HIV risks

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I would like to know too, PLEASE POST
 
I did a little research on this topic while at work today. Looks like the risk of infection for dentists is very small. From what I have read there has never been a documented case of any dentist contracting aids from a patient.

http://www.wsws.org/news/1998/jun1998/crt-j27.shtml
(6th paragraph down under "A rebuff to keneth star")

also

http://www.healthcarespeaker.com/images/Dental_HIV.pdf

If you are really paranoid about it you can visit:
http://www.hivdent.org

I don't know how reliable these sources are so please don't hold me to them.

Also, from what I have been reading, it looks like we (future dentists) can get into a lot of trouble for refusing to treat a patient with HIV. What do you guys think about that? Should dentists be forced to treat HIV patients so as not to be discriminatory, or should a dentist have the right to refuse treatment to any patient they want? Sounds like a good topic for debate.
 
just becareful while you're working... i asked one of my friends that graduated ucla dent how many of his classmmates poked themselves w/ needles and he said a few did...and I asked the same questions bout HIV etc etc...and he said some takes medication after this incidence to decrease the risk of accquiring HIV... i don't recall the name of the drug but it's suppose to make you tired while you're on it...

NEVER cap your needles w/ both hands... it freaks me out whenever i see anyone do that in clinic... and always remove burrs from your handpiece this should reduce the risk even more...
 
As long as your using the Universal percaution saying. gloves and a mask you should be okay.

When I was volunteering at a 3 day dental mission of mercy trip down in El paso. the Doctors were more prone to infection from TB than HIV. Your more likely to come into contact with patients infecting you with TB than HIV especially on the poorer regions of the country. Especially in El PASo right on the border an all.

As far as treating HIV patients. Dentist and hygienst believe that everyone you treat is a potential HIV carrier. So you can't pick and choose your patients. As long as you are following the universal precation of gloves and mask, you should be all right, regardless if the patient does or doesn't have HIV.
 
Originally posted by hockeydentist
As long as your using the Universal percaution saying. gloves and a mask you should be okay.

gloves, mask, AND GLASSES!!!

you can contract a heck of a lot of diseases
if blood or saliva splashes into your eyes.
Click to expand...
 
Thanks all for your comments. I am not going to worry about it too much. I guess the key thing is to be cautious...and never work without gloves and masks. On the other hand, I feel that dentists should not be forced to treat patients who are HIV positive. No matter what precautions we take, ACCIDENTS CAN ALWAYS HAPPEN. I believe that individuals with HIV should understand that they are putting their dentists at risk and thus try to look for dentists who are comfortable with this idea. We have only one life to live, and we have every right to protect it in any way we want.
That is all.
 
Just forgot, so use to wearing a mask with the eye shield already attached that I forgot glasses as well.

good catch
 
The incidence of HIV transfer in North America from patient to dentist is very rare. If memory serves me correct, the risk of HIV transfer following needle stick is around 0.3% where HepB is closer to 30%. The risk is however dependent on a number of factors including type of needle used/amount of blood transfer/viral titre. Post-exposure anti-viral drugs can be administered and the decision to do so is based on the associated risk of infection.

While everyone is entitiled to their opinion, I would kindly urge you to consider the principles behind refusing to treat HIV+ pts. I believe with a willingness to enter a health profession should come the willingness to assume various risks such as these. If one is uncomfortable with these risks then maybe one should reconsider careers rather than a right to refuse treatment. It is this type of attitude that can lead patients to provide incomplete medical histories which can in turn lead to inappropriate patient management.

Best of Luck
 
I think that the risks are extremely low - however, the risks for dental graduates from south african universities are rediculously high due to the fact that they must perform a mandatory 2 year community service within the townships. so much for 3rd world health care systems.
 
My clinical instructors have it drilled into our heads:

1) Always use the single-hand recapping technique for needles.

2) Always turn the handpiece on its bracket so it faces the tray rather than you.

3) All the other universal precautions apply.

I don't think anyone in my class has ever had an accidental needle stick thus far.
 
" On the other hand, I feel that dentists should not be forced to treat patients who are HIV positive. No matter what precautions we take, ACCIDENTS CAN ALWAYS HAPPEN. "

Actually I think that HIV patients have a right to dental care. Your likelihood of contracting HIV from a stick are very low. It's not the people who know they have HIV that are the high risk patients, it's the people who don't know and can't tell you!

" I believe that individuals with HIV should understand that they are putting their dentists at risk and thus try to look for dentists who are comfortable with this idea. We have only one life to live, and we have every right to protect it in any way we want."

Oh, trust me they do know the risk. They know they're going to die from AIDS! If your going to turn a way HIV patients maybe you should have been an accountant! Every profession has a risk and this is one of them. Instead of deciding who your going to exclude from your practice focus on how to deliver safe care to NEEDY patients.
 
Something else worth considering...

It's already been mentioned that AIDS is a medical condition, and we're all planning to work in a <i>health care career</i>, folks. If you want to refuse someone dental treatment based on a pretty negligible possibility of transmission, that's your decision.

Of course, the discrimination lawsuit they file against you will be <i>theirs</i>, and based on the body of medical evidence on transmission rates, your chances of an expensive judgment (which you have no control over) are substantially higher than your likelihood of contracting HIV from the patient in the first place (which is <i>entirely</i> within your control to prevent).
 
Contracting HIV from solid instruments such as burs and other metal instruments is almost non existant. The main route HIV transmission can occur is via poking yourself w/ a needle that has been used on an infected patient or blood spurting out and into your mucous membranes (nostrils, eyes, mouth, or other open wounds). Remember HIV cannot live longer than a few seconds when exposed to air, for this reason most solid instruments would have HIV on the surface exposing it to air. However, a needle might have no air, hence increasing the HIV survival rate.

So use all the universal precautions. I have been poked about twice already (Thank goodness it was before it was injected or used).

I remember Dr. Jeff saying that, you will get poked. Every dentist has had an accident. Accidents happen. Be ready. If you do get poked with an infected instrument hurry and take the HIV-cocktail. This is a must w/in 2 hours of exposure. Also, if the patient is nice s/he can take a blood test to illustrate HIV status.

DesiDentist
 
Correction: HIV can survive outside the body for more than a few hours not minutes.

Heres an interesting fact: 17% of Canadian Dentist refuse to see HIV infected patients

Reference: Stine, Gerald. AIDS Update 2000 (He has a new book out but I don't have it)

Dr. Stine is Known throughout the world on AIDS research and continues to educate underserved areas such as China and Africa.

I was fortunate enough to take a class tought by him and learned a great deal.

For all you in undergrad, if your school offers an upper elective science coarse in AIDS...TAKE IT!!!

My class was called AIDS Biomedical Issues
 
Regarding this statistic that 17% of Canadian dentists refuse to treat HIV infected patients, is this recent? I find this difficult to believe because it is most certainly grounds for a Discrimination Suit in Canada and disciplinary action on behalf of the College representing dentists.
 
Data from 2000. If I get the new book soon I will update
 
that doesn't make sense that you can refuse treatment to HIV patients... then what's the purpose of universal precaution??? You never really know who has HIV or who doesn't... This was my topic at Temple's interview... it was something like should patients have to tell the Dr if they have HIV... I'm just going to assume everyone has HIV and be super cautious...
 
Well that's just it, you can't refuse treatment.
 
technically you can't even double glove with an HIV infected patient if you don't double glove for every patient!
 
Well I have nothing againist treating them bec I learned alot in that class I mentioned. I admit I had a big fear of this issue but now its minimal.

I will dig up that book and try to find who did the study about the 17% and post the article
 
Hey Job314...first of all, accountant is the last thing I want to be. I was just stating my opinion like everyone else. I think it is important to explore these issues and try to educate one another. Prior to posting my message, I knew little facts about this whole issue...but after reading these posts and seeing that most of us don't seem to be too frightened by it...I must say that I feel more comfortable about the idea of treating HIV patients.
Thanks again for all your comments.


:clap:
 
Ok, slight miss reading on my behalf (should have read more than the conclusion 😳 ). But here it goes:

At the time of publication of this article there were 15,232 Dentist in Canada. A random sample of 6,444 was sent a survey on whether they would refuse to treat HIV-infected patients. Of that sample 4,281 anwsered and 17% of THESE said they would refuse to treat those with HIV. Sampling was found to be statistical significant.

Most common reasons for refusal: Lack of belief in an ethical responsibility to treat patients with HIV and their fears of becoming infected.


See guys I could admit my errors. I don't want to post BS

Heres the article in case someone wants to read it:

McCarthy, Gillian et al. (1999). Factors associated with refusal to treat HIV infected patients: The Results of a National Survey of Dentists in Canada. Am. J. of Public Health, 89:541-545
 
Hi all,

We actually hit this in lecture today. In the US, there's a double-whammy that stops you from treating an HIV-positive patient.

First, HIV-positive status is federally protected under the Americans with Disabilities Act. You can't discriminate on that basis.

Second, the second half of HIPAA went into effect this April, and refusing treatment would become very difficult without navigating a pretty tangled mess of concealment from your staff who aren't involved in his/their treatment (like front desk).
 
Hi all,

We recently had a lecture on HIV infection as part of our year 1 & 2 medical curricula. The risk of contracting HIV during sexual intercourse male to female is about 1/300, female to male is about 1/500, between homosexuals is about 1/200.

Now with respect to health care professionals, receiving HAART (Highly Active Antiretroviral therapy) inmediately after the incident brings the risk of chronic infection to zero. As you guys probably know the immune systems puts a strong fight against the virus during the initial stages of infection (before sero-conversion). This aided by anti-retroviral medication helps to eliminate any viral particle before infection to CD4+ cells and exponential replication.

So, should you get injured with a needle or bur, even if the patient declines being HIV positive, stop whatever you're doing, run to the nearest hospital emergency room and demand HAART. This will save your live. The reason I say, not to care about the patient's response is because it takes 6 months for sero-conversion to occur, most importantly only 1/5 HIV infected individuals actually know they're infected.

I hope this helps.
 
While a visit to a hospital/clinic is important, anti-viral treatment need not be administered every time. The side effects are not very pleasant, thus the decision to administer the drugs is based on an assessment of the relative risk of infection, ie. if the pt claims to be HIV-, does he/she present with risk factors?
 
That's debatable,

I rather take side effects for a while that not for my entire life. Should it happen to me, I go for HAART not matter what.

Cheers
 
Some of the side effects are,

Fat redistribution, stomach ache, diarrhea...these are the one. I'm pretty sure there should be many more.

Cheers,
 
Suppose your pt. is 6 yrs old (i.e. not sexually active, not an iv drug user) whose mother claims to be HIV- and presents with little/no risk factors. Combine this with the 0.3% risk of transfer if the blood IS infected, would you still request PEP? I suspect your physician would advice to the contrary.
In addition, PEP is not 100% effective, I believe it is around 79%.
 
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