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The Legislative Insider is published during the Legislative Session by the Georgia Dental Association. It contains updates on the activities of GDA's Government Affairs team as well as information about bills relevant to dentists and patient care.

Phlebotomy in the Dental Office

Dec 22, 2025 by Lee M. Whitesides DMD, MMSc.

Phlebotomy is the surgical opening or puncture of a vein with the intention of drawing blood or introducing a fluid. This process allows the health care professional to sample the blood for diagnostic purposes, generate a biological surgical additive, or administer medications intravenously producing an almost instantaneous effect on the patient.

Accessing a patient’s venous circulation is not new in medicine. The ancient Greeks, Romans, and Egyptians all practiced “bloodletting” as a means of therapy to rid the body of evil spirits & demons (so-called bad humor) which traveled in the blood. This practice continued for centuries until modern medicine realized draining the patient’s blood resulted in poorer patient outcomes.

Phlebotomy is a fragmented industry in America. Only California, Louisiana, Nevada, and Washington require phlebotomists to be certified to work in a medical office or hospital. Until recently, the drawing of blood by a dental assistant or dental hygienist was at the discretion of the supervising dentist.

 

Phlebotomy in Dentistry

One of the primary reasons phlebotomy is practiced in Dentistry is to generate Biological Surgical Additives (BSA). The most popular BSA is platelet Rich Fibrin (PRF). Platelet Rich Fibrin is used to improve and accelerate the healing of a surgical wound by providing an extremely high concentration of growth factors and cytokines at the site of the wound.

Using the patient’s freshly drawn blood, tubes of blood are centrifuged according to specific protocols to generate a supernatant of fibrin, rich in growth factors and cytokines. The growth factors and cytokines contained in the fibrin matrix accelerate the wound healing process, attenuate inflammation and pain, as well as provide a biological barrier membrane superior to any commercial membrane the dentist may purchase.

 

Proper Education

The practice of phlebotomy is a specific skill which must be properly taught while the student gradually, by trial and error, develops the skills necessary for success. With proper instruction and patience, the dental professional may develop the skill set necessary for the repeated success of drawing blood from a patient.

The safe drawing of blood from a patient by the dentist, dental assistant, or dental hygienist requires proper education, appropriate armamentarium, professional patient interaction, and OSHA-approved disposal of biomedical waste (BMW).

Proper education can begin with a Georgia Board of Dentistry-approved course offered by the Georgia Dental Association. This course will serve as a primer to the continuing education of the dentist, dental assistant, and dental hygienist in the practice of phlebotomy on their patients. Appropriate armamentarium includes the centrifugation machine, blood collection tubes, correct instruments for manipulating the fibrin matrix, and the right instruments for drawing the blood.

Professional patient interaction in drawing blood in the dental office is an important aspect of the phlebotomy process. Since drawing blood is not a routine experience in the dental environment the dental professional drawing the blood must explain the process, answer any questions, explain the risks and benefits of the procedure, and strive to make the patient as comfortable as possible during the experience. Informed consent is mandatory.

OSHA dictates all BMW must be properly disposed. Phlebotomy generates considerable and varied BMW. Needles, catheters, and bloody gauze need to be properly segregated and placed in proper containers to be OSHA-compliant. Non-compliance with OSHA rules and regulations exposes the practice to considerable fines and penalties.

 

Being Prepared for the Risks

The practice of phlebotomy comes with an increased risk to the patient and phlebotomist concerning an accidental needle stick. An exposure control plan must be incorporated into existing office procedures and policies to be compliant with OSHA.

Complications can and will occur with phlebotomy. Most complications are minor and necessitate simple first aid such as wound irrigation and dressing, elevation of the extremity, and analgesics. A serious complication includes arterial puncture or cannulation. While rare, this significant complication can result in serious consequences including limb amputation. Prompt recognition and appropriate therapy by a physician are necessary steps to better patient outcomes.

 

Better Dental Outcomes

The practice of phlebotomy offers Dentistry an avenue for better patient outcomes with minimal cost and risk. Wounds heal better, patients experience less pain, and tissue response is accelerated when PRF is employed.