Dentists, Clean Thyselves.
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There is a growing body of evidence supporting claims that dental offices do not implement adequate infection/contamination control procedures. While one may argue that this situation should always have been a major public health concern, it certainly has become much more apparent today in the face of the AIDS epidemic.
In a letter printed in the January issue of Dental Economics, ADA president, Dr. William Ten Pas, reiterated his association`s position that “patients with HIV infection may be safely treated in private dental offices when appropriate (emphasis added) infection control procedures are employed.” He adds that the “generally accepted scientific view” is that “universal precautions are effective in reducing the risk of transmission of bloodborne disease–and that the dental office is safe.” Contrast this, however, with the results of a recent survey of 1,226 dentists by the NIH`s National Institute of Dental Research. Fifty percent of the male and 62 percent of the female dentists surveyed said they did not think private practice was an acceptable location in which to treat patients infected with HIV.
Unfortunately, much of the current debate and litigation within the dental community surrounding this issue appears to be focused on dentists` rights vs. the civil rights of HIV-infected patients. Somehow, the need to fix the problem has become lost in the posturing. Yet, HIV is far from being the only increasingly prevalent, deadly infection in question here–tuberculosis and Hepatitis C, for example.
It appears the time has come for individual dentists, the ADA–and barring this–OSHA and the NIH, to take the necessary steps to ensure the control of cross-contamination via blood, aerosols and other mechanisms within the dental office. No doubt, the costs involved are significant, but this is where our industry can help by developing cost-effective solutions.
Dentists must face the reality that, in 1996, modern contamination-control equipment and environments have become a baseline cost of doing business. And, they should also realize that those who can point to, and describe, a truly safe treatment facility will enjoy a significant competitive edge.
Alternatively, dentists can choose to deal with the litigation, harassment, and ethical and moral turmoil intrinsic to deciding who is safe to treat, and who is not. And, of course, this approach will only be effective in those instances where dental practitioners are informed upfront of the higher risk factors involved. Otherwise, it will continue to be a crapshoot as to whether they are risking the health of themselves, their staff, and their patients. While the ADA appears comfortable relying on “the generally accepted scientific view,” its members may be better served by recognizing that this is changing.