[Question #8826] HIV test and can I continue having unprotected sex with my partner?

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39 months ago

Hello Doctors, I hope that you are having a wonderful day. I like to apologize for my long question. I tried to make my question as short as possible but I believe that every piece of information here is important, so I would really appreciate your time and effort in helping me with this case. I am a 26 year old male (soon to be 27) who lives in Dubai, United Arab Emirates. About three years ago I visited a dental clinic for some tooth filling and while being there I noticed that one of the nurses was also responsible for dealing with the payments and reception job. While I handed her my credit card, I noticed that she had some blood on her gloves. This caused me to get skeptical of the overall hygiene of the clinic. Regardless of that I did the dental work and tried to ease my mind. Since that time I have been to the same clinic a few more times because I totally forgot the blood on gloves incident. Fast forward to current month which is May 2022, I had to visit a dentist for some dental work. Unfortunately since I had forgot about the incident, I visited the same clinic. After the dental process was done, there was some bleeding in my mouth and I went back home. For some reason I started worrying what if they are not following the disinfection guidlines and the tools they use are not clean. I had to visit the clinic twice more and upon my second visit I realized that while doing dental work, they change the "bur" (which is the drill that they use to shape teeth). So basically each patient gets a new bur and the previous drill bit will go to the trash. I also realized that the suction tip (saliva ejector) is also changed between patients. Knowing these calmed my mind a bit and I got more relaxed. I went home and after a few days I had to visit the clinic one last time, this time when I reached there the dentist was already a bit preoccupied with some conversations and he was shouting at some people over the phone and behaving unprofessional in my opinion. I tried to ignore the situation, he came and attached a dental crown on my teeth and used the saliva ejector and a dental bur(drill) for the job. I did not see him changing the saliva ejector tip this time so this caused me to wonder if he had changed the saliva ejector. This has made me all worried because of a few reasons: firstly the blood on glove incident, second the unprofessional behavior of the dentist and lastly MOST IMPORTANTLY because very recently I have realized that when dentists use the drill(bur), some splashed blood gets stuck inside the rotary motor of the device, and although they change the bur(drill tip) between patients, but it is unclear if my dentist has disinfected the actual motor itself or not. I am not sure if this is part of the CDC guidline or not.., ALSO I have also read some scientific articles that mention: when a saliva ejector is used, the saliva and blood and other debri is sucked inside the machine and usually dentists do not disinfect the whole tube in between patiens, (they just change the suction head tip), It is important to mention that Backflow is really common within these devices and it might happen even if the patient is unaware of it, Backflow means when the previous patient's dental material (saliva, blood, debris) which are stuck in the suction device, flow in the opposite direction and enter the new patient's mouth. For all of the mentioned reasons I am worried if there is a chance that I could be infected with any STD, STI. I am hesitant to continue unprotected sex with my partner because I do not want to put her at risk. Do you recommend me to do an HIV test? Or any other tests?

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39 months ago
I must also mention that I am pretty sure that this dentist did not disinfect the drill betweem me and previous patient and he only changed the tip. Same goes for the saliva ejector tip 
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H. Hunter Handsfield, MD
39 months ago
Welcome to the forum. I think I follow your question, but you apparently wrote it in another program and pasted it:  the software prevents direct entry of more than 1500 characters, and you're right that this is a greatly overlong question. But in scanning it, I'm pretty sure I have the picture.

I have no comment about the various individual events, how drills are used in the dental office, etc. I'll cut to the chase and say that on scanning it I see nothing that seems risky for HIV or other blood borne infections. I am unaware of any information about whether dental instruments in fact get contaminated with patients' blood, but in the ~40 years of the known worldwide HIV/AIDS pandemic, there has never been a report of HIV transmission due to a dental procedure or exposure (nonsexual, of course) in a dental practice. (This doesn't count an infamous case over 30 years ago, when an HIV-positive dentist is believed to have intentionally infected several patients by injecting them with his own blood.)

Blood on gloves? If true, it was unprofessional, but I see no risk in handling your credit card; and I would bet that the nurse and others in the dental practice always change to new gloves before providing care to each patient. That you didn't see someone change out a drill bit before using it on you does not imply it didn't happen. I have no comment on what you apparently found online, about whether drill motors become contaminated, are not disinfected, and in theory could infect the next patient. But I'm very much inclined to doubt it, given the absence of any known HIV or viral hepatitis transmission from dental procedures. (I have to wonder whether your anxieties are leading you to over-search the web, looking for or selectively noticing statements that elevate your concerns.)

So I do not believe you are at the slightest risk and would advise no testing of any kind on account of your dental office experiences and would encourage you to continue your usual sexual practices with your partner.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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39 months ago
Hello Doctor, Thank you for your helpful response. I am not sure if all of my question was shown to you or not (because of the 1500 characters limit)
Regardless of that, the main points are that the drill machine and saliva ejector tube are not disinfected and only the tips are changed between patients. The risk of backflow is also one of the points and Also I had seen some unprofessional behavior and other than that I must mention that I have had some symptoms about a week or so after the dental visit which included: chills and sweating (i felt hot but did not notice fever), under my neck and chin was a bit swollen, diarrhea, skinny skin with a minor rash that went away in a few days, pain on my sides pn kidney area, burning sensation while urinating, feeling of my stomach being bloated and extreme anxiety. I would like to know if you were able to read my original post completely? (Just to confirm, it started with "hello doctors" and ended with "any other tests")
Also please let me know if the new provided information about the symptoms would change your opinion? Would you still recommend not to get any test and encourage me on continuing normal unprotected sex with my partner? (I do not have sex outside my relationship) again I apologize for the lengthy question.
Lastly I would like to thank you for your contribution to helping thousands around the world. I have been following your work since many years ago and I am planning to do a donation on the foundatio. I would appreciate if you can answer my concerns and provide me with info about donation.
Thanks
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39 months ago
Hello Doctor, KINDLY IGNORE MY PREVIOUS REPLY AS IT HAD A TYPO. Thank you for your helpful response. I am not sure if all of my question was shown to you or not (because of the 1500 characters limit)
Regardless of that, the main points are that the drill machine and saliva ejector tube are not disinfected and only the tips are changed between patients. The risk of backflow is also one of the points and Also I had seen some unprofessional behavior and other than that I must mention that I have had some symptoms about a week or so after the dental visit which included: chills and sweating (i felt hot but did not notice fever), under my neck and chin was a bit swollen nodes and glands, diarrhea, itchy skin with a minor rash on my chest that went away in a few days, pain on my sides pn kidney area, burning sensation while urinating, feeling of my stomach being bloated and extreme anxiety. I would like to know if you were able to read my original post completely? (Just to confirm, it started with "hello doctors" and ended with "any other tests")
Also please let me know if the new provided information about the symptoms would change your opinion? Would you still recommend not to get any test and encourage me on continuing normal unprotected sex with my partner? (I do not have sex outside my relationship) again I apologize for the lengthy question.
Lastly I would like to thank you for your contribution to helping thousands around the world. I have been following your work since many years ago and I am planning to do a donation on the foundatio. I would appreciate if you can answer my concerns and provide me with info about donation.
Thanks
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H. Hunter Handsfield, MD
39 months ago
These comments do not change my evaluation or advice and I see nothing I missed previously. Your symptoms are not typical of acute HIV or any other blood borne infection. They are, however, typical of the physical manifestations of anxiety. From the stand point of the medical issues (risk of infection, symptoms, protection of your partner) no testing is necessary or recommended and I think you should continue sex with your partner.

That said, some anxious persons are more reassured by negative test results than by professional analysis and advice, no matter how expert or science based. If you're going to keep worrying regardless of my assessment, you should be tested for reassurance. This does not mean I believe there is any chance at all of a positive result; it would be strictly for the reassurance you may gain from the negative result. It's up to you.
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39 months ago
Thank you for your response doctor, would you please provide info about how I can donate please?
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H. Hunter Handsfield, MD
39 months ago
Thank you very much for offering to support the American Sexual Health Association, which sponsors this forum. ASHA is the one of the nation's premier organizations in support of sexual health and the one with the strongest emphasis on STI prevention. There's a Donate link on ASHA's home page:  www.ashasexualhealth.org.

That concludes the thread. Thanks again for your support. I hope the discussion has been helpful.
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