Dear Dr. Reznik:

Where can I find a dentist who doesn't have HIV? I understand that someone might be offended by this request but I have a right (I am a lawyer by the way!!) to choose a dentist of my own preference. The Americans with Disabilities Act is a triumph (or at least a minor victory in most cases) for HIV/AIDS victims. However, those of us without HIV have a right to not have to worry whether Universal Precautions were correctly followed that day that we visited the HIV positive dentist (or were treated directly after an HIV positive individual.) Thank you for your time. [I don't suppose that you will ever answer my questions judging from your fixation on answering many redundant questions asked over and over about mouth sores(and actually answering very few or no iatrogenic-oriented questions).]

You ask a very interesting question and one that is not easy to answer. Let's see if I cannot break up my response into sections:

1. The HIV status of your provider can only be proven for a short period of time. For instance, you may visit a dentist who claims to have had a recent negative HIV test. The question then arises: has this person in question engaged in any unsafe sexual activities since the test was performed? Is there any way of knowing other than accepting the dentist's word. Shortly after the Dr. Acer incident, there were several dentists who advertised on TV and radio that they were HIV negative. Again, the validity of this statement was short lived as there is no way of knowing if the person in question engaged in unsafe sexual practices after the test. Also, be advised that the Acer case is the only documented case of transmission of HIV from a dental health care worker to a patient.

2. As a patient you should be aware if your provider practices Universal (standard) Precautions. There are many other viruses, such as Hepatitis B and C which are much more easily transmitted than HIV. I would advise that you visit potential dental offices and inquire about their sterilization techniques. The latest CDC guidelines, "Recommended Infection Control Practices for Dentistry" are available on the HIVdent Internet website at the following URL and can be used as a point of reference: http://www.hivdent.org/infctl/icrecomend.htm. You will also find the Infection Control Manual we use at our facility in the Infection Control Section of the HIVdent Internet Project.

DR