Dental Courses

Virus Infections Risk for Dentists

Dentists are at a risk for virus infections, the most common ones being the Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and the Hepatitis C Virus (HCV) from percutaneous exposure incidents and some from direct transmission cases like airborne diseases such as tuberculosis. Recommended practices for infection control are applicable as long there is dental practice.

Even if previous studies show that the number of HIV cases through occupational exposure for dental workers is relatively low, chronic Hepatitis B poses an exposure threat that is about 10 times greater than the average person. Tuberculosis, on the other hand, stems from mycobacterium tuberculosis.

Patients who are suspected of having laryngeal or pulmonary tuberculosis are easily triggered by aerosol-generated or cough-inducing procedures or whose sputum smears test positive for acid-fast bacilli are considered infectious.

Stricter and more consistent adherence as well as proper dissemination of infection control strategies must be carried out. This includes emphasizing the importance of protective barriers and sterilization procedures. Dental facilities should come up with their personal protocol for injury management, operatory cleanup and instrument reprocessing.

Out of the transmissible diseases, Human Immuno-deficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are of most consequence. They amount to massive amounts of dollars, with numerous indirect and direct costs, reaching up to US $1 million each usually with seroconversion cases. The implications of the occupational hazards for PEI are quite significant for health care management and workers alike, given the high frequency of cases. The possibility of seroconversion in health care workers following a single sharps or needlestick injury contaminated by Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are 0.3%, 6-30% and 1.8% respectively.

Blood-borne Viruses

Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), is an occupational hazard since transmission is possible between a patient and a health worker through contaminated instruments. These are categorized as percutaneous exposure incidents since they are usually transmitted through needlestick or sharp injuries or exposure to mucous membranes. The infector may be an asymptomatic carrier or may be seriously suffering from chronic or acute infection.

A study in the UK states that Hepatitis C is the most common blood-borne virus among their dental workers. Many of the infectors were asymptomatic and undiagnosed, without knowledge that they were carriers of the infection.

Majority of Hepatitis B and C carriers are people below 44 years of age. Sexual transmission and Intravenous Drug Use (IDU) were reported to be the most frequent vehicles for passing the disease on, with Hepatitis C being more associated with IDU. One third of

Mouth lesions

IDU users showed current or past evidence of Hepatitis C, a fifth declared symptoms of Hepatitis B and less than one percent reported signs of HIV transmission. Patients who require extensive dental treatment were often intravenous drug users and showed high levels of periodontal diseases and caries.

Scottish and American dental practitioners reported that on average, 1.7% to 3.3% of sharps injuries are sustained per year. 30% of the injuries in the Scottish study were claimed to be moderate to high risk for transmission of blood-borne infections (patient to health worker). Dental assistants were reported to have a much higher frequency of sharps injuries as compared to hygienists, therapists or dentists since most incidents take place when cleaning up after procedures. One can avoid such diseases by reading good articles in dental education.

In the study, the rate for seroconversion that follow a sharps or needlestick injury is estimated to be at 0.3% for HIV, 7% to 30% for Hepatitis B (of which the higher figure pertains to unvaccinated health workers), and 1.8% to 10% for Hepatitis C. While the general belief is that the overall risk of acquiring blood-borne infections for dental personnel is low despite fluctuating percentages, complacency is still unwelcomed.

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