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Dentist with exposure to positive patient
Jan 30, 2008

Hi Dr Frascino, Thank you for all you do on here! You are an inspiration to many and a wonderful resource for so many concerned folks. My situation is the following. I was performing a filling on an Hiv patient of mine and during the process was cut with a metal strip through gloves while in the patients mouth. It was about a two cm laceration on my pointer finger. I am unsure if there was any visible blood on the metal strip. My finger did produce blood when the glove was removed. I went through the following work related injury procedures and was baseline tested that day. The pateint was very concerned as was I. He did state that at this time he is on meds and has a viral load that is undetectable. What are the possibities of infection from this occurance? My husband and I are actively trying to conceive and I am overwhelmed by this incidence. Any information you could provide would be greatly appreciated. Once again thank you so very much for your time. CS

Response from Dr. Frascino

Hello CS,

Your HIV-acquisition risk is extremely low, but not completely nonexistent. That the patient's HIV plasma viral load was suppressed to undetectable levels significantly decreases the chance for HIV transmission. There are also components of human saliva that inhibit HIV. Saliva that is not contaminated with blood does contain HIV, but in such low titers that exposure-transmission risk is negligible. If the saliva is contaminated with infected blood, the risk increases. It would be unlikely that considerable blood would be present from a routine filling procedure.

I'm pleased you followed the guidelines for a possible occupational exposure by documenting the incident and getting baseline HIV screening. At this point, I would only recommend routine follow-up screening per the published guidelines (three and six months). I would also recommend you and your husband hold off on the baby making and use latex condoms for penetrative sex until you get your "all clear" negative HIV follow-up tests.

Try not to be "overwhelmed" by this incident. The odds remain astronomically in your favor that you did not contract HIV from this possible exposure.

Good luck.

Dr. Bob



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