Individual states are in charge of licensing, inspection and regulation of dentists, said Dr. Matt Messina, consumer adviser and spokesman for the American Dental Association. He said he practices in Ohio, where random inspections are done every other year.
"This is exceedingly rare. ... I'm just angry, because this is a case I think is so far outside of the bounds of normal that it makes it remarkable," he said.
The Centers for Disease Control and Prevention provides national guidelines for dental offices to help prevent the spread of infections. They include cleaning and sterilizing all non-disposable items such as dental tools between patients; disinfecting surfaces; and requiring staff members to wear protective wear like masks, gloves and eye protection.
Patients should look for gloves being changed after every patient and sterilized instruments -- sometimes in sterilized bags or wrappings opened after the patient is seated, Messina said. Patients should feel free to ask questions about sterilization procedures.
Since 1991, only three cases of dental infection in patients have been documented -- two with hepatitis B and one with HIV, the CDC said. No cases of hepatitis C have been reported.
Rogers said Harrington told investigators that he had a higher population of HIV and hepatitis patients. That compounded the infection risks, Rogers said.
He would accept Medicaid for oral surgery, which often meant treating lower-income people who popped up at emergency rooms and were transferred to him to do extractions and other procedures, she said.
Many of these procedures were invasive and exposed patients' blood, tissue and bones, and investigators discovered that these procedures were being carried out in an unsanitary environment.
"The instruments that came out of the autoclave were horrible," Rogers said, referring to a device used to sterilize tools. "I wouldn't let my nephews play with them out in the dirt. I mean, they were horrible. They had rust on them."
Furthermore, at Harrington's office, the autoclave was not being used properly, the complaint states. There should be a monthly test to ensure the autoclave is properly sterilizing the equipment, but no test had been done in at least six years, the complaint says.
According to the document, when the dentist was asked about the sterilization and drug procedures in his office, he replied: My staff "takes care of that, I don't."
In all, Harrington is accused of 17 violations, including negligence and "being a menace to the public health." He faces possible punishment including the revocation of his license.
Infection in a setting such as a dentist's office is rare, the health department said, but the patients should be tested as a precaution.
"Hepatitis B, hepatitis C and HIV are serious medical conditions, and infected patients may not have outward symptoms of the disease for many years," the department said.