AIDS in the office

[al]

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The other day I was assisting a dentist at the clinic at the clinic I volunteer at, and we treated a patient with AIDS. Now, I've always understood that in dentistry, treating an AIDS patient will be bound to happen, and that contraction of the disease from a patient is just one of those extremely rare risks that come with the job. I've accepted this and still desire to pursue dentistry (I'm entering dental school in the fall). But I guess since this patient was pretty much the first person with AIDS I've ever encountered, let alone interacted with in a dental setting, I was just taken aback and couldn't help but think of potentially contracting AIDS or any other non-curable disease via needle prick, accidental cut with the drill, etc.

I guess I'm wondering how real is the possibility of this ever occurring? Do you dentists have this thought in the back of your mind as well when you are treating patients, let alone AIDS patients, etc? How often will a typical dentist prick himself or cut him/herself with a drill during their career? (I apologize if these questions seem ridiculous)

I have no intentions of ditching my dental career plans, no matter what your responses maybe. I know that with the exposure and education I'll receive while in school on such clinical situations and precautions, I'll feel more comfortable. but I'll admit at this moment I have these worries in the back of my head. should I be worried? Any thoughts or opinions would be appreciated.

 

[chocobo]

Here are some resources for you:

U.S. Health care workers with documented and possible acquired HIV infection, by occupation reported through June 2000
<a href="http://www.avert.org/needlestick.htm" target="_blank">Healthcare workers, AIDS and Prevention</a>

Some statistics of transmission risk included:
<a href="http://www.cdc.gov/ncidod/hip/Blood/Exp_to_Blood.pdf" target="_blank">CDC: Exposure to Blood - what health-care workers need to know</a>
<a href="http://www.ucsf.edu/hivcntr/resources/pep/pep_steps.pdf" target="_blank">PEP Steps - a quick guide to postexposure prophylaxis in the health care setting</a>

<a href="http://www.thebody.com/whatis/carework.html" target="_blank">The Body - healthcare workers and HIV/AIDS</a>

I have heard from various people that we will inevitably poke ourselves sometime in our career.

<a href="http://www.ucsf.edu/hivcntr/paetc/about.html" target="_blank">Pacific AIDS Education & Training Center</a>
HIV TELEPHONE CONSULTATION SERVICES FOR CLINICIANS: Discuss specific cases with experiences providers

National HIV Telephone Consultation Service (HIV Warmline)
(800) 933-3413 or (415) 476-7969, Monday through Friday, 7:30 a.m. to 5 p.m. (Pacific Time)
The Warmline offers health care providers up-to-the-minute clinical information and case consultation. The Warmline is staffed by clinicians experienced in HIV care who can help you provide the best possible care to your HIV-positive patients.

National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline)
(888) HIV-4911 or (888) 448-4911, available for emergencies 24 hours a day, 7 days a week
The PEPline offers treating clinicians around-the-clock advice on managing occupational exposures to HIV, hepatitis, and other blood-borne pathogens.

HTH

 

[DrJeff]

Real world experiences here that occurred to me and my fellow residents during our residency. Myself personally, event #1 accidental stick with a bur after some serious subgingival decay removal (read as bloody) on an HIV positive patient. I did not take the cocktail on that one. Then less than a year later I was stuck with a suture needle while suturing an HIV positive patient after doing a full mouth extraction. I took the cocktail this time. I've been both Hep and HIV negative for the last 4 years now.
One of my fellow residents stuck herself with the tip of an east/west elevator ladened with HIV positive blood. She took the cocktail and has been negative for 3 years now.
Now for the real eye opener, and a true test of how tough it is actually to contact HIV through a needle stick. One of the dental assitants in my residency was an ER tech before he switched within the hospital to dental assisting. He was stuck with a large bore needle that had just been withdrawn from the femoral artery of a patient who 3 days later died from HIV related complications <img border="0" title="" alt="[Eek!]" src="eek.gif" /> <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" /> He took the cocktail and has been HIV negative for 8 years now.

Yes, there is a risk, however it is extremely, extremely low. Also, in *most* private practice situations, the patient pool that you're treating is at a greatly decreased risk for HIV than the patient pools that you're exposed to in both dental school and residency.

 

[Kawrou]

I think people would be lying if they said that is wasn't a concern to them, but in the opinion of my classmates and I, we actually feel safer when we know someone's status. It means that we are extra careful because of the reality involved. Suddenly every single precaution that we can take we do. To be honest it is the patients that you don't know that are the concern, and should be dealt with in the same way as anybody who has a contagious disease.

If I were you though I wouldn't worry, as Dr. Jeff has stated, it is extremely difficult to get HIV if you are careful. If anything your patients are more at risk than you are, as countless cases have proved.

And, if you do get stuck there is always the PEP.

Dr. Jeff, sorry you had to take that stuff. A buddy of mine got stuck with a needle, and had to take it. It didn't look fun.

Anyway, worry enough to take the Universal Precautions that you are supposed to be taking. Hope this helps.