BOP Program Statement 6400.03 § 3

The CDO is responsible for ensuring that there is a local Institution Supplement on dental health

care. The National Program Statement provides greater continuity of care and treatment Bureau-wide; the Institution Supplement provides dental program clarification as it applies to the

specific institution and its mission. The Institution Supplement is updated annually and amended

to reflect local and/or national policy changes.

The CDO periodically reviews the Inmate’s Admission and Orientation (A&O) Handbook to

ensure that information about the dental program is correct. The handbook should include the

following information: the dental clinic hours of operation, access to care (sick call protocol and

national dental routine waiting list), method to request continued care when transferring, inmate

co-pay policy, availability of commissary items, and any applicable local dental policies.

a. Staffing. The CDO must be knowledgeable about both Office of Personnel Management

(OPM) and U.S. Public Health Service (PHS) personnel systems.

The BOP Health Services Division establishes staffing guidelines for dental clinics. Generally,

each institution should have one dentist for every 1,000 inmates. Staffing guidelines may vary

by institution, depending on the mission. Re uests for modification to an institution’s dental

staffing are submitted to the National Chief Dentist for consultation with the National Health

Services Administrator.

(1) Auxiliary Personnel. Auxiliary dental personnel consist of dental assistants (DA) and

registered dental hygienists (RDH). Team composition will vary by the institution’s mission.

Auxiliary personnel are essential to an efficient, productive, and secure dental service unit.

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Institutions will provide one DA for each clinical dentist. Restorative and surgical procedures

are not performed without a dental assistant. Routine use of a dentist or registered dental

hygienist as a dental assistant is inappropriate

Dental hygienists are an important adjunct to the oral health program. Each institution should

have one RDH. Additional hygienists are added based on the mission, size of population, or

Central Office staffing guidelines. Hygienists should be encouraged to establish prevention

programs, provide patient education, and support the dental program.

(2) Continuing Dental Education. Dental staff maintain their professional skills and current

unrestricted licensure through continuing dental education programs. Fund allocation is listed in

the current Program Statement Health Services Administration.

(3) COSTEP/Student Interns. Local institutions may employ students who have entered into

an a reement with the PHS’s Commissioned Officers Student Extern Pro ram (COSTEP) for

short-term engagements. This program is subject to Central Office funding.

Institutions may establish training agreements with local professional schools to use student

interns in various capacities. The Memorandum of Understanding (MOU) must be in writing

and subject to annual review. MOU templates are available on Sallyport. A copy is sent to the

National Chief Dentist for review before starting or when renewing the program.

Students must provide care under supervision. The patient is notified of the provider’s student

status before each treatment encounter; written consent documenting this notification using the

Consent For Treatment By Student Dentist/Hygienist (BP-A1080) will be entered in the EMR.

Inmates refusing treatment by a student should be rescheduled for the staff provider at the

earliest appointment available. Electronic Medical Record (EMR) entries are co-signed by the

supervising dentist or reviewed by the hygienist for hygiene students only. Staff participation in

preceptor programs is voluntary.

b. Clinical Privileges. The extent of privile es ranted depends on the practitioner’s education,

training, and experience. All dental staff must work within their current privilege statements and

practice agreements, and within the scope of their professional license. Protocols may be

negotiated locally if necessary.

Dental assistants and hygienists, staff or contract, must have signed practice protocols and/or

agreements on file. Both disciplines undergo competency assessments by a Chief Dental Officer

every two years. See the current Program Statement Health Care Provider Credential

Verification, Privileges, and Practice Agreement Program.

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c. Quality Management (QM). The CDO will be familiar with the current Program Statement

Health Services Quality Improvement and will attend the IOP meetings. The IOP Coordinator

conducts studies of dental operations and collects the pertinent data.

d. Facility Management. A clean and properly functioning dental clinic is essential to provide

high-quality dental services in a safe and timely manner. The CDO maintains dental facilities at

a high standard of sanitation, minimizing the opportunity for cross-contamination. The CDO or

designee ensures that all equipment works properly.

The CDO ensures that dental clinic equipment is included in the Health Services Unit preventive

maintenance program of bi-yearly safety inspections according to the current Program Statement

Patient Care. X-ray units are inspected and calibrated, and protective aprons/shields are

inspected according to the current Program Statement Patient Care.

e. Intra-oral Metal Removal. Precious metal (gold) and base metal that is removed from the

inmate’s mouth will be autoclaved, placed in an envelope, and marked with the patient’s name,

number, date, and description of the item. The Inmate Personal Property Record (BP-A0383)

will be used. The autoclaved item and form will be taken to the Inmate Systems Management

(ISM) department for disposition as the inmate’s personal propert. A cop of the form will be

placed in the EMR Document Manager. Refer to the current Program Statement Property

Management Manual.

Non-precious alloys may be discarded as biohazardous waste in an appropriate biohazard

container. Those containing amalgam should be handled as amalgam waste in accordance with

state and local municipality requirements. Amalgam-containing items (i.e., tooth or crown) in

this category should be subjected to high-level disinfection or cold sterilization instead of

autoclaving.