Quality & Affordable Dentistry in Malaysia

How Concerned Should You Be About Hiv/Aids, Hepatitis, & Other Infectious Diseases While Receiving Dental Treatment in Selangor, Malaysia

Posted by dentist3 in Dental Articles | 0 comments

The issue of cross-contamination have been a top priority since the advent of HIV/AIDS, and medical/dental personnel have been mandated to eliminate the possibility of cross-contamination from individuals carrying these viruses.
The issue of cross-contamination have been a top priority since the advent of HIV/AIDS, and medical/dental personnel have been mandated to eliminate the possibility of cross-contamination from individuals carrying these viruses.

One of the most asked questions by dental patients is: “How concerned should I be about HIV/AIDS, hepatitis and other infectious diseases while receiving dental treatment?

First, let me explain that all medical and dental offices are mandated today to render treatment and surgical rooms and personnel safe for patients, staff, and doctors alike. The issue of cross-contamination have been a top priority since the advent of HIV/AIDS, and medical/dental personnel have been mandated to eliminate the possibility of cross-contamination from individuals carrying these viruses.

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A great deal of thought lead to the institution of universal precautions. Thus, facilities where medical and dental treatment are performed must follow certain preventative procedures to prevent the spread of infections to healthy people, even when infected patients are being treated at the same facility. Sometimes, individuals do not know of an infection that they might have or may, in certain cases, withhold the information they do have, but all doctors and their staff must, nevertheless, treat them. Recognising that any scenario is possible, medical personnel must treat everyone as though he or she is infected.

By following universal precautions, the set-up, treatment, clean-up, sterilisation of equipment, and storage of materials are always clean and sterile. The treating staff must also be vigilant not to allow any distractions or carelessness to break this cycle. With these procedures in place, cross-infections are virtually impossible.

This elimination of cross-infection also employs a myriad of new and ever-developing expendable (one-use-only) materials, supplies, and equipment. In the dental clinic, this includes needles, swabs, small applicator brushes, suction tubes, saline solutions, trays and napkins, drinking cups, impression trays, gauze, cotton supplies, and many other products.

We also employ barrier systems to protect working surfaces, such as countertops, light switches, water and power adjustments, and anything else that the treatment staff may touch. The underlying work areas are cleaned with anti-bacterial/viral solutions before reapplying new barrier materials. These materials are often supplied in rolls, like tissue paper, and are of thin plastic on the outer surface and a sticky under surface that clings to the “touch” surfaces or areas. All surfaces are wiped down between patients, including the dental chair itself with biocides (germ killers).

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The instruments just used, including the hand pieces (dental drills), are then washed with soap and water by a staff member in a sterilising room or laboratory. The operator wears heavy industrial rubber gloves that are designed to be puncture proof. After rinsing, these same instruments are placed in an ultrasonic cleaner and soaked in a special biocide cleanser while vibrating for several minutes. Then, after rinsing and drying, the instruments are placed in one-use sterilisation packs and sealed. Next, the packets are placed in an autoclave or other medically accepted device. There, they are heat-pressure and chemically treated for several more minutes. After depressurisation, the packets are then cooled and then appropriately stored. When these procedures are fully implemented, patient safety is assured. Virtually all professionals are careful to fully comply with these universal precautions.

There are additional new regulations that have been implemented and enforced by the Occupational Safety & Health Administration (OSHA). Several areas of the federal government, including the Center for Disease Control (CDC), and many university dental and medical schools are continuing to research new and more effective measures of control and safety assurance.

The only alleged case of a dental patient acquiring the HIV virus was several years ago when a Florida dentist who later died of AIDS was accused of infecting the live virus into his patients. There has been much investigation into this situation and no final conclusion has apparently been drawn.

Hepatitis B and tuberculosis, however, is another story. Hepatitis B is also a disease carried by the blood and is much easier to contract than HIV/AIDS. While I am not sure whether any dental patients have acquired it (at least since the advent of universal precautions) at the dental office, several dentists have acquired it, presumably from their patients. The wonderful development here is that doctors and their treatment staff can be immunised with a vaccine to prevent hepatitis, and they all should be.

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Tuberculosis (TB) is different still from either of the above-mentioned diseases in that it is airborne and can be contracted through the air that we breathe if in close proximity to an infected individual. That is the reason why staff wear masks during treatment- to prevent the exchange of lung air both ways. The occurrence of TB, after decades of relative quietness, has broadened considerably in recent years. In fact, in some segments of the population, it is even epidemic. Universal precautions and vigilance are thus a necessity and the dental team should be tested periodically, or at least upon any suspicion, of exposure to the bacterium.

Practitioners in all dental facilities must now wear eye protection, and masks. Their outer clothing is worn only in the office. One-use, throw- away gowns are increasingly being used today; but when scrub suits and lab coats are used, they must be taken off, carried, and laundered in very specific ways that reduce the chances of cross-contamination. All used supplies and materials are discarded in a hazardous waste container which is picked up on site by a medical waste disposal service.

The box is sealed and transported to the disposal site where it is incinerated. Needles, glass local anaesthetic capsules, and all other sharp objects are discarded in special smaller plastic containers. Dental offices now provide regular (at least annual) on-site training and education for the entire staff, by properly sanctioned firms and instructors, on the proper maintenance of these techniques and on the latest advances in safety and disease prevention.

With all the rules, regulations, systems, materials, and technology available today, one would think that the risk of contracting disease in the dental environment would be infinitesimal. And it almost is! The only problem is the human factor. Carelessness and accidents do happen. Still, nearly all practitioners and their staff that I know are extremely conscious about maintaining these standards. Patients have told me that they quit going to their former dentist because of what they perceived to be lapses in these standards. 

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For example, the dropping of a dental instrument on the floor and continuing to use it. If you should experience anything of this nature which you consider inappropriate, you are certainly within your rights to question the action and demand compliance with KKM rules and regulations. If appropriate action is not taken to correct the infraction, report the dentist and the facility to KKM.

Dentistry has greatly advanced its skill to protect you, the patient. Even as the profession progresses, there are threats such as HIV/AIDS and recurring ones such as TB out there. However, the new precautions, intensified awareness, and efforts by health professionals virtually ensure safe visits to the dentist.

Should you be concerned? I, for one, am concerned when I cross the street, drive my car, or take an airplane. However, I am less concerned when I visit a health care provider because of all the precautions being taken and advances being made today.

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