[Question #1521] Confused

95 months ago

Sir , I read a post from website . do you agree with it . I am posting it here . pls read it .

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.

1) do you agree him response that it is low risk not non existent risk

2)when Dr. Bob advises them to abstain from Sexual intercourse , does he mean there is some risk?? Do you agree with him in this particular response ?? I am not understanding it.

H. Hunter Handsfield, MD

95 months ago

Welcome to the forum. Thanks for your question.

Dr. Bob Frascino was a superb HIV/AIDS expert and ran a great forum; his death due to AIDS was a great loss and he is missed.

I agree with his response to this question, but I would describe the risk as even lower than he did, perhaps truly zero. That question is almost 9 years old. In the intervening years, we have more data on the effectiveness of anti-HIV treatment. We now know even better that the dental patient probably was entirely non-infectious. I still cannot say for sure the risk was zero, but it was sufficiently low that that person probably could have safely continuned unprotected sex with her partner.

It probably would be helpful if you would like to provide details of your own exposure, if you had one. Even apparently similar situations often are quite different when the details emerge. Let me know. In the meantime, it sounds like you shouldn't be seriously worried. I hope this information has helped.

HHH, MD

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95 months ago

1)Thanks for response., I went to dentist . He used some of his tools and put his hand (with gloves) inside my mouth. I was worried about the sterilisation of equipments and his gloves . I heard that dentist can sometimes pass hiv infection . I was checking about this in body.com website . Dr. Bob says it is negligible or low risk .I hope you also have same opinion.

2) one more thing , I also read from body.com about case where dentist was doing root canal procedure and there was a lot of blood in the patient mouth .so he sprayed water +air with high suction speed. Some of fluid (water+blood) splashed back into dentist eyes. Dr. Bob considered it as negligible risk for hiv . Sir, do you have same opinion

H. Hunter Handsfield, MD

95 months ago

1) There has never been a known case of HIV transmission in a dental office, with one exception. Back in the 1980s, a deranged dentist with HIV intentionally injected some of his own blood into a patient, who later died of AIDS. (The allegation was not proved, because the dentist also died soon afterward and the case was dropped, but that was the belief of health experts who invesitagated the situation.) Nobody has ever been infected because of unintentional contamination in a dentist's or doctor's office.

2) I agree with Dr. Bob on this as well.

Here is a true fact about HIV: Nobody ever gets it through environmental contamination or by accident from HIV infected people. If you do not have unprotected sex or share drug injection equipment with an HIV infected person, you will never catch it. Disregard, do not worry about, and stop searching the web about any other risks. You're only going to make yourself more anxious, for no reason.

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95 months ago

Sir , you mean dentist intentionally injected his blood into patients body by using a syringe

H. Hunter Handsfield, MD

95 months ago

That's what is believed to have happened. You should be able to find online information about the event and accusations at the time.

Each question includes two follow-ups and replies, so that completes this thread. You should not be at all worried. Please do not re-post any new questions about this kind of risk. Thanks.

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