Question:
I haven't been to the dentist for a few years but now I need to
go. However I am very concerned. I have researched DejaNews and
whilst there is a lot of debate about how dentists can avoid
catching HIV from their patients, there is a complete dearth about
how patients can avoid catching HIV (& Hep.B etc.) from dentists -
or more specifically from the instruments used by dentists.
Dentistry is when all said and done invasive surgery, and the
least that can be expected is for the instruments used to be
thoroughly cleaned between operating on successive patients. But
it appears that many dentists are NOT following what is called
"Universal Precautions," i.e. a considered programme of
sterilization and cleaning, with gloves and masks, etc. for ALL
patients - with the assumption that ALL patients are infective.
There was the recent case in the UK of a gay man with HIV who
was told that he could only have treatment if he came in at the
end of the day otherwise the instruments used would have to be
especially sterilised. Evidently sterilisation after each patient
was not the usual routine in that surgery!! What should I?
Answer:
Talk to your dentist, examine his office, demand that he uses instruments
that have been sterilized
when he treats you, (most dentist's in the US do not do there own
sterilization they send the tools out to be
sterilized and they are returned in sealed airtight clear bags so it is easy
to verify that they are sterile.
There are many precautions you can take. Being a PWA I am at much higher
risk of infection
then a healthy individual, and the above mentioned things I do with all
medical offices that
treat me.
I've never heard of sending instruments out to be sterilized and then having
them returned in sealed bags. I have heard of sterilizing instruments in bags
so they stay sterile until they are used on an individual patient.
To make the statement that you've been so careful and "most dentists in the US
do not do their own sterilization..." is clearly demonstrating that you are
sadly misinformed.
Not sure where you are getting your information, but the above statement is
entirely untrue. U.S. dentist almost universally do their sterilization in
office. You would be hard pressed to find a dentist who does not sterilize
all of his used instruments. The clear bags do not insure sterility,
special monitoring is done for that purpose.
In spite of the big AIDS scare, you are right in that the patient with AIDS
is at much more risk than those treating him or her.
During my walk through of 4 different dentist's offices I did not see
a workstation or work area that seemed adequate for the task so I asked were
sterilization was done. The answer was that they had a service and that most
US dentists no longer performed there own sterilization. The location of the
offices are as follows 3 in the Washington DC area and 1 in Palm Springs Ca.
If this is not the norm I have been misinformed. I do understand that sterility
is not a function of the bags, however if proper procedure is followed during
sterilization and post- sterilization handling is it then safe to assume
that instruments that are bagged are in fact sterile?
