[Question #1843] A innocent visit to the dentist hiv dentist tool(braces tightening)

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86 months ago
I tried to keep myself calm with  the title...

Good day doctors pray you are best of Health and can help with your immense knowledge 

I have risk factor of HIV . 

I visited the dentist for ONLY BRACES tightening 

I have 3 appointments left and was tested for HIV last month .  

Instruments were put in autoclave everything was simple and good . 

However once I started having my braces tighten I noticed doctor used a clipper type instrument to tighten my braces and that he brought himself and was not in autoclave package which I had prepared earlier . 

I asked my dentist was This was tool in package which I put in auto clave ,  he said no but don't worry it's sterile and I'm not going to touch you with it . My questions are 

Q1 ) if any HIV blood was on the solid steel tool(it's not a syringe ) . The tool used only to tighten your braces , how can he infect me what action will he have to do to put me at risk and how severe a wound needs to be ?.

Q2) Would he have to cut my gums heavily to put me at risk ,like a stich wound or would small nicks or scratch  be enough to trasmit HIV ? 

Q3) HIV blood outside the body won't live on the tool ?

Q4) has anyone been infected with HIV by only braces tightening?  

Q5 how many HIV  cases through dentist and what procedure was done that people got HIV 
From dentist ? 

I checked my gums they seem normal  and also I did not feel any nick . And no sign of blood in my mouth 

I just read on aids Vancouver that HIV cannot live on dental tool or any surface for that matter 

But Your thoughts are more trusted and up to date thanks 

Am I at risk 

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Edward W. Hook M.D.
86 months ago

Welcome to the Forum.  The events you describe are not associated with any risk for HIV.  No one has ever been infected in this way and you will not be the first.  I would advise you to believe the dentist who assured you that the tool used was clean but, even if it was not (I believe it was), HI quickly becomes non-infectious on exposure to the atmosphere.  There is no risk and no need for testing related to this event.  Now, in answer to your specific questions:

1.  See above, even if blood was present (why would you not believe the dentist?), it would not be infectious.

2.  Neither nicks, not cutting your gums deeply would put you at risk because none of these actions would introduce infected secretions into you.

3.  Correct, see above.

4.  No, never to my knowledge and I would have heard of it if it had occurred.

5.  To my knowledge, only one patient has been directly infected by a dentist and that was done intentionally by a mentally ill dentist in Florida who intentionally infected a young woman by injecting (with a needle) infectious material directly into her with a needle.  

I agree with the information you received from the Vancouver site.  As I said early, I see this as a no risk event and see no reason for concern or to seek HIV testing.  I hope you will find my comments reassuring.  EWH  . 

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86 months ago
This answer was very fruitful doctor . 

May I just ask about point number 2 you made which was very interesting  neither nicks nor gutting gums deeply would infect 

Forgive me if I am wrong this was the only worry because I thought if he cut my gum with hiv blood tool I'm done for it 

If you can further give  sceince assurance on point number as to why if he cut my gum with HIV blood tool won't lead to infection ?  . My gums are not acess to blood stream ?.  Point number 2 just needs more simple English reasoning can you give me the secret ? Thank you 

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Edward W. Hook M.D.
86 months ago
The reason dental tools, unlike needles, would not transfer HIV is because the dental tools tend to be solid and not hollow, like needles.  Blood can pool in hollow needles and be transferred by needles sticks while blood is not typically transferred when cuts of sticks occur with solid objects. As I mentioned earlier however,  there are no recorded instances in which infection has been transferred in the way you asked about.  nothing to worry about, even in the unlikely circumstance that the instrument used was not clean.  EWH
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86 months ago
Thank you doctor 

1)hiv become quickly  becomes non infectious to atmosphere on tool is there a time Frame (how many seconds) when you say quickly if small amounts of blood would be on tool ? Or once it hits the air it's dead ? 

2) when you say "typically" blood cannot live on sharp solid objects  and transfer HIV .  And this leaves a bit of doubt as I would like it to be zero  chance . This had me a bit worried because what I would love to know what sort of injury to the gum would be needed to transfer HIV even if I was at small risk . 

Even though you say infection has never occurred this way which was nice of you to assure me that .

I would still would like to know how my gums would protect me , and act as protection and what sort of cut I would be looking at ?  

Unfortunately this is the last post i do understand that maybe one post won't be enough for you to give me a reply can I message again to you ?  And then you can explain how gums would protect me or what sort of wound is required ? 

Or would you like to reply  it in this post for me as this  is my only concern for peace of mind . 

I would sincerely request you to explain what sort of injury would one have to sustain in simple English .  Like a small cut or gushing wound which needs medical attention ? 

Thank you since your an expert with all the knowledge and I am not 

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Edward W. Hook M.D.
86 months ago

You are clearly nervous about the events you describe and apparently facts will not change this.  You are now asking "what if" and "is it possible" type questions which serve little purpose.  Further, you clearly would like to have a guarantee and I cannot do this.  In human science there are no absolutes because something that has not been seen or described before could be discovered tomorrow.  Further, scientific data are estimates and probabilities but estimated with a known degree of precision.  If I tell you that millions of people have had their braces adjusted on multiple occasions and that there has never been a case of HIV linked to such procedures, that should be comforting.  It does not mean that it could not occur tomorrow but that the odds are very, very strongly in your favor that and that there is no reasonable reason for concern.  That's the best science can provide you with and asking repetitive questions will not help that.  Below are the final answers provided as part of this thread.  Later today, now that you have received three replies  there will be no further answers and as described in the Forum guidelines, this thread will be closed. 

1.  This effect is immediate.  Conditions such as temperature, humidity and other environmental conditions could effect this but there are no absolute data.  As I said earlier, there are NO instances in which transmission has occurred with transfer of infectious material to another person on hands or the surface of inanimate objects.

2.  See my comment about science and scientific data above.  Your risk is lower than the risk that you will be struck by lightening while reading my reply.

The oral cavity is not a site where infection occurs regularly.,  Your mouth and gums are full of bacteria and yet no infection occurs.  Observation of millions and millions of people show that gum disease is not a demonstrated source of infection.

You are hung up in CUTS while this is NOT the way HIV is transmitted.  Cuts with dental instruments or even blades are different from the process of INJECTING material deep into tissue with hollow bore needles which, unlike solid objects like dental instruments, can carry blood deep into tissue.  The distinction is an important one

I hope you will be able to move on.  Further, repetitive posts will not be answered.  EWH .         . 

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86 months ago
Best 25 dollars I have spent yet 

Thank you doctor I will quit the worry 

Good health to you