AIDS and dentistry: the governmental view

Article Abstract:

The health care industry had become complacent about the risks posed by infectious diseases, until the AIDS (acquired immune deficiency syndrome) crisis. At that time dental professionals gave the impression that they were unwilling to treat patients with AIDS (acquired immunodeficiency syndrome). During interviews with various government health officers discussion focused on the obligation of health care professionals to care for those who are ill. Health officers disagreed about the desirability of establishing separate clinics for AIDS patients. Relative to dentistry, when proper precautions are taken, a dentist has little risk of becoming infected with HIV (human immunodeficiency virus, which causes AIDS). If a dentist is exposed to HIV by a needle stick, the risk of infection is less than a half percent (the conversion rate is estimated to be 0.42 percent). The risk of HIV transmission from doctor to patient is extremely small, and many believe that if a health care worker is HIV positive, he/she should be allowed to care for patients. However, the public is owed common sense and ethical behavior on the part of those who provide medical and dental care. In taking a health history, dentists may ask about sexual practices and drug use, if it is considered to be pertinent. As with all medical and dental histories, the information obtained is confidential. Education regarding AIDS is needed for both the public and health care professionals. Dentists should be familiar with the clinical manifestations of AIDS, since about 30 percent of early AIDS symptoms involve oral lesions. Education regarding HIV infection control procedures must be continued. Treatment distribution problems have also interfered with the ability of HIV-positive and AIDS patients to obtain dental care. There are shortages of physicians, dentists and other health professionals in major urban areas where these patients are concentrated. The health care industry has little time to prepare for what lies ahead. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dental care, Public health, Oral hygiene

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Dentistry and AIDS: a ethical opinion

Article Abstract:

A profession is defined in part by its expected behavior or code of ethics. Dentists and dental hygienists have codes of ethics which no not allow them to discriminate against patients with AIDS (acquired immune deficiency syndrome) or HIV (human immunodeficiency virus) infection. Other dental office personnel are not governed by codes of ethics; if staff members in a dentist's office are not willing to provide the care needed, the dentist remains responsible for doing so. Some dentists may look for excuses to avoid caring for AIDS and HIV-positive patients. When these patients seek dental care, the dentist has three choices: to refuse to treat the patient, to provide dental care and risk infection, or to give up being a dentist. If he/she chooses to remain a dentist, the dental code of ethics does not allow him/her to refuse to treat the patient. In addition, this code does not allow the dentist to refuse to treat an AIDS or HIV-infected patient as a means of protecting other patients. However, the dentist is required to take certain precautions against spread of infection in order to protect his other patients. The code could be changed if it demanded more than could be reasonably expected of dentists; based on current evidence regarding AIDS and HIV this does not seem to be the case. According to the author, a profession that appears to protect its own safety over providing care for those in need of their service is more like a trade association than a profession. Legal considerations relative to providing dental care for AIDS and HIV-positive patients are presented, such as the application of discrimination laws if AIDS is considered a handicap, legal liability for abandonment of a current patient, and legal responsibility if the dentist is a carrier of an infectious disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The psychosocial aspects of HIV/AIDS care

Article Abstract:

The psychosocial care of the HIV-infected person is a challenge to health care providers. A person who tests positive for HIV can expect to develop AIDS at some point in the future; once AIDS is diagnosed, there is an 80 percent chance of death within five years. At the very minimum, the identification of HIV infection or the diagnosis of AIDS results in a period of turmoil and adjustment that may last from months to the rest of the individual's life. These patients need help in maintaining their quality of life and regaining control over it. Many communities and areas of the country have organizations that provide specific support to AIDS and HIV-positive patients. Along with resources there is also the need for service providers; everyone has the responsibility to develop the skills and knowledge needed to cope with the expected increase in the number of these patients. The dentist and his/her staff must know how to limit their risks of being infected and spreading infection to their other patients. Dentists must understand the medical and emotional impact of the diagnosis, and use sensitivity in discussing these issues with their patients. They must also realize that dealing with AIDS patients may evoke their own reactions to death and dying and that these feelings can interfere with the caring process. Caring for HIV-positive and AIDS patients involves protecting them from the stigma of this infection. Patient confidentially is essential. Dentists must change their own risk-related behavior. Any resistance to infection control must be confronted and overcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Dentists

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