Healthcare-associated viral and bacterial infections in dentistry

Abstract

Infection prevention in dentistry is an important topic that has gained more interest in recent years and guidelines for the prevention of cross-transmission are common practice in many countries. However, little is known about the real risks of cross-transmission, specifically in the dental healthcare setting. This paper evaluated the literature to determine the risk of cross-transmission and infection of viruses and bacteria that are of particular relevance in the dental practice environment. Facts from the literature on HSV, VZV, HIV, Hepatitis B, C and D viruses, Mycobacterium spp., Pseudomonas spp., Legionella spp. and multi-resistant bacteria are presented. There is evidence that Hepatitis B virus is a real threat for cross-infection in dentistry. Data for the transmission of, and infection with, other viruses or bacteria in dental practice are scarce. However, a number of cases are probably not acknowledged by patients, healthcare workers and authorities. Furthermore, cross-transmission in dentistry is under-reported in the literature. For the above reasons, the real risks of cross-transmission are likely to be higher. There is therefore a need for prospective longitudinal research in this area, to determine the real risks of cross-infection in dentistry. This will assist the adoption of effective hygiene procedures in dental practice.

Compliance with infection prevention and control in oral health-care facilities: a global perspective

“…The highest risk of infection is associated with accidental punctures with used and/or contaminated needles, or injuries with sharp instruments. The most common occupational risks to which oral health‐care workers and dental patients are exposed include exposure to blood‐borne pathogens, in particular HBV, hepatitis C virus (HCV) and HIV.…”

Comparative evaluation of psychophysiological response of children with special health care needs to use of facemask‐eyeshield and visor in a dental setting—A cross‐sectional study

“…The pathways of infection may be bidirectional . Emphasis should be laid on the use of protectors for eyes, nose and mouth like eyeshield, facemasks, respirators, visor, etc .…”

“…[3][4][5] The pathways of infection may be bidirectional. 6 Emphasis should be laid on the use of protectors for eyes, nose and mouth like eyeshield, facemasks, respirators, visor, etc. 7 Using these protectors may have a negative impact on perceived empathy and dentist-patient relationship and may induce anxiety among these children.…”

Effect of cleaning and disinfection on naturally contaminated clinical contact surfaces

“…The term acceptable risk, which evolved from the realization that absolute safety is an unachiev able goal, describes the likelihood of an event whose probability of occurrence is small 2 . Ac cording to the more severe line of reasoning, the few ascertained cases of infection occurred in dental healthcare settings do not necessar ily mean that the infection risk is minimal, but could be due to insufficient evidence, thus leav ing room for the application of the precaution ary principle, which states that when an activity presents an uncertain potential for substantial harm to human health, precautionary measures should be taken even if there is no scientific evidence that such measures are needed or ef fective 3 . Guidelines based on the acceptable risk seek to decrease the occupational risk, the risk of infection for patients and, indirectly, the risks of litigation and dental treatment failure due to surgical site infection.…”