Possible transmission of human immunodeficiency virus to a patient during an invasive dental procedure

Article Abstract:

An investigation by the Centers for Disease Control (CDC) is described; the case is that of a young woman who developed AIDS 24 months after having two teeth extracted by a dentist with AIDS. The patient had no other apparent risk factors for the disease. The extractions were performed in the dentist's office under local anesthesia, and the dentist wore gloves and a mask throughout the procedure. The teeth were not impacted and the extractions were not difficult. The patient did not recall coming into contact with the dentist's blood; she did not remember him being cut or stuck with a needle. Four weeks later, the patient consulted a physician for a sore throat, at which time enlarged tonsils and lymph nodes in the neck were noted. Seventeen months later, oral candidiasis (a fungal disease in the mouth) developed, and Pneumocystis carinii pneumonia, a common complication of AIDS, was diagnosed 24 months after the dental visit. Review of the patient's medical records and interviews with her family and friends revealed no history of intravenous drug use, blood transfusions, sexually transmitted diseases, or other AIDS risk factors. The DNA, or genetic material, from the HIV (human immunodeficiency virus) of both dentist and patient was analyzed and compared. The sequences were similar to the degree seen for cases that are epidemiologically linked. Details regarding assistants who may have also have had contact with the patient cannot be recalled; nor is it known whether these personnel were tested for HIV infection. A discussion is provided of the transmission of hepatitis B virus from infected health care workers to patients, a situation that is not entirely comparable. Adherence to universal precautions remains the best way of preventing HIV transmission. The case will be considered when the CDC reviews its guidelines for infected personnel who perform invasive procedures, such as surgery, on patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Dentist and patient, Dentist-patient relations

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Update: Transmission of HIV infection during invasive dental procedures - Florida

Article Abstract:

Three patients of a Florida dentist were found to have been infected with human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). Now two additional patients of the same dentist have been found to be infected with HIV. Bases on an analysis of the DNA from the virus, these two patients are considered to have been infected with the same strain of the virus as the dentist. One other patient also tested positive for HIV infection, but it is more likely that he contracted the infection from another source. The dentist first tested positive for HIV infection in 1986; nevertheless, he continued to practice dentistry and to perform invasive procedures. This is the only known instance so far in which HIV has been transmitted from an infected health care worker to patients during invasive procedures. It is not known how the virus was transmitted, nor why it was transmitted to several patients. However, other blood-borne viruses, such as hepatitis B, have been passed from health care workers to patients during invasive procedures. Some of the factors involved are the types of procedures performed, the techniques used, infection-control procedures, and the strength of the virus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patients

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Absence of HIV transmission from an infected dentist to his patients: an epidemiologic and DNA sequence analysis

Article Abstract:

The risk of an HIV-infected dentist transmitting the virus to patients may be low if infection control precautions are adhered to strictly. A study examined the incidence of HIV infection among 1,192 patients treated by an HIV-infected dentist in Florida from Oct 1, 1985 through May 15, 1991, before he developed AIDS. Five of these patients were HIV+ when they died. All were either intravenous drug users or engaged in homosexual se . Of the 900 patients who underwent HIV testing, five were HIV-positive. Four of these had other risk factors for HIV infection. A comparative DNA analysis found that the HIV virus strains from the five HIV-positive patients was not closely related to the HIV virus from the dentist.

HIV (Viruses), HIV

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