You suspect that your dental assistant is using drugs. What is the most appropriate INITIAL action?

Correct answer: B. Speak with her privately about your specific concerns

• A. Waiting for visible harm to patients before acting inverts the duty of care entirely.
• B. CORRECT as the FIRST step. Address it directly, privately, and factually — describe the specific behaviours you have observed rather than the conclusion you have drawn — and offer a route to help such as an employee assistance programme or the state's impaired professional programme. Document the conversation.
• C. Immediate reporting is the correct action if patients are in current danger or if she is impaired while providing care, but it is not the first step for a suspicion. Escalation follows the conversation if she declines help or the behaviour continues.
• D. Passive observation while suspicion persists exposes patients to risk and is not a defensible position.

Note: Suspicion with no immediate patient danger → talk to her first. Impairment observed during patient care → remove her from clinical duties immediately and report. Most state boards have a mandatory reporting threshold; know your own state's.