Standard Operating Procedures (SOP) in Dentistry

Standard Operating Procedures (SOPs) are the building blocks of any successful organization. As professional tasks have become more complex, making it almost impossible to be free of mistakes, SOPs and checklists are becoming an integral part of work. In his book “The Checklist Manifesto”, Atul Gawande describes how true experts, who cannot afford to make mistakes, make use of checklists to complete their tasks successfully. A perfect example is in the aviation industry, where the smallest error can have dramatic results. The same principle applies to dentistry. Overlooking a small step in operating procedures can lead to an infection or other issues for a client, which can not only be detrimental for them but can also have devastating consequences for the reputation of a dental practice and possibly the health of the team.

What is an SOP in a dental office?

A standard operating procedure is a written, step-by-step description of how a specific task is performed in your practice.

In dentistry, SOPs most often cover clinical and infection control processes — how instruments are cleaned and sterilized, how waterlines are maintained and tested, how hand hygiene is performed, when and how PPE is used, and how suction lines are cleaned.

A good SOP answers four questions: what the task is, who is responsible for it, how often it happens, and exactly what steps it involves. If a new hire couldn't follow it without asking anyone, it isn't finished.

When Things Go Wrong

The implementation of SOPs covering every aspect of work is critical. Many organizations do not see the value of employing such strategies initially, but when an error occurs, they quickly realize the value of having checklists and protocols in place. Very few businesses ever regret incorporating SOPs as they provide clearly defined guidelines and structure. In the dental profession, taking SOPs seriously can reduce the risk of both minor and major issues. However, when something unfortunate does happen, demonstrating that all safety recommendations and protective measures were in place can minimize liability.

In a recent survey conducted by Dental Economics magazine, more than 30% of respondents were unsure or confirmed that there were no protocols in place if biological monitoring fails. As biological monitoring is such an essential part of infection control, knowing that almost a third of practices do not have defined guidelines to deal with a failing, is very worrying. So while initially, practices might not see the need for SOP’s, when things do go wrong, they will be relieved that they can show that they followed proper procedures. Having comprehensive SOPs in place will decrease the chance of errors and provide dental healthcare professionals (DHCPs) with a plan B if a rare error does occur.

Your SOP Checklist

Standard operating procedures must also meet certain demands to be qualitative. The following six elements should be part of your SOP creation checklist:

1. The reason for the SOP: Clear communication of what the SOP is trying to achieve is essential. Teams will be more motivated to comply with them if they understand why they are important.

2. The SOP date: It is crucial to keep SOPs updated, especially in times of pandemic. The date alsomakes team members aware of any changes made, which procedures may be new, and if further training is required.

3. The scope of the SOP: The scope notation sets out what areas are covered.

4. The responsible party or parties: Who is responsible for implementing these SOPs? Moreover, who should comply with them? Communicating responsibilities removes doubt and prevents blame games.

5. The procedure’s actual steps: Through words and illustrations, precisely define the processes and procedures step by step.

6. The key elements of success: Outline what success looks like and achieve it through constant revaluation. SOPs should be reviewed and revised when needed and adapted to changing circumstances.

Who is responsible for writing SOPs in a dental practice?

Somebody has to own it, and that's usually where practices stall.

When infection control is everyone's job, it becomes nobody's. The practices that get this right name a specific person — an infection control coordinator — and give them the time and authority to build and maintain the program. It's usually a dental assistant or hygienist, and it doesn't require a new hire. It requires a decision.

The owner still owns the outcome. But the day-to-day belongs to one named person, or it belongs to no one.

Applying SOPs and Team Training

Of course, SOPs are only useful through their correct implementation. In the survey mentioned above, almost half of the respondents said they were unsure if their teams received adequate training on proper instrument processing. This shows that even if the practice has the most brilliantly detailed SOPs, they are useless unless they are in constant, consistent use. The need for constant training of teams on updated processes and procedures is an intrinsic part of ensuring SOPs are effective.

One way to maximize compliance is to have the team participate in the process of setting up the SOPs. If team members know why these procedures are in place, they can use their acquired experience and insights to propose the right procedures. This active involvement can skyrocket the motivation to comply with the processes.

Once a format is chosen, it is vital to stick to it and keep it simple to reduce confusion and increase compliance. The team should not only receive initial training, but it requires repeating at least yearly to refresh memories and inform everyone of any possible updates. The goal of SOPs is to make work easier, and simplicity and consistency are essential to get everyone on board.

SOPs Must Adapt

It cannot be stressed enough how imperative SOPs are. But they should not always be set in stone — they must adapt to changing circumstances. When guidance is updated or new recommendations are issued, those changes need to be incorporated into your existing toolbox rather than filed away and forgotten.

Incorporating standard operating procedures and following the ADA recommendations, leads to the enhancement of team workflow and the minimization of hygiene breaches. While setting up SOPs, it is important to involve the team to maximize compliance. Standard operating procedures are a must to encourage high standards of hygiene adherence by all dental professionals. If an error occurs or a crisis arises, the team will feel confident in knowing what to do, and this will reduce the stress in the workplace and improve the wellbeing of all personnel and patients.

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Don't start from a blank page

The Infection Control Coordinator Guidebook is a 90-page printed binder covering all 13 areas of CDC infection control guidance. It includes ready-to-use SOP templates for waterline maintenance, sterilization, hand hygiene, PPE, and suction line maintenance — plus fillable logs and tracking sheets designed to be pulled out, used, and returned to the binder.

Stickers for your sterilization center and calendar are included to keep your team on schedule.

Get the Guidebook →

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Frequently asked questions

What does SOP mean in dentistry?

SOP stands for standard operating procedure — a written, step-by-step description of how a specific task is carried out in the practice. In dentistry these most often cover infection control processes such as sterilization, waterline maintenance, and hand hygiene.

Are dental practices required to have written policies and procedures?

CDC guidance calls for written infection prevention policies and procedures, along with documented training and monitoring. Specific requirements are set and enforced by individual state dental boards, so check your state's rules.

What's the difference between a policy and a procedure?

A policy states what your practice does and why. A procedure states exactly how it gets done, step by step. Most practices need both, but the procedure is what a new team member actually follows.

How long does it take to write dental SOPs?

Longer than a weekend, shorter than you fear — if you stop treating it as one project. Practices that succeed take one section at a time, working from templates rather than a blank page.

How often should dental SOPs be reviewed?

Annually at minimum, and any time equipment changes, guidance is updated, or new team members join.

[1] "The Checklist Manifesto | Atul Gawande." http://atulgawande.com/book/the-checklist-manifesto/. Accessed 4 Aug. 2020.