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Woman Apparently Gets AIDS From Infected Dentist, CDC Says

July 26, 1990

ATLANTA (AP) _ In the first case of its kind, federal researchers reported Thursday that a woman apparently got AIDS from her dentist during a tooth pulling, even though he was wearing gloves and a mask.

The case has prompted the government to review its guidelines for AIDS prevention during medical procedures even though ″the possibility of another source of infection cannot be entirely excluded,″ the federal Centers for Disease Control said.

It said all evidence was ″consistent with″ the patient being infected during her trip to the dentist.

The dentist, who had been diagnosed three months earlier, was wearing protective gloves and a mask, as recommended, while extracting two molars for the patient, who was visiting him for the first time.

″We don’t know exactly what happened during that procedure,″ said Dr. Harold Jaffe, deputy director for science in the CDC’s HIV-AIDS program. ″We have to assume there was some kind of an accident that exposed the patient to the dentist’s blood.″

But there was no indication of that. The patient didn’t remember the dentist having any cuts, the dentist didn’t recall any accidents - such as sticking himself with the anesthetic needle - and dental records indicated the procedure ″should have been uncomplicated,″ the CDC said.

Officials of the American Dental Association said the CDC may have jumped to conclusions.

″We’re not happy about it,″ said Dr. Enid Neidle, director of scientific affairs for the Chicago-based ADA. ″We think it is not a totally conclusive case of transmission. ... We are not happy at any report that could raise fears on the part of the public that the dental office is a place of danger and infection.″

CDC officials stressed that there is no reason to believe the virus was transmitted just because a dentist with AIDS came close to a patient. ″We are not suggesting some unique, previously undescribed kind of transmission,″ Jaffe said. ″And we’re certainly not suggesting to people they should be afraid to go to their doctors and dentists.″

The case has prompted the government to review its recommendations for AIDS prevention in medical settings. ″We will be looking at the guidelines to see if they need to be modified to decrease the chance this might happen again,″ Jaffe said.

AIDS activists worried that the report would spawn new fears about the disease.

″I think that’s inevitable,″ said Paul Sathrum, program director for the National Association of People With AIDS. ″The hysteria is always out there. ... Any little thing like this always brings it back to the surface.

″This may be the type of situation that would provide ammunition for the forces who would love to see more restrictions on people with HIV. I hope that doesn’t happen.″

Two years after the woman’s trip to the dentist, she was diagnosed with a rare pneumonia that strikes some AIDS patients. She then tested positive for the AIDS virus.

A lengthy investigation found no risk factors for AIDS in the woman’s past, such as intravenous drug abuse or numerous sex partners. She said she had two boyfriends before her diagnosis; both tested negative for the virus.

The CDC, as is its custom, did not identify the dentist or patient, except to describe the patient as a young woman.

DNA ″virus sequence″ tests performed on the dentist and the patient led investigators to believe their specific viruses were ″closely related,″ with ″a high degree of similarity between the strains,″ the CDC said.

Still, Neidle said, the ADA believes too little is known about the details of the tooth extraction and what might have caused the infection, including whether the patient was subsequently treated and whether some complications might have arisen in the placement or removal of stitches.

Jaffe said there was no indication that the dentist failed to follow any guidelines for preventing AIDS transmission. ″The only question,″ he said, ″would be whether or not the dentist should have continued in practice″ after being diagnosed with AIDS.

The ″most obvious″ guide for that, he said, ″is whether the person is physically or mentally able to do his or her job.″

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