IPAC for Ontario dental offices: what is actually required

Why "IPAC certification" is a search term rather than a thing

The phrase conflates two different subjects, which is why it is worth untangling before you spend money on either.

A dental practice in Ontario is not certified in IPAC. It is required to meet the RCDSO Standard of Practice on infection prevention and control, which is mandatory, and failure to comply may result in allegations of professional misconduct. There is no certificate at the end of it and no badge to display — the obligation simply applies.

CIC® — Certification in Infection Control — is a real credential, but it belongs to an individual, not a practice. It is administered by the Certification Board of Infection Control and Epidemiology, and endorsed by IPAC Canada as a core requirement for infection control professionals. It is oriented to infection prevention professionals, largely in acute care, and it is not a dental practice accreditation.

So if someone offers to make your office "IPAC certified", ask precisely what document you will receive at the end and who issues it.

The standard that does apply

The governing document is the RCDSO Standard of Practice on Infection Prevention and Control in the Dental Office, approved by the College in November 2018, replacing the earlier 2010 version. The RCDSO states the standard aligns with Public Health Ontario, the Public Health Agency of Canada and PIDAC.

What the standard requires in practice

• Written IPAC policies and procedures for the office. The RCDSO publishes templates, but the policies have to describe what your office actually does.
• IPAC training for staff at orientation and annually thereafter. Personnel responsible for sterilization are expected to hold a certificate from a dental assisting programme.
• Biological indicator (spore) testing: one test per sterilizer, per day of use, for each type of cycle run. This is daily — the "weekly spore test" figure that circulates widely is not the RCDSO requirement.
• A daily air-removal test before the first cycle on pre-vacuum sterilizers.
• Chemical indicators used in accordance with the standard.
• Documentation of cycle time, temperature and pressure for every load.
• Sterilization records kept for at least ten years from the date of the last entry.

Who checks, and when

This is the part most often described incorrectly, including by people selling IPAC services. The RCDSO does not run a routine IPAC inspection programme for general dental practices. It operates two facility inspection programmes: one for practices operating dental CT scanners, and one for practices providing sedation and general anaesthesia.

IPAC oversight works differently. The standard is mandatory and enforced through complaints, investigations and discipline, and the RCDSO states that local public health units have jurisdiction to investigate IPAC complaints against individual dental offices. An IPAC lapse is typically investigated by public health, using IPAC checklists, after a concern is raised.

The practical consequence is not reassuring, and it is the reason to take this seriously: because there is no scheduled inspection to prepare for, the first time your IPAC practice is examined closely is likely to be during a complaint or a lapse investigation — when the records either exist or do not. The RCDSO provides a self-audit checklist as a voluntary tool, and using it before somebody else does is the entire point.