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"When I was a young dentist, I sterilised the instruments I fondly used, with care and attention, in a vessel of boiling water. None of my patients got sick or died and, after 30 years in practice, I only go to my doctor cos of impending follicular challenge or suspect creaking of the joints.

25 years ago I bought myself an autoclave. I didn't announce it to the world by a press release or a brochure stuffed into my neighbours' letterboxes [which also told them I was a member of the Pukeuru Dental Association - big deal!]. It was a useful gadget and I knew my instruments remained reasonably clean and shiney.


I am now using my fifth autoclave, and it seems to work pretty good. I mean, when I forget where I am and grab an instrument recently released from the confines of the machine, my fingers take on the appearance of a well done steak, and the smell permeates the office and my staff get hungry.

But I now have representatives of dental supply firms telling me that I need a testing unit to make sure that my autoclave is properly sterilising my instruments, and that the NZ Dental Association endorses this testing. So I reply that all this nonsense started after one dentist in the whole world deliberately injected his own rotten blood into a few patients he wasn't particularly fond of at the time and, as a result of this act, I am suffering extreme pressure from the media [who know a good story when they see one], from dental supply firms [who are making megabucks on this sky-is-falling-in mentality, and from wimpy colleagues who haven't stopped to think for themselves [and perhaps with all that mercury in their heads, can't think anyway!].

I then point out that there are testing units to make sure the testing units are working, and I am told on good authority [whatever that is!] that next month there will become available a testing unit for the testing units that test testing units that test autoclaves that seem to be working extremely satisfactorily [and had bloody well better do, considering the extreme amount of money they cost!].

So I am now at the point of thinking I will change to the sterilising system my respected and unpressured-by-the-media medical practitioner uses, which is a boiling water vessel very similar to what I had all those 30 years ago. And if that's not good enough for my patients who seem to think they know more about sterilisation than I do, then I shall offer to use the same sterilising techniques currently used for all those nice fibreglass optical things that get pushed into all the hidden and unmentionable parts of the body for a look around or a nip of this or that. And those entirely intrusive and breath sucking instruments get a bit of a wipe with an alcohol impregnated rag, and a swish around in some chemicals while they wait for the next orifice to be presented to them.

And while I am on patients who know more than I do, I might mention the 25 year old lady who sat in my chair and asked me to desist [with my dental stuff!] while she checked if I had an autoclave - she pulled a piece of paper from her pocket and read 'autoclave' but pronounced it 'outer-clarv'.
"That's it there" I responded "why do you ask?"
"Which one?" she asked - not recognising the autoclave from the other equipment on the bench - an ultrasonic vibrator [no not that sort, silly!], a pressure cooker, an impression material dispenser, a sandwich maker, and pocketknife thingy for taking stones out of horses' hooves "I read a letter in the Womens' Weekly that said if your dentist doesnt have an outer-clarv then you should go find another dentist"
I finished the filling I was doing after explaining [politely] that I was using an autoclave before she was born and, as her mouth had more bacteria than a buffalo's bum, I didn't really see the need for any form of sterility anyway.
I was quite suprised when she never returned to the office.

One of the lectures at a recent California Dental Association conference was headed 'In some areas, infection control regulations and even clinical practice have gone beyond the consensus of science'.
I find that comment very easy to live with and I have now made the following decisions:

• I will wear a face mask when kissing is banned oh health grounds.
• I will use a rubber dam when someone proves that splatter into the air is less with the dam on, than when no dam is used
• I will be concerned about 'mercury vapour' when someone shows how vapour can escape from my cavity drilling procedure where there is more water being squirted into the cavity than is going into the Auckland City water storage system
• I will tell my patients that research in the U.S. has shown that lubricated and autoclaved handpieces discharge enough oil onto teeth to significantly reduce bonding strengths, and powder from gloves likewise reduces bonding of materials to teeth. So if they want me to place the best restorations I can, I will not oil/autoclave my instruments, and I won't wear gloves. And the bonus from that is that my expenses will drop, and my fees will too and also.
• and I don't wear gloves anyway when I am doing exams or polishing teeth or making dentures, cos there aint no blood around then and we all know that saliva does not carry the AIDS virus. And even if there is blood around, I tell my patients that gloves are to protect me from them but not them from me because they won't catch anything like AIDS from me anyway unless my name is David Acer and I have just injected blood into their nearest soft bit.

And a post script to those wimpy colleagues who, when I point out that this AIDS nonsense is completely that [nonsense, I mean], reply by sighing wisely "ah, but then there is hepatitis" - well you unthinking dentist sheep, I and my staff have had all the vacccinations for that stuff and there is more chance of a 747 dropping out of the sky on my head than there is of me passing on hep A or B or C or uncle tom cobbley and all onto anyone alive or dead. So there!"