Hepatitis B virus infection in dental surgical practice.

Abstract

Sixty-one dental surgeons at King's College Hospital were interviewed to establish the incidence of attacks of viral hepatitis and to relate this to environmental risk factors. Six (10",,) had a history of hepatitis, in one case due to infection with the hepatitis B virus. Screening blood for HBsAg by radioimmunoassay showed no carriers of the antigen, but transient antigenaemia was observed in one dentist. Antibody to HBsAg, tested by radioimmunoassay, was detected in four dentists (7)0), only one of whom had had clinical hepatitis. Dental surgeons may be more at risk from infection with the hepatitis B virus than the general population, although this should be minimised in hospital practice, where the most infected patients will already have been identified and appropriate precautions can be taken. The risk of transmission from an antigen-positive dentist to his patients is probably much smaller, and there is no evidence to restrict his clinical activities.

Hepatitis B virus infection in dentistry: a forgotten topic

“…However, these dentists also believed they had always taken appropriate precautions [47]. In 1976, a study showed that approximately 50% of dental surgeons had knowingly treated HBV-infected patients, and some dentists had treated patients with HBV infection many times.…”

“…PatientsÕ attendance in dental clinics exposes them to two risks: first, the probability of cross-infection from one patient to another from an infected dental instrument; and second, the potential hazard of an infected dentist [47]. Because of HBV vaccination, the infection rate has decreased significantly.…”

“…In 1976, a study showed that approximately 50% of dental surgeons had knowingly treated HBV-infected patients, and some dentists had treated patients with HBV infection many times. However, these dentists also believed they had always taken appropriate precautions [47]. A study from Taiwan revealed that approximately 75% of dental students would treat an HBV-positive patient [48].…”

“…Thus, additional precautions for infected patients are unnecessary [53]. Dental surgeons, who wear glasses and work with ultrasonic and rotary instruments, are aware of the amount of droplet spread of saliva, blood and water because of deposits on their glasses [47]. Considering that the annual cumulative HBV infection risk of routine treatment of patients whose seropositivity is undisclosed is 57 times greater than HIV and mortality risk of HBV infection is 1.7 times greater than HIV, one must attempt to restrict HBV exposure as much as possible [76].…”

Hepatitis-B Virus Infection in Anaesthetists

“…The hepatitis-B (surface) antigen (HBsAg) is present in] saliva (Heathcote, Gateau and Sherlock, 1974;Villarejos et al, 1974), other body secretions, and in the blood of chronic carriers of the hepatitis-B virus (HBV). Dentists come into close contact with saliva and blood in the course of their work, and they have been shown to be particularly at risk from infection by this virus (Feldman and Schiff, 1975;Moseley and White, 1975;Goubran et al, 1976). One might expect that anaesthetists would share the increased risk.…”