HIV positive dentists/ students?

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fusedtometal

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I haven't found any information on dentists or students who are HIV positive. Is it possible to practice anywhere in the US? Are HIV positive people going into dentistry? I would like to know what people think. If you were positive would you tell that as part of your story when applying to dental school?
Thanks
 
fusedtometal said:
I haven't found any information on dentists or students who are HIV positive. Is it possible to practice anywhere in the US? Are HIV positive people going into dentistry? I would like to know what people think. If you were positive would you tell that as part of your story when applying to dental school?
Thanks
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Interesting, first time I have heard of something like this. I am sure though that there aren't any HIV dental students. Seems too unlikely. I mean, HIV positive make up what percentage of the US population? Then divide that by the current dental student population. Unrealistic.

And yes, to answer your question, I would tell others if I was HIV positive when applying to dental school. It's safe to be safe, right?

PS. Can you please tell me how you got HIV (in private)? I am just curious.
 
K90 said:
Interesting, first time I have heard of something like this. I am sure though that there aren't any HIV dental students. Seems too unlikely. I mean, HIV positive make up what percentage of the US population? Then divide that by the current dental student population. Unrealistic.

And yes, to answer your question, I would tell others if I was HIV positive when applying to dental school. It's safe to be safe, right?

PS. Can you please tell me how you got HIV (in private)? I am just curious.
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Coming from our infection control lectures, you don't have to tell anyone. If you have any type of exposure, you have to inform your patient. Is it ethical probably not, but that is the way it is. Once word gets out, your practice will be done with. The risk the dentist takes treating any patient with a blood born diseae is disproportionaly greater then patients risk.
 
fusedtometal said:
I haven't found any information on dentists or students who are HIV positive. Is it possible to practice anywhere in the US? Are HIV positive people going into dentistry? I would like to know what people think. If you were positive would you tell that as part of your story when applying to dental school?
Thanks
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You can practice anywhere, and it's illegal for an employer to discriminate against you for being HIV positive. It's hard to say whether to use it in your personal statement. At some schools it may work to your advantage, but could work against you at others. I guess it depends on who is reading the personal statement.

K90 said:
Interesting, first time I have heard of something like this. I am sure though that there aren't any HIV dental students. Seems too unlikely. I mean, HIV positive make up what percentage of the US population? Then divide that by the current dental student population. Unrealistic.
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About 1/2 of 1 percent of the US population is infected with either AIDS or HIV, so according to the math it's actually quite likely.

K90 said:
PS. Can you please tell me how you got HIV (in private)? I am just curious.
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Seriously? 🙄
 
I have a few questions because I don't know much about being HIV positive.

How long is the life expectancy with modern treatment if it diagnosed early? I ask this because not more than a few years ago the life expectancy was around 10 years. Dental school might not be a worthwhile investment as far as stress, time and money if someone could not stay healthy for a long career.
 
Thanks for the replies. I still hope more people reply, and although I never actually said in my post I was positive, it was inferred by some respondents. There is virtually no information on this out there on the web that I can find. Life expectancy for people with HIV who are diagnosed quickly, respond to treatment and have good adherence to their medication regimens, and live a healthy lifestyle, is pretty much a normal life expectancy, minus four or five years. It has been over ten years for quite some time now, maybe ten years.
Nobody knows of an HIV positive dentist? Would you go to one? Would you say that your practice would be over after having an exposure or simply over after people finding out your status? Have you ever cut your hands when working in a patient's mouth? Are there dentists who specialize in treatment of HIV positive populations?
 
From a patient standpoint, I would contemplate seeking out a different dentist depending on the type of procedure that is going to be involved, how competent I feel the dentist is, how well I like the dentist, and a number of other factors.

As a dental student, I am well aware that contracting HIV from a dentist is EXTREMELY unlikely, yet I still would have reservations about receiving specific treatments from him/her.

For me, it's just an unnecessary risk that I have more control over.

Hypothetically, as a dentist, I would feel ABSOLUTELY obligated to tell my patients of my status as I feel they should have a right to know in order to make their own decision.

I remember hearing about a gynecologist in MN with AIDS, I believe, performing exams and delivering babies. Of course she wore gloves, but it was found by a review board that she was practicing with open sores on her arms and hands. Definitely a different risk hazard, but unsettling nonetheless.
 
Interestingly some people tend to transmit more readily than others. A french ortho surgeon infected 21 patients, despite strict aseptic measures and barriers. now that is something. I read in laws and ethics in health that you are not required by law to disclose it to anyone, any entity but it is ethical to inform your patients.

(Ref: Longest: managing health system organizations)
 
To be honest, I would never go to a dentist if I knew he/she was HIV positive. Too risky, even if they take the necessary safety precautions. Just the thought of it sends chills down my spine.

Revellian said:
About 1/2 of 1 percent of the US population is infected with either AIDS or HIV, so according to the math it's actually quite likely.
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Yeah, and how many in the US population are dentists (or doctors)? Apply that ratio to HIV positives. 1/2 of 1% in this case = 1,5m, and somehow I don't think most of them have dental school on their agendas. 😀
 
generationX said:
Interestingly some people tend to transmit more readily than others. A french ortho surgeon infected 21 patients, despite strict aseptic measures and barriers. now that is something. I read in laws and ethics in health that you are not required by law to disclose it to anyone, any entity but it is ethical to inform your patients.

(Ref: Longest: managing health system organizations)
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People with high viral titers in their blood transmit more readily. Such people are usually newly infected and unaware of their status. I searched for the case of the French Orthopedic Surgeon, and I found information about it, and it seems he infected ONE patient and it is not for sure who infected whom, though it seems he infected the patient, it is indefinite. It happened in 1993, which is before the era of highly active antiretroviral treatment, the surgeon was unaware of his status; therefore, he was not being treated. Also, the surgery was a complex ten hour long operation.

From what I have found, it seems like you are required to disclose it to your local licensing board, and then they make recommendations which you follow and they follow up to see how you are remaining compliant.
 
fusedtometal said:
From what I have found, it seems like you are required to disclose it to your local licensing board, and then they make recommendations which you follow and they follow up to see how you are remaining compliant.
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This is my impression as well.
 
okay, question,

My school required me to submit a battery of immunization records to be admitted. I had to go in for immunizations and titers for stuff I have not been immunized and or tested for before. HIV was not on that list? I now wonder why? Why is it necessary to test for all those other ones (TB, chicken pox, Hep) but they don't test for HIV?

P.S. On a total side note: I think that a HIV positive MD/DDS should tell his/her patient if they are HIV positive. I would be pretty upset after the fact to find out.

Also, to the OP, are you really considering not telling your future patients? You have to realize that to be ethically wrong.
 
fusedtometal said:
Thanks for the replies. I still hope more people reply, and although I never actually said in my post I was positive, it was inferred by some respondents. There is virtually no information on this out there on the web that I can find. Life expectancy for people with HIV who are diagnosed quickly, respond to treatment and have good adherence to their medication regimens, and live a healthy lifestyle, is pretty much a normal life expectancy, minus four or five years. It has been over ten years for quite some time now, maybe ten years.
Nobody knows of an HIV positive dentist? Would you go to one? Would you say that your practice would be over after having an exposure or simply over after people finding out your status? Have you ever cut your hands when working in a patient's mouth? Are there dentists who specialize in treatment of HIV positive populations?
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Just to answer your last question, yes absolutely there are dentists who specialize in treatment of HIV positive populations. I know this because I volunteer at a free dental clinic in Houston, TX that is only for people with HIV and AIDS that live below the poverty line. Most of the dentists that work there are full time dentists that deal strictly with HIV patients. And there are some extra precautions that we have to take, but for the most part we treat them like any other patient at any other dental office or clinic. And just fyi, the clinic is Bering Omega Dental Clinic. The dentists there are truly inspiring.
 
Lopyswine said:
okay, question,

My school required me to submit a battery of immunization records to be admitted. I had to go in for immunizations and titers for stuff I have not been immunized and or tested for before. HIV was not on that list? I now wonder why? Why is it necessary to test for all those other ones (TB, chicken pox, Hep) but they don't test for HIV?

P.S. On a total side note: I think that a HIV positive MD/DDS should tell his/her patient if they are HIV positive. I would be pretty upset after the fact to find out.

Also, to the OP, are you really considering not telling your future patients? You have to realize that to be ethically wrong.
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They can't ask for an HIV test because it is a protected status. Due to past discriminatory practices, there are laws to protect witchhunting of HIV+ patients. However, it has become a very complicated political and legal issue. I believe only a policeman who is worried that he may have been infected by a suspect can mandate an HIV test from that person. There is pretty much no other way to force someone to take an HIV test or require them to release the results.

If you look at some of the dental school websites, many mention testing for blood borne pathogen testing. They usually list this as Hep B, Hep C, etc. I'm sure HIV is one that can be of concern, but they can't ask about it. They can ask about other illnesses though. Some programs, such as U of MD, won't accept students who are Hep B or C positive.

I would really check with the dental board of the state you wish to practice in if you can be licensed. Keep in mind the dental board is not about being fair or protecting dentists' rights, they're there to look out for what they perceive to be the best interests of the public.

As for the OP's question about whether there are practices that only treat HIV patients, outside of community clinics, I've yet to see it advertised though it might be out there. I know at UOP, we have the CARE program which is partially funded by the Ryan White Foundation. It pays for dental care for San Francisco HIV+ residents who meet certain income requirements. It used to be just one faculty member who would see them, but as the program grew, patients get distributed to all the students. Every student has about 4 or 5 CARE patients. The only extra procedure we take is that we monitor their labs and medication, and look out for any oral manifestations of the disease. That one faculty member still sees CARE patients, but she has cut back her hours to only a couple days a week.
 
ploy said:
Just to answer your last question, yes absolutely there are dentists who specialize in treatment of HIV positive populations. I know this because I volunteer at a free dental clinic in Houston, TX that is only for people with HIV and AIDS that live below the poverty line. Most of the dentists that work there are full time dentists that deal strictly with HIV patients. And there are some extra precautions that we have to take, but for the most part we treat them like any other patient at any other dental office or clinic. And just fyi, the clinic is Bering Omega Dental Clinic. The dentists there are truly inspiring.
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Thank you. I like knowing about what's out there in dentistry, especially for this segment of the population.
 
HIV is not a mandatory test because it is not easily communicable, and also because it is considered a disability under the ADA. There has to be a significant viral load much of the time, it is not airborne, and the virus is actually weakly infectious, even if it is extremely virulent, it isn't nearly as infectious as Hepatitis. Adhering to the universal precaution, and even adding one's own precautions, there is no need that an exposure to be likely, and therefore as a dentist I would definitely protect my right to privacy from the prejudice and ignorance of others. To test for HIV might be good, to ensure treatment, but since there is no vaccine, why make it mandatory?
 
"You have to realize that to be ethically wrong."

I do tell all my sex partners. It is the law. Also sex is much more likely to transmit HIV. To tell complete strangers at work, is different to me, though I would definitely consider that; I will know more what is appropriate in the future, I'm sure about that. For example, researchers in Germany discovered in Dec 2007 that there is a protein in semen that makes HIV 100,000 times more infectious than just alone in blood. For a long time researchers wondered why HIV, so weakly infectious in vitro, was so transmissible in vivo.
 
fusedtometal said:
HIV is not a mandatory test because it is not easily communicable, and also because it is considered a disability under the ADA. There has to be a significant viral load much of the time, it is not airborne, and the virus is actually weakly infectious, even if it is extremely virulent, it isn't nearly as infectious as Hepatitis. Adhering to the universal precaution, and even adding one's own precautions, there is no need that an exposure to be likely, and therefore as a dentist I would definitely protect my right to privacy from the prejudice and ignorance of others. To test for HIV might be good, to ensure treatment, but since there is no vaccine, why make it mandatory?
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That's true, seroconversion from a needle stick injury for HIV is ~0.3% whereas with Hep C, it's around 1.8%. So, while it is low, the chance is still not zero. Even though everyone is taught universal precautions, there are still over 1 million needle stick injuries by healthcare workers in the US. No matter how careful you try to be, accidents can happen.

While I'm not trying to discourage you from pursuing your goals, this is a very complicated issue when dealing with the public. You have every right to not disclose your personal health issues with the public, but should there be an unfortunate incident in which a patient of yours was exposed, how would you handle it? Would you tell them then so that they can start on HART therapy to decrease the chances of seroconversion? Is the risk low enough that you could sleep at night if you didn't tell your patient?
 
Absolutely if I exposed my patient I would tell them. I would follow the law. A needlestick injury to me would not expose the patient. I talked to my dad, and he has never injured himself in a patient's mouth. I realize that's just him, but there are ways to be careful in your treatment rituals I imagine.
 
fusedtometal said:
Absolutely if I exposed my patient I would tell them. I would follow the law. A needlestick injury to me would not expose the patient. I talked to my dad, and he has never injured himself in a patient's mouth. I realize that's just him, but there are ways to be careful in your treatment rituals I imagine.
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So what do you think would happen to your practice or reputation? How do you think the patient would feel? They may be understanding, but you have to be prepared for if they are not. What will the dental board's take on it be? How about your malpractice insurance?

Routines can help keep exposures to a minimum, but there are always unanticipated accidents that you can't plan for. Many of the times, its not even your fault.
 
fusedtometal said:
"You have to realize that to be ethically wrong."

I do tell all my sex partners. It is the law. Also sex is much more likely to transmit HIV. To tell complete strangers at work, is different to me, though I would definitely consider that; I will know more what is appropriate in the future, I'm sure about that. For example, researchers in Germany discovered in Dec 2007 that there is a protein in semen that makes HIV 100,000 times more infectious than just alone in blood. For a long time researchers wondered why HIV, so weakly infectious in vitro, was so transmissible in vivo.
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It seems to me that in NOT telling your own patients your status that you are putting your own self interests above theirs. Regardless of what you call the ignorance of the population, you have an ethical responsibility to do a patient no harm and to put their interests above your own.

I don't want to make false accusations, but I get the sense that any number of HIV+ people withhold telling their status specifically because they fear the backlash. In the dentists case, they may fear that patients will reject them. However, this action of withholding this information may be exactly what is contributing to the "ignorance" of the population you describe.

I believe it's your duty to disclose your status, make yourself an example, and educate the public on this issue. Will it make a difference? That's up to the patient population to decide, but they'll probably be much more likely to do a little more research on the subject on their own time.

Will you be confronted with quite a bit of rejection? You probably already know the answer to that based on your experiences with how your sex partners respond to your disclosure.
 
fusedtometal said:
Adhering to the universal precaution, and even adding one's own precautions, there is no need that an exposure to be likely, and therefore as a dentist I would definitely protect my right to privacy from the prejudice and ignorance of others.
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I also think that your right to privacy takes a backseat to a patients' right to choose...for them to evaluate the risks and make their own decision on the matter.
 
I too agree with most of the posters here that you should seriously consider that you would be putting each and everyone of your patients at risk, be it the chance is small, the risk is still there. Another point I would like to bring to light, is say you get out of school and buy a practice for lets conservatively say 300k, now you have student loans, all of this debt in a new practice, word gets out that you are HIV+, I would imagine this is going to greatly impact your reputation as a dentist and business might not be so good. That said, I too believe it is your ethical duty to disclose your status to each and every patient that walks through the door. If I were going to a dentist I would sure want to know before hand that I was putting myself at a greater risk than going to an HIV- dentist. Just my 2 cents...
 
So, thank you for all your replies. As somebody newly considering the profession, I like that I have your input, and knowing what people really feel and why. I think for someone like me without any dental school experience, like me, this helps. Also, I will be talking with a doctor who has a lot of experience with HIV positive dentists, and I will be posting what I learn there here.
 
I want to add that I recently called the California Licensing Board, and they told me that they do not advocate disclosure. Since HIV is a disability, it would be discriminatory to require disclosure. They said they don't even track that information or require anything different of positive practitioners. They also stated that it is illegal for a dentist to refuse treatment to an HIV positive patient. They said they took this position to prevent discrimination on both sides and because universal precautions are sufficient. What does your state's licensing board say about this?
 
fusedtometal said:
I want to add that I recently called the California Licensing Board, and they told me that they do not advocate disclosure. Since HIV is a disability, it would be discriminatory to require disclosure. They said they don't even track that information or require anything different of positive practitioners. They also stated that it is illegal for a dentist to refuse treatment to an HIV positive patient. They said they took this position to prevent discrimination on both sides and because universal precautions are sufficient. What does your state's licensing board say about this?
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Just to stir the pot a little, is HIV the only acquired infectious disease that enjoys the label of "disability"?
 
fusedtometal said:
Since HIV is a disability, it would be discriminatory to require disclosure. They said they don't even track that information or require anything different of positive practitioners. They also stated that it is illegal for a dentist to refuse treatment to an HIV positive patient. They said they took this position to prevent discrimination on both sides and because universal precautions are sufficient. What does your state's licensing board say about this?
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I don't buy that. If that is true, it is ridiculous. I know it is not that way in normal states. And, I would never willingly go to a doctor or dentist with HIV/AIDS. Why would any person chose to expose themselves to that risk? That doesn't make me a discriminator against the "disabled". I would have no problem going to a dentist who was actually disabled but still performed excellent work. But if going to the dentist puts me at risk, I will chose another. I can't believe you would be ok with lying to your patients. And before you say the ignorant "I am not lying cause they didn't ask" garbage, I will point out that omission IS the same as lying. You KNOW they should have that information to make an informed decision.
 
TheDrewYouKnew said:
I don't buy that. If that is true, it is ridiculous. I know it is not that way in normal states. And, I would never willingly go to a doctor or dentist with HIV/AIDS. Why would any person chose to expose themselves to that risk? That doesn't make me a discriminator against the "disabled". I would have no problem going to a dentist who was actually disabled but still performed excellent work. But if going to the dentist puts me at risk, I will chose another. I can't believe you would be ok with lying to your patients. And before you say the ignorant "I am not lying cause they didn't ask" garbage, I will point out that omission IS the same as lying. You KNOW they should have that information to make an informed decision.
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This response is exactly why policies like this are in place :laugh:
 
aphistis said:
Just to stir the pot a little, is HIV the only acquired infectious disease that enjoys the label of "disability"?
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The history behind why HIV/AIDS is considered a disability stems from the discrimination surrounding the way people were being treated. In 1994, a HIV+ patient named Sidney Abbott was refused treatment for a filling by her dentist. She sued, citing the American with Disabilities Act (ADA), and in 1998 the Supreme Court ruled in her favor that HIV/AIDS is a disability and the ADA applies.

I guess if we try really hard to discriminate against people with measles, colds, chicken pox, etc, then other infectious diseases can be added to this list.
 
This is a tough one, but I think that I would not disclose my status to my patients. Here's why:

If I was HIV+ and going to dental school, I'd be doing it because I thought I could still make a significant impact in the field of oral health and do more good than harm. I would be optimistic that my treatment and lifestyle would allow me enough years of survival to practice a good amount and live a satisfying life.

The MOMENT that one person is notified, your practice is shot. There's no other way about it. So since that'd be the only reason I went INTO practice, I would not risk it.

It's very rare for a dentist to expose a patient. If that happened, I would then disclose (but assume that it's likely my practice is over once word got out.) I would not for an exposure from a patient.

I mean, you can easily kill an elderly patient by transmitting a respiratory virus, not to mention any other diseases that are much more likely to be transmitted. People would not call a dentist unethical by not disclosing a head cold even though the risk of death would be higher for an immunocompromised patient (and the rate of transmission MUCH higher than HIV).
 
You can refuse to treat any patient you want; I guess not in gay California where the liberals are all about universal health care. Since we don't have universal health you dont HAVE to treat anybody. here's why... It is a private institution where people come for a service that you can either give or choose not to. If I owned an airline company and someone was drunk I wouldn't let them on my aircraft due to safety. If someone has AIDS and I don't want to treat them I have every right to not treat them (in my eyes). Obviously due to the screwed up disability act there are ways you have to get around this violation of our constitution. As long as you don't give a reason on why you aren't treating the patient then they can't claim you violated the disibility act. It's as easy as that!
 
ObliqueRidge said:
You can refuse to treat any patient you want; I guess not in gay California where the liberals are all about universal health care. Since we don't have universal health you dont HAVE to treat anybody. here's why... It is a private institution where people come for a service that you can either give or choose not to. If I owned an airline company and someone was drunk I wouldn't let them on my aircraft due to safety. If someone has AIDS and I don't want to treat them I have every right to not treat them (in my eyes). Obviously due to the screwed up disability act there are ways you have to get around this violation of our constitution. As long as you don't give a reason on why you aren't treating the patient then they can't claim you violated the disibility act. It's as easy as that!
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1) Private institution or not, you're still prohibited by law from discrimination on the basis of protected status. Like it or not (I personally disagree with it for reasons I've mentioned above), that list includes HIV status. Much to the detriment of your flawed comparison, the list does not include acute alcohol intoxication.

2) I don't mean this disrespectfully, but your eyes don't matter here. The courts have resolved this issue very clearly. Go back about 150 years, and you'd find great many Americans who had every right to own slaves--in their eyes. Your argument didn't work for them either.

3) ...violation of the Constitution? See #2.

4) It's nowhere NEAR as easy as that. They most certainly can claim discrimination, and it'll cost you time, money, and reputation to prove you didn't--assuming they aren't correct in the first place, in which case you're seriously up the creek without a paddle.
 
If they want to claim discrimination they most very well can, but they will have to prove that I solely did not treat them due to AIDS. This has only been done once and that was when the law was made! Show me another time this law has come into affect. I'm pretty sure AIDS and slavery are two different topics. I'm not using an AIDS patient for physical labor; i am simply refusing to use the skill I learned to treat them. Until the laws say that we have universal healthcare and by law i HAVE to treat every patient that is sent to me or my hands will be cut off ...I can refuse treatment to whomever I chose. Obviously I did not say this was the law. The law states I can't refuse treatment to these patients on the simple fact that they have HIV;if they wan't to go through the process to prove this then let them go ahead. It will be much easier for them to go to another dentist than to do all of that. In saying all of this i will still treat a patient with HIV, i just dont agree with the law. Just showing the other perspective.
 
You won't be the only one at risk to get infected. 🙄 Dental assistants and dental hygienists could also be at risk. They spend more time with the patients. It doesn't matter anyway. The only time that you would be at risk if you become clumsy and stick yourself. That is your problem if you are not careful enough after you just learned that the patient is HIV positive! If you that concern with infectious diseases, DO NOT GO INTO DENTISTRY!!!!! Noone wants HIV, AIDS, hep. C, etc. You just have to be careful. You realized that you are putting yourself at risk when you enter this profession. Nurses, MDs, dentists, techs etc. could put themselves at risk everyday for infectious diseases. If you don't want to treat HIV patients, go into radiology, psych, pharmacy, physical therapy, or chiro.
 
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My friend cut herself while doing extraction because an elevator poked her finger. Whatever, blood was dripping in the patient's mouth. Both of them were tested and every thing was fine. What if the doctor had HepC or HIV+? Sure the patient would be scared that day? A drop of blood is a drop of blood, especially when it's in patient's mouth. Nobody likes going to dentist that much already, it just creates a negative experience on both sides, I think.
As practitioners, we know that we have risk getting exposure and we accept it when we enter dental school. Patients come to us because they trust that they come to a clean office with super universal precaution and I don't think they are willing to take that kind of risk. Well, disclose or not, is up to the practitioner. But if accident happens, you are seeing a big law suit and be prepared for that. It would be a lawsuit that ends your career & your business.
 
ObliqueRidge said:
If they want to claim discrimination they most very well can, but they will have to prove that I solely did not treat them due to AIDS. This has only been done once and that was when the law was made! Show me another time this law has come into affect. I'm pretty sure AIDS and slavery are two different topics. I'm not using an AIDS patient for physical labor; i am simply refusing to use the skill I learned to treat them. Until the laws say that we have universal healthcare and by law i HAVE to treat every patient that is sent to me or my hands will be cut off ...I can refuse treatment to whomever I chose. Obviously I did not say this was the law. The law states I can't refuse treatment to these patients on the simple fact that they have HIV;if they wan't to go through the process to prove this then let them go ahead. It will be much easier for them to go to another dentist than to do all of that. In saying all of this i will still treat a patient with HIV, i just dont agree with the law. Just showing the other perspective.
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Do you have any proof of this "it has only been done once" claim or are you simply making things up to suit your argument? This is one of the most ignorant posts I've ever read. Assuming you are in dental school and have taken ethics courses, you know that you have absolutely NO right to deny treatment to anyone. The law DOES say you have to treat everyone. If I was HIV positive and was refused treatment, you can be sure I'd be suing that dentist real quickly. Go ahead and refuse- it will rid our profession of people like you.

On another note, I'm no fan of universal health care at all, but you also clearly don't understand it. Universal health care has nothing to do with whether or not you have to treat people. It only involves how their payment will be provided. Understand the law before you make ignorant statements.
 
Dukie said:
Do you have any proof of this "it has only been done once" claim or are you simply making things up to suit your argument? This is one of the most ignorant posts I've ever read. Assuming you are in dental school and have taken ethics courses, you know that you have absolutely NO right to deny treatment to anyone. The law DOES say you have to treat everyone. If I was HIV positive and was refused treatment, you can be sure I'd be suing that dentist real quickly. Go ahead and refuse- it will rid our profession of people like you.

On another note, I'm no fan of universal health care at all, but you also clearly don't understand it. Universal health care has nothing to do with whether or not you have to treat people. It only involves how their payment will be provided. Understand the law before you make ignorant statements.
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There's a little too much piss and vinegar in this thread, and not quite enough understanding of law and ethics.

As a dentist, you're perfectly entitled to refuse treatment to anybody you choose--as long as you aren't basing the decision on protected characteristics like race, gender, religion, HIV status, etc., etc.

For example, I don't like the New England Patriots, so if DrJeff comes walking into my office wearing his Tom Brady jersey one afternoon, I can refuse to treat him on that fact alone, without breaking any laws.
 
tinker bell said:
My friend cut herself while doing extraction because an elevator poked her finger. Whatever, blood was dripping in the patient's mouth. Both of them were tested and every thing was fine. What if the doctor had HepC or HIV+? Sure the patient would be scared that day? A drop of blood is a drop of blood, especially when it's in patient's mouth. Nobody likes going to dentist that much already, it just creates a negative experience on both sides, I think.
As practitioners, we know that we have risk getting exposure and we accept it when we enter dental school. Patients come to us because they trust that they come to a clean office with super universal precaution and I don't think they are willing to take that kind of risk. Well, disclose or not, is up to the practitioner. But if accident happens, you are seeing a big law suit and be prepared for that. It would be a lawsuit that ends your career & your business.
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Thank you. This is a very straightforward posting, and it seems accurate of how events would unfold.
 
A dentist should be obligated to disclose to someone about their status. If an accident were to happen he/she needs to take responsibility.

I don't care if it's to their patients or a health review board, but I have serious misgivings about a dentist that chooses not to disclose.

I can already envision a dentist that doesn't disclose have an accident. Then, while knowing that his/her career is in jeopardy, begin to justify keeping it a secret because of the aforementioned "more good than harm" rationalization.
 
I was just completing our quiz on infection control. This is from our manual:

A dental health care worker (DHCW) with a communicable disease must minimize the likelihood of his/her providing care during communicable stages of any infectious disease. The decision of a DHCW to provide care and/or service during a period of potential communicability requires that the DHCW can safely perform expected tasks without the risk of infecting patients and other DHCWs.

Take it for what its worth, but can an HIV+ ever safely perform tasks without the risk of infecting patients and other employees? No.

Just my thoughts.
 
ScubaDr2B said:
I was just completing our quiz on infection control. This is from our manual:

A dental health care worker (DHCW) with a communicable disease must minimize the likelihood of his/her providing care during communicable stages of any infectious disease. The decision of a DHCW to provide care and/or service during a period of potential communicability requires that the DHCW can safely perform expected tasks without the risk of infecting patients and other DHCWs.

Take it for what its worth, but can an HIV+ ever safely perform tasks without the risk of infecting patients and other employees? No.

Just my thoughts.
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While HIV is communicable, it is not easily contagious. I have found that because a substantial risk is not involved, that the issue isn't one that is talked about in medicine very much anymore after epidemiological studies showed a risk of between 1:200,000 to 1:2,000,000. Except for the one Dr. Acer, there has never been any record of an infection transmitted from a dentist either in the U.S. or Canada. Universal precautions would cover that. In my informal research, I have found that there are a number of HIV positive dentists in my area. i hope I will have a chance to talk to them. I have also found that in dentistry HIV is a very stigmatized disease. I can't imagine telling every patient and still being able to afford to run a practice. I can imagine telling patients undergoing extractions or more invasive procedures, or not doing those at all. Treating HIV patients would be very rewarding for me, especially if they could know they could relax in my care. The number of HIV infections in the U.S. is approaching one million.
 
fusedtometal said:
While HIV is communicable, it is not easily contagious. I have found that because a substantial risk is not involved, that the issue isn't one that is talked about in medicine very much anymore after epidemiological studies showed a risk of between 1:200,000 to 1:2,000,000. Except for the one Dr. Acer, there has never been any record of an infection transmitted from a dentist either in the U.S. or Canada. Universal precautions would cover that. In my informal research, I have found that there are a number of HIV positive dentists in my area. i hope I will have a chance to talk to them. I have also found that in dentistry HIV is a very stigmatized disease. I can't imagine telling every patient and still being able to afford to run a practice. I can imagine telling patients undergoing extractions or more invasive procedures, or not doing those at all. Treating HIV patients would be very rewarding for me, especially if they could know they could relax in my care. The number of HIV infections in the U.S. is approaching one million.
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The obvious answer if for you to only treat HIV positive patients. Either work for a clinic or do outreach work with HIV/AIDS groups overseas. You'll get to treat patients and no is at risk. However to not disclose your status to unaffected patients because it will hurt your INCOME, is wrong.
 
fusedtometal said:
While HIV is communicable, it is not easily contagious. I have found that because a substantial risk is not involved, that the issue isn't one that is talked about in medicine very much anymore after epidemiological studies showed a risk of between 1:200,000 to 1:2,000,000. Except for the one Dr. Acer, there has never been any record of an infection transmitted from a dentist either in the U.S. or Canada. Universal precautions would cover that. In my informal research, I have found that there are a number of HIV positive dentists in my area. i hope I will have a chance to talk to them. I have also found that in dentistry HIV is a very stigmatized disease. I can't imagine telling every patient and still being able to afford to run a practice. I can imagine telling patients undergoing extractions or more invasive procedures, or not doing those at all. Treating HIV patients would be very rewarding for me, especially if they could know they could relax in my care. The number of HIV infections in the U.S. is approaching one million.
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One in two MILLION? You're going to have to show me the literature citation for that one.
 
aphistis said:
One in two MILLION? You're going to have to show me the literature citation for that one.
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I don't imagine blood to blood exposure of doctor to patient is that frequent, not to mention the fact that if he's well controlled his viral load is probably somewhere around 0. In that situation, the chance he'd infect someone without sexual contact is basically nil.

The problem here isn't about the highly, highly unlikely chance he'll infect someone, it's the public perception and effect on his practicing life IMO.
 
Lopyswine said:
The obvious answer if for you to only treat HIV positive patients. Either work for a clinic or do outreach work with HIV/AIDS groups overseas. You'll get to treat patients and no is at risk. However to not disclose your status to unaffected patients because it will hurt your INCOME, is wrong.
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And I am very interested in both of those things. I don't feel I need to disclose because the risk is insignificant, and it isn't required. I would consider not doing extractions, for example, though. I just think it would make patients uneasy, and maybe hurt my income so much I couldn't practice unless I was always working for someone else. Do patients always assume their dentist is negative? If a patient asked me, I would tell them exactly what the universal precautions entail, what the CDC estimated risks are, andthat I believe that information is private.
 
armorshell said:
I don't imagine blood to blood exposure of doctor to patient is that frequent, not to mention the fact that if he's well controlled his viral load is probably somewhere around 0. In that situation, the chance he'd infect someone without sexual contact is basically nil.

The problem here isn't about the highly, highly unlikely chance he'll infect someone, it's the public perception and effect on his practicing life IMO.
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I guess this depends on where you live and who the public is. I consulted with HIVdents, the California State Licensing Board, a social worker who has a dentist brother and a few HIV positive dentist clients, one dentist, and they all said they wouldn't disclose, and I have no reason to.

Others, said they felt I had to, and my father, a dentist himself said a dentist with HIV cannot practice. Another dentist I shadowed told me he thought I couldn't legally practice, but then added that he really didn't know what the law was. So public perception seems to me like its all over the map. Does it really make sense that patients would automatically assume that their dentist is HIV negative? Patients also have a responsibility to seek out the disclosure laws and know what they say.
 
tinker bell said:
My friend cut herself while doing extraction because an elevator poked her finger. Whatever, blood was dripping in the patient's mouth. Both of them were tested and every thing was fine. What if the doctor had HepC or HIV+? Sure the patient would be scared that day? A drop of blood is a drop of blood, especially when it's in patient's mouth. Nobody likes going to dentist that much already, it just creates a negative experience on both sides, I think.
As practitioners, we know that we have risk getting exposure and we accept it when we enter dental school. Patients come to us because they trust that they come to a clean office with super universal precaution and I don't think they are willing to take that kind of risk. Well, disclose or not, is up to the practitioner. But if accident happens, you are seeing a big law suit and be prepared for that. It would be a lawsuit that ends your career & your business.
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Yes, but disclosing to any patient would almost definitely be the end of your career anyway.

Now, practitioners have the right to ask a patient's status, so patients should have the same right. That's the only reason I would argue that a dentist should disclose. I'm just not totally sure that I would (unless an incident happened.) But I'm also strange and would not take prophylactic antiretrovirals if I had a needle stick with an HIV+ patient, so I may be of a different perspective. 🙂 (I started a thread with just that thought.)

But like I said before, disclosing an HIV+ status and therefore likely ruining one's career defies the entire purpose of deciding to pursue a dental career as a positive person. So if I were to do that, I wouldn't disclose.
 
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