Virus Transmission In The Dental Office

The risk of disease spread at the dentist’s office, and how to control it.

Medical providers, especially dentists, have long been concerned about the spread of infections in medical settings. This concern often extends to the general public, and for good reasons. Many transmissible diseases, including HIV, and hepatitis, show early signs in the mouth of a patient. A knowledge of these diseases, and their transmission methods, will allow an oral care provider to identify and treat them early. A dentist with a knowledge of these diseases will also know how best to limit their transmission in the dental office. 

This concern isn’t only for patients visiting a medical office. It extends equally (possibly even more so) to the professionals working in that office.

How are the studies performed?

Seroprevalence studies have been the primary method of testing and study of these transmissible diseases. These studies are done by testing serology (blood samples). It’s often represented by the number of people in a population who are positive for a specific disease. Often the sample size is a total  population (a group of workplaces for example), or out of 100,000 people. Those who show antibodies for specific diseases are regarded as positive for the diseases being tested.

What diseases are of most concern?

Given the last few years of history on planet Earth, COVID-19 might be the first that comes to mind. However, there are much more serious and dangerous diseases out there.

HIV

From 1985-2013 there were 58 confirmed, and 150 possible cases of HIV acquired by health care workers at work. Given the millions of healthcare workers and patients in the US, this is a good sign. It’s a low number considering how many healthcare workers there are. But even one is too many. Additionally, there have been reports of two separate health care workers transmitting HIV to patients. In one case, a dentist in Florida transmitted HIV to 6 patients. These studies notably omit the spread of HIV from infected blood donations. HIV spread danger may be present, but is extremely unlikely.

Hepatitis

Of most concern are Hepatitis B, C, and D. Hepatitis C and B are especially of concern in the dental environment.

Because the viruses are typically spread from blood or saliva, the greatest threat is to healthcare workers from infected patients. It has been estimated that 6,800 unvaccinated healthcare workers in the US become infected with hepatitis B every year. Of this nearly 7000 people, about 100 are predicted to die from liver cirrhosis.  

Herpes virus

The herpes viruses often affect oral and mucus membrane regions of the body. They are spread via saliva. Herpes simplex viruses (HSV) can be easily spread from a patient to a healthcare worker in clinics. Similarly, the virus can also be spread from dentists or other oral health workers to patients. Viral spread can occur when a medical worker with HSV treats patients and does not use gloves. It can also happen when a dental hand piece is exposed to the virus and then used on patients. The use of personal protective barriers and PPE including surgical masks, gloves, and face shields helps reduce the spread of HSV.

Other Blood-borne diseases

Surgical procedures in the high-blood flow and sensitive areas around the mouth increase exposure to blood and the viruses in it. Any open cuts that a dentist may have increase risk of blood-borne virus transmission during a procedure. Another risk is splashes of blood or blood-infected fluids in the eyes, nose, or mouth. Dangerous blood-borne diseases include HIV and the hepatitis viruses, which we mentioned earlier, and are extremely dangerous. Also included in that group are hepatitis a through e, malaria, syphilis, and brucellosis. 

Respiratory infections

A pubmed study has shown that dentists and oral surgeons have higher amounts of antibodies to influenza A and B viruses. They also showed higher antibodies to other viruses of the lungs and airways. Medical offices are places where airborne diseases, and diseases that carried on water droplets are easily spread. The reasons are two fold. The first is that patients go to dental offices to have procedures done on their mouths. They have to have their mouths and breath directly on whoever is treating them. The other reason is that respiratory diseases spread easily where population density is high. Any kind of office or workplace that is small and has a concentration of people makes this disease spread easier. A good solution for this is for dental workers to get their yearly influenza shot. Many dental offices were shut down during the height of the COVID-19 pandemic. PPE wearing and vaccinations have made sizable impact on stopping the spread of the novel coronavirus.

What is the risk?

Unfortunately, this is a difficult subject to study. Almost certainly, many cases of disease spread at dental/medical offices go unreported and undocumented. Disease spread not being reported may occur due to legal and confidentiality regulations. Many viral infections also may go unnoticed or un-diagnosed, further reducing the ability to report them. 

There is a real risk of viral transmission at the dentists office, however, it’s full danger is presently unknown. What we do know, is basic steps can make a large difference in preventing the spread of disease. These things include good hygiene and wearing of PPE, as well as regular seasonal disease vaccination.

Go to a dentist who cares about you

Here at Josey Lane Dentistry, the patient always comes first. We didn’t get to be the best dental office in Carrollton by not treating our patients as well as possible. If you want a full-service family dental office, then we would be happy to serve you. Our services include preventative care, regular check-ups,  cosmetic and restorative surgery/care, and much more. Message us today if you need any dental advice or care.