Every September, the dental community pauses to recognize DICAM, an annual initiative led by the Association for Dental Safety (ADS, formerly OSAP) that promotes education, awareness, and best practices in dental infection prevention. For Canadian dental professionals — particularly those in Ontario regulated by the Royal College of Dental Surgeons of Ontario (RCDSO) — DICAM is more than a calendar event. It is a structured opportunity to identify gaps in your IPAC program before a regulator, a patient complaint, or a near-miss forces the issue.
What "Safety Starts with Every Step" Actually Means in Practice
The 2026 theme is deliberately process-oriented. Rather than spotlighting a single product category or technology, "Safety Starts with Every Step" emphasizes the chain of actions that constitute safe dental care: hand hygiene before gloving, proper donning and doffing of personal protective equipment (PPE), instrument cleaning before sterilization, correct loading of autoclave pouches, biological monitoring of sterilizers, surface disinfection between patients, and waterline management throughout the day.
Each step is individually simple. The challenge — and the risk — is consistency. A 2023 study published in the Journal of the American Dental Association found that compliance with recommended IPAC protocols dropped measurably during high-volume clinic days, particularly in multi-operatory practices where staff moved between rooms. The lesson: infection control failures rarely stem from ignorance. They stem from shortcuts taken under time pressure.
DICAM 2026 Focus Areas for Canadian Dental Offices
While DICAM is a North American initiative, Canadian dental practices operate within their own regulatory framework. Here is how this year's theme maps to the standards that govern Ontario and Canadian dental offices.
1. Instrument Reprocessing and Sterilization Monitoring
The RCDSO's Infection Prevention and Control in the Dental Office standard requires that all reusable instruments classified as critical or semi-critical undergo heat sterilization in an autoclave. The standard further requires that sterilizers be monitored with biological indicators (spore tests) at least weekly, and that results be logged and retained.
DICAM 2026 is an ideal time to verify that your sterilization monitoring program is up to date. Key questions to ask: Are you running spore tests weekly? Are chemical indicators (Class 4 or Class 5) included in every pouch? Is your autoclave maintenance log current? Do all staff members who load the sterilizer understand the difference between mechanical, chemical, and biological monitoring?
Pro Tip: Designate one team member as your IPAC lead and give them 30 minutes each Friday to run the biological indicator test, log results, and flag any pending autoclave maintenance. Making it a named responsibility — not a shared afterthought — is the single most effective way to ensure compliance.
2. Dental Unit Waterline Management
The 2026 DICAM theme places particular emphasis on dental unit waterline (DUWL) safety. Dental unit waterlines are prone to biofilm accumulation, which can harbour bacteria including Legionella and Pseudomonas. The Canadian Dental Association (CDA) recommends that water used in dental treatment meet the drinking water standard of fewer than 500 colony-forming units per millilitre (CFU/mL), which aligns with the ADA and CDC recommendations.
Waterline treatment is not a set-and-forget process. It requires an ongoing protocol of chemical treatment (either continuous or intermittent), periodic testing to confirm CFU levels, and staff training on flushing procedures at the start and end of each day. The ADS recommends testing waterlines at least quarterly, with independent laboratory analysis.
Pro Tip: If your practice has never tested its waterlines — or if the last test was more than six months ago — September is the month to establish a baseline. Contact a dental waterline testing laboratory (several serve Canadian practices by mail) and schedule your first round of tests. The cost is modest, typically $25–$50 CAD per operatory per test, and the results give you a defensible record if a patient or regulator ever asks.
3. Surface Disinfection and Barrier Protocols
Surface disinfection between patients is one of the most visible IPAC steps — and one of the most inconsistently performed. The RCDSO standard requires that all clinical contact surfaces be either barrier-protected and the barriers changed between patients, or cleaned and disinfected with a Health Canada-registered low-level disinfectant between patients.
Common failure points include light handles, chair controls, radiograph positioning devices, and countertop areas near the treatment zone. DICAM 2026 encourages practices to walk through a "turnaround audit" — observe the full room turnover process between two patients and note every surface that was touched but not disinfected or barrier-changed.
4. Hand Hygiene Compliance
Hand hygiene is the foundational step in any IPAC program, yet compliance rates in dental settings remain imperfect. The Public Health Agency of Canada (PHAC) and the RCDSO both require hand hygiene before donning gloves, after removing gloves, and between patients. Alcohol-based hand rub (ABHR) is acceptable for routine hand hygiene when hands are not visibly soiled; soap and water are required when hands are visibly contaminated.
A practical DICAM activity: place a poster at each hand hygiene station listing the "5 Moments for Hand Hygiene" adapted for dental settings, and conduct a brief observational audit during one clinic day. Share the results with the team — not as a punitive exercise, but as a baseline for improvement.
The Regulatory Landscape for Ontario Dental Practices in September 2026
Ontario dental practices face a regulatory environment that has grown more detailed in recent years. The RCDSO's Quality Assurance program now includes a peer assessment component that explicitly evaluates infection prevention and control practices. Practices selected for peer assessment can expect their sterilization monitoring logs, waterline testing records, IPAC manual, and staff training documentation to be reviewed.
Beyond the RCDSO, Ontario Public Health Units retain the authority to inspect dental offices under the Health Protection and Promotion Act. While routine inspections of dental offices are less common than restaurant inspections, complaints — particularly from former employees or patients — can trigger an unannounced visit. A strong IPAC program documented in writing, with dated logs and training records, is the practice's best defence.
Health Canada also regulates the products used in infection control. Surface disinfectants must carry a Drug Identification Number (DIN) to be legally marketed in Canada, and sterilization monitoring products must meet applicable standards. During DICAM, it is worth verifying that every product in your IPAC supply chain carries the appropriate Health Canada registration.
How to Use DICAM 2026 as a Team Training Opportunity
DICAM is most valuable when it becomes a team activity, not a solo compliance exercise. Here is a practical framework for using the month productively.
Week 1 (September 1–7): Sterilization Audit
Review your sterilization monitoring log for the past 12 months. Confirm that biological indicator tests were run weekly, results were recorded, and any failed tests triggered the required recall and re-sterilization protocol. Update your autoclave maintenance schedule if it has lapsed.
Week 2 (September 8–14): Waterline Testing
Order waterline testing kits if you do not already have them. Collect water samples from each operatory following the testing lab's instructions. While waiting for results, review your waterline treatment protocol with the clinical team.
Week 3 (September 15–21): Surface Disinfection and PPE Walkthrough
Conduct a turnaround audit in each operatory. Observe the full room turnover process and identify any surfaces that are being missed. Review PPE donning and doffing sequences with the team, paying particular attention to gown removal and face shield or goggle disinfection.
Week 4 (September 22–30): Documentation and Training Review
Update your IPAC manual with any protocol changes identified during the month. Ensure all staff have signed off on annual IPAC training. File waterline testing results and sterilization monitoring logs in a location accessible for peer assessment or public health inspection.
Pro Tip: Take 15 minutes at a team meeting to discuss one IPAC "near miss" from the past year — a pouch that was not sealed properly, an instrument that was used before the sterilizer cycle completed, or a barrier that was missed during a busy day. Normalizing discussion of near misses (without blame) builds a safety culture that prevents actual incidents.
Why DICAM Matters for Patient Trust
Infection control is not only a regulatory obligation — it is a patient expectation. The COVID-19 pandemic permanently elevated public awareness of infection prevention in healthcare settings. Patients now notice hand hygiene, PPE use, and visible cleanliness in ways they did not before 2020. A practice that demonstrably prioritizes IPAC communicates competence and care, which builds the trust that drives retention and referrals.
Conversely, a single visible lapse — reusing gloves, failing to disinfect a surface, or using instruments from an open (unsealed) sterilization pouch — can erode patient confidence in an instant. In the age of online reviews, that perception can reach hundreds of potential patients before the practice has a chance to respond.
Frequently Asked Questions
Q: How often does the RCDSO require biological indicator testing of dental autoclaves?
The RCDSO requires biological indicator (spore) testing of dental sterilizers at least once per week. Results must be documented and retained. If a biological indicator test fails, the practice must follow a defined recall protocol for any instruments processed since the last passing test. The CDC also recommends weekly testing as a minimum standard.
Q: What is the acceptable bacterial level for dental unit waterlines in Canada?
The Canadian Dental Association (CDA) recommends that water used in dental procedures contain fewer than 500 colony-forming units per millilitre (CFU/mL), consistent with the CDC and ADA recommendations. Achieving this requires an ongoing waterline treatment protocol — either continuous chemical treatment or periodic shock treatment — combined with regular testing to confirm compliance.
Q: Does DICAM apply to Canadian dental practices, or is it a U.S.-only initiative?
DICAM is recognized across North America, and the Association for Dental Safety (ADS) provides resources applicable to both Canadian and American dental practices. While the regulatory framework differs (Canadian practices follow RCDSO, CDA, and provincial public health standards rather than OSHA and CDC mandates), the underlying infection prevention principles are universal. Canadian dental professionals are encouraged to participate in DICAM and use the month to strengthen their IPAC programs.