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Tell my new dentist I'm HIV+ ? (DISCLOSURE TO DENTIST)
Oct 12, 2007

I'm going to be going to a dentist in a couple of weeks. I'll be a new patient. I'll be having just a checkup and a cleaning.

I'm wondering if it is necessary, or perhaps even required,that I inform the dentist that I am HIV+ .

On the one hand, I think that dentists and their care-giving staff would already be taking necessary protection when treating any patient. On the other hand, I wonder if they would like to know so that they can take even more precaution.

I'm reluctant to share my status with the dentist's office on privacy concerns. The more people and places who know my status, the more chances of it becoming public knowledge somehow.

Response from Dr. Frascino

Hello,

You are correct: all health care professionals use "universal precautions" to prevent the transmission of bloodborne disease to patients and vice versa. Personally, I would recommend disclosing your status to your dentist. This is not because he/she will need to take additional precautions, but rather so that he/she could be on the lookout for HIV-specific pathology in the mouth. (See below.)

Dr. Bob

Dentist Visit Feb 9, 2007

This maybe a silly question, but am going to ask only because am unsure on how to handle it. I have an appointment with the dentist in a couple of weeks and I want to know do i have to inform him on my Status??

Response from Dr. Frascino

Hello,

No, you don't have to inform him, but I would strongly encourage you to do so. Not so much for his sake, but rather for yours. Health care professionals, including dentists, are trained to look for certain conditions more closely if they know you have an underlying medical problem, be that diabetes, cancer, HIV or whatever. If you are worried about HIV transmission, you shouldn't be. All health care professionals are trained to use "universal precautions." These measures are designed to prevent the transmission of bloodborne diseases, like HIV and hepatitis, from patients to health care workers and vice versa. Remember 25% of the over 1,000,000 HIV-positive Americans do not know they are infected! Why would you not advise your dentist of your HIV status? If you feel that dentist would discriminate against you for being HIV positive, that's not the office you want to be treated in any way, right? Being HIV positive is not something to be ashamed of. It's a viral illness!

Dr. Bob

Disclose to dentist? Aug 31, 2006

I recently went to a dentist for cleaning. On their health form, they wanted to know medical history, some of the conditions in the checklist included HIV/AIDS, venereal diseases, hepatitis, ulcers, etc. I left that blank, because I felt that was intrusive and unecessary for him to know. Was there any reason I needed to disclose to the dentist?

The way I see it, it is extremely unlikely that I would be of any risk to him. I could tell they were following the necessary universal precautions, I do not have bleeding gums or undergoing anything that would have any remote likelyhood of them accidently splashing anything anyhow. Was I right in doing so? Is there any law against me keeping it a secret?

Maya

Response from Dr. Frascino

Hello Maya,

The reason I would suggest disclosing your status to your dentist is that knowing you are HIV positive, he/she may examine the oral cavity more closely to make sure there are not HIV-related problems.

Regarding safety, "universal precautions" are in place for all healthcare offices. These procedures protect both the healthcare worker and the patient. It's worth noting that 25% of the estimated 1,000,000 Americans who are HIV positive have absolutely no idea they have contracted the virus. Consequently it behooves all healthcare workers to strictly adhere to universal precautions for all patients.

Dr. Bob

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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