The difference between “Should” and “Shall” in Regulatory Speak can make a big difference in how you go about interpreting the many new guidelines coming out regarding infection control.
The rush of new recommendations coming out has been not only confusing with a lack of clarity but also sometimes contradictory. To add to the confusion, an often misunderstood but very important criteria when reading regulatory guidelines is to understand the implication of the wording being used. Words like “Shall” or “Must” will mean you are required to do what the regulation is stating if the agency has enforceable authority over your practice. However, words like “Should,” “Consider,” or “Recommendations” mean they are only suggesting you follow these guidelines, but there is no requirement or mandate that you must do so. For example, one protocol recommendation is to have patients wait in their vehicles and have staff accompany them inside. This is not a mandate in any of the regulations we have seen. Most patients and staff find this particular protocol disruptive and find other ways to achieve the same objective. An important note is that the ADA, CDC, and OSHA have recently put forth science-based recommendations that are guidance documents and not requirements. Therefore, dental offices should also be evaluating their state/local regulations because those are requirements that must be followed.
