What is the significance for dental professionals of the recently documented case of patient-to-patient transmission of hepatitis B?

摘要

While speaking with dental professionals in recent years, I have found an increasing concern on their part with the potential occupational risk of hepatitis C virus (HCV) and HIV infections, even though clinical and scientific evidence has overwhelmingly shown hepatitis B virus (HBV) to be the most infectious bloodborne pathogen. The success of dental infection control practices over the past 20 to 30 years, especially vaccination of health care workers, safer handling of contaminated sharps, and routine use of gloves, masks and eyewear, has changed how some health care workers perceive HBV. As a result, many health care providers have turned their attention to other infection control issues, such as contamination of the water in dental units and environmental asepsis. This shift in thinking is not surprising, given that the last instance of dentist-to-patient transmission of HBV was reported by the Centers for Disease Control and Prevention (CDC) in 1987.1 In contrast to the situation for medicine, where sporadic HBV outbreaks continue to occur, dentistry has a good record for safety with regard to transmission of HBV and other infectious diseases. Unfortunately, a recent report by Redd andothers2,3 has brought HBV back to the forefront of attention among dental practitioners. The following discussion highlights the major aspects of this unusual case and considers its implications for dental professionals.