Strategies to manage risk will depend somewhat on the program's scope of services, how long you will be at each site, and what arrangements you have made for comprehensive, specialty and emergency care. Here are a few tips:

• Discuss what emergencies you will be equipped to manage. How far away is the nearest emergency response unit and hospital?


• Identify dental emergencies early on and extract teeth first. This allows for follow-up if there is a problem, e.g., dry socket, and use methods to reduce dry sockets.


• Have patients sit a little longer to assure that bleeding is well-controlled before dismissing. Decide how you will provide follow up for post-operative complications, especially if you have left the area.


• Give clear oral and written post-operative instructions and have a plan to follow up on patients. In the case of children, send home instructions to parents if they are not present, and discuss with the site liaison. If an adult, have patient repeat instructions, sign to say they understand and will follow the instructions--keep a copy in chart. Who will patients contact after hours?


• Always complete any procedure started. If the treatment plan cannot be completed, or if a tooth that has had a pulpectomy needs a root canal elsewhere, give the treatment plan in writing with written follow-up instructions, with copy kept in chart. 


• Mobile clinics are not the place for maximum dosages or maximum treatment limits. Do not over-treat or over-anesthetize a patient. Do not give in to pressure to do anything you do not think is wise. 


• Regarding HIPAA record requests: Determine how patients or their representatives can contact you to obtain a copy of their record after you leave.


• Have a procedure in case of an occupational exposure such as a SHARPS injury. How will you obtain a blood test of the source patient? Where will you go for follow-up?