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AIDS Fear Sends Dentists to Infection Control Class

November 3, 1985

SAN FRANCISCO (AP) _ Fear of AIDS sent hundreds of dentists trooping into weekend lectures on infection control, where they were urged to stop discriminating against AIDS patients and pay more attention to office hygiene.

″There is a lot of hysteria. I’m trying to tell dentists there is no reason for concern,″ said Dr. Mario Andriolo Jr., a New York dentist who lectured on treatment of acquired immune deficiency syndrome patients during the American Dental Association’s annual meeting.

The AIDS virus is spread primarily by sexual contact or contact with infected blood. But it also has been found in saliva. Droplets of blood and saliva are frequently splattered toward dentists’ faces during routine dental work. Dentists also nick themselves with sharp tools.

However, ″despite the public hysteria, this remains a difficult disease to transmit,″ said Dr. Harry Hollander, head of the AIDS clinic at the University of California at San Francisco.

Hollander told a standing-room-only crowd of 300 dental care workers ″to not shun the responsibility of care for these patients.″

″Dentists have an obligation morally to provide service to any patient who needs it. It’s not a legal obligation, unfortunately,″ except where cities have antidiscrimination laws, said Dr. Jack Rosenberg, founder of the Manhattan Dental Guild, a group of gay New York dentists.

During lectures and workshops held Saturday and Sunday at the dental association meeting, dentists fearful of AIDS were told to wear masks, plastic gloves and eye protection when treating any patient, dispose of waste in double plastic bags and improve sterilization of dental tools.

″There’s no question but we have been very cavalier in dentistry as far as sterilization techniques,″ said Alice M. Horowitz, chief of health promotion for the National Institute of Dental Research. ″There is obviously a need to do more than has been done.″

All the lecturers said the AIDS virus dies easily outside the human body, and that proper precautions in the dental office will allow treatment of AIDS patients without endangering dentists or other patients.

Edgar Mitchell, secretary of the association’s Council on Dental Therapeutics, said the only reported AIDS patients among dental care workers were members of known risk groups. Those groups include homosexual and bisexual men, intravenous drug abusers who share needles and recipients of blood transfusions from infected donors.

Mitchell said studies are following 1,750 health care workers who accidentally pricked themselves with needles used by AIDS patients. Only three who aren’t members of high-risk groups have shown any signs of having been infected, he said.

Rosenberg said he is among only a few New York dentists who accept AIDS patients.

″I see a lot of patients who get thrown out of dental offices they’ve gone to for 15 years,″ Rosenberg said. ″It’s pathetic that educated people like dentists are as ignorant as they are. There’s no reason for this kind of behavior.″

Dentists are often the first to detect AIDS, which wrecks the body’s ability to ward off infections, because the infections frequently are seen first in the mouth.

Dr. Sol Silverman Jr., chairman of oral medicine at UCSF, showed graphic slides of AIDS patients with oral cancers and infections, drawing occasional groans from his audience.

″I feel like I’m O.D.-ing (overdosing) on horror here,″ Mitchell said.

Silverman said oral diseases in AIDS patients include a fungal infection named candidiasis or thrush, a cancer called Kaposi’s sarcoma, premature disease of the gums and underlying bone, herpes sores and a corrugated whitish crust on the tongue called hairy leukoplakia.

Some dentists also groaned when Mitchell urged them to change gloves as they move from patient to patient - something some dentists view as a nuisance. Many believe gloves interfere with their sense of touch.

″You have to wear gloves. That’s all there is to it,″ Mitchell said.

Dental association guidelines for years have urged dental workers to use gloves and other precautions, largely because they often are exposed to hepatitis B.

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