting under you, taking the necessary actions to regain your stability is the only way to avoid falling down. From the President Larry Levin, dds president@cda-adc.ca Lifelong Learning: Navigating Shifting Sands