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Dentist working with HIV+ patients
Jul 6, 2005

Hello Dr. Bob! I am a senior dental student and I have recently volunteered to treat HIV+ patients and patients with AIDS at the medically complex dental care clinic in my dental school. As far as I have seen so far, we have not been instructed to take any extra precautions (Double gloving, etc) and the instruments (even those covered in blood as after an extraction) are sterilized along with the other instruments used in the regular dental clinic. This clinic is a very reputed one in an ivy league dental school and I am assuming that they know what they are doing. I just wanted to know the calculated risks that I, the care provider, face statistically, if there is something I should do to give myself that extra protection (I am not at all an anxious person and if the risks are too tiny to bother, I would just as soon treat my patients as if they are healthy), and is the school right in not providing any extra protection/ separate sterilization facility for the instruments used on HIV/AIDS infected patients. The work itself is great, working with my patients has given me a new perspective on life, and reading up on the work of medical professionals like yourself has given me the determination to provide the best for my HIV patients... I only hope to get half the respect and admiration that you have earned.

Response from Dr. Frascino

Hello,

I agree with almost everything in your post. For instance, (1) no "extra" precautions are warranted or necessary when treating HIV-positive dental patients and (2) no "extra" sterilization procedures are warranted or necessary for dental tools used to treat HIV-positive patients. However, the one statement I would have you reconsider is: "I would just as soon treat my patients as if they are healthy." Actually what you and all health care professionals must be cognizant of is that "universal precautions" are "universal" because we really have no idea if even our "healthy" patients may be harboring a bloodborne pathogen or not. That's the reason your Ivy League dental school does indeed "know what they are doing" by instituting appropriate "universal precautions" for all patients, regardless of their known or assumed HIV status. You should also realize HIV is not the only bloodborne germ we need to be aware of. Hepatitis, for instance, is also a growing problem. Once again, "universal precautions" are your key to staying healthy while providing equal treatment for all patients. Competence combined with compassion will earn you both the respect and admiration you desire and deserve.

Good luck with your career, and please pass the information you learned here on to your fellow dental students, especially the ones who may be avoiding the "medically complex dental care clinic" for all the wrong reasons.

Dr. Bob



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