UNLV’s School of Dental Medicine is warning 184 patients that they may be at risk of complications after the school’s clinic re-used dental devices that the manufacturer specified were supposed to be used only once.
But the dentist and former faculty member who was reusing the devices said they were visually inspected for damage and extensively sterilized before reuse, and never posed a risk of spreading disease. He said that he's never had problems after doing what says is a common practice in the field.
The school announced Friday that it was “voluntarily” notifying people who had come into the school’s clinic between 2014 and 2017 and received devices called “healing abutments” that are temporarily used until a replacement tooth is put in place. When used more than once, the device can lead to implant failure — which could include swelling, severe pain, discomfort, gum inflammation or movement of the implant, according to a press release from the university.
The school says it will offer free exams to affected patients and replace the implant or otherwise treat patients for the next three years if they have an implant failure because of a reused abutment. Patients are being notified with phone calls and notification letters.
UNLV says the abutments were sterilized before their subsequent uses and that “the school is not aware of any increased risk of the spread of infectious disease.” Still, the school is offering patients who are worried about catching a disease a chance to contact the school and arrange a testing plan.
Nevada System of Higher Education Chancellor Thom Reilly said he was “extremely troubled with what has transpired at the UNLV Dental School.”
“Dental schools embedded in academic institutions should adhere to the highest professional, ethical and best practices standard,” he said in a written statement. “UNLV will be as transparent as possible. The Nevada System of Higher Education is committed to the well-being of the schools’ patients and the community at large. UNLV is reaching out to every patient potentially impacted and will do what is necessary to address these issues.”
The faculty dentist identified as reusing the devices, Dr. Phillip Devore, had taught dental implant placement at UNLV since 2003 and testifies as an expert dental witness in court. He said that thanks to assistants, he "really wasn’t conscious of the fact that it was labeled for single use" and only saw literature about six months ago that raises the possibility of problems with reused healing abutments.
"It had nothing to do with finances. I wasn’t paying for it," he said of the devices, which cost between $40 and $100 each. "It’s just wasteful not to reuse them."
After concerns were brought to his attention, he said, he immediately went and ordered more healing abutments so they could be disposed after a single use. The inquiry into the reuse hampered his ability to practice fully at UNLV, and he left for private practice at Image Dental in Las Vegas in December.
"I don’t understand what the concern is. I would fully understand if there was an infection risk. Everybody agrees that there’s none," Devore said. "A lot of drugs are prescribed off label. As professionals, we make decisions all the time that may not agree with the manufacturer's recommendation."
Officials with the state Division of Public and Behavioral Health, which includes epidemiologists and has jurisdiction on health questions over UNLV because the school is a state institution, said it “did not conduct a formal investigation of the UNLV School of Dental Medicine since there was no factual information that indicated any increased risk of the spread of infectious disease.”
The State Board of Dental Examiners, which licenses and disciplines dentists, didn’t immediately return requests for comment about their involvement in the situation.
A university spokeswoman said the university doesn't believe any more than one dentist was reusing the devices. She didn’t immediately answer a question about whether there would be disciplinary action against the dentist's supervisors in light of the revelations.
UNLV’s dental clinics are staffed by faculty doctors and hygienists, as well as dental students and residents, and maintain locations at the medical school complex on West Charleston Boulevard and on UNLV’s main campus. The faculty dental clinic operates like a private practice clinic. Faculty and students combined conduct 50,000 to 60,000 patient visits per year, serving both students and the public.
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This story was updated at 4:20 p.m. on March 9, 2018, to add comment from state health officials and note that the dentist is no longer with UNLV. It was updated at 6:30 p.m. to add comments from Devore.