Dentists and cross-infection

Abstract

A structured questionnaire was administered to a random sample of general dental practitioners in Natal, South Africa in 1994, to ascertain the precautions they use against cross-infection and to gauge the attitudes and behaviour towards the treatment of HIV-infected individuals. An interview was conducted covering 5 broad topics: demographic details, personal barrier protection, instrument sterilization and disinfection, sharps disposal and incidence of needlestick injuries and the extent of the knowledge, attitude and behaviour of the practitioners toward the treatment of HIV-infected individuals. The key findings were: routine glove wearing, for all patients, was practised by 87 per cent. The most common heat sterilization method was by autoclave (68 per cent), although a dry heat sterilizer and water boiler were used by 22 per cent of the respondents. Of the 18 respondents reporting a needlestick injury in the past 6 months only one sought after-care. 42 per cent of the respondents would continue to treat carriers of HIV in their practices. This survey shows that a significant number of dentists are using unacceptable cross-infection control procedures. Educational efforts should be made to improve their knowledge and to alleviate anxiety of health workers to treat HIV-infected patients.

PIP: The precautions against occupational HIV transmission employed by general dental practitioners in Natal, South Africa, were investigated in 1994 in a survey of 100 dentists (33% random sample) drawn from the South African Medical and Dental Council registry. The interviews addressed personal barrier protection; instrument sterilization and disinfection; sharps disposal and needle-stick injury incidence; and knowledge, attitudes, and behavior related to the treatment of HIV-infected patients. In response primarily to seminars and scientific journal articles, 73% of dentists had made some modifications in their clinical practices to prevent HIV cross-infection. 87% of dentists routinely wore gloves and 65% wore masks. 68% used an autoclave for heat sterilization, but only 4% decontaminated impressions or appliances before sending them to the laboratory. 25% discarded used sharps in the normal rubbish bin. 18 respondents had experienced a needle-stick injury in the 6 months preceding the interview; however, only 1 had sought post-exposure care or testing. 42% expressed a willingness to treat patients known to be HIV-positive. It is recommended that these findings be used as a basis for formulation of specific guidelines for treating HIV-infected dental patients in South Africa. Also urged are educational interventions to increase the willingness of South African dentists to treat HIV-infected individuals.