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By Kate
Foster
Thousands of people infected with the
life-threatening hepatitis C virus may have caught it during
routine dental treatment.
Health campaigners warned that current
practices in dental surgery, including the way
tools are sterilized, may
not be rigorous enough to remove the risk
of transmission of the highly infectious virus between patients.
Although intravenous drug use is the most
common method of transmission, health workers say dental practices
could be the source of infection for a "substantial number"
of the 38 percent of sufferers for whom the source of infection
is not known.
In Scotland, 10,000 people are known to
be infected with the disease, which can cause liver disease
and cancer and is 100 times more infectious than HIV.
But because sufferers
can live for 20 years before
showing any symptoms, experts believe that a further
25,000 Scots are unknowingly infected.
Jeff Frew, the secretary of Capital C,
an Edinburgh-based support group for sufferers, said many
people do not know how they became infected and he believes
there is a risk of infection
from dentists' tools.
His claims have been backed by Nigel Hughes,
the chief executive of the British Liver Trust, who said the
risk of infection from dental surgeries "could not be
ignored".
Mr. Frew said "Many of our hepatitis
C positive clients do not fall into any of the risk categories
for catching the infection.
"Dental treatment is the only time
when members of the public come into contact with blood and
there's a huge throughput
of patients receiving dental treatment every day.
"
He added: "Although dentists sterilize
their tool-heads, there
is a risk of infection from the actual tools themselves,
from the machinery that drives the tools. Blood could gather
behind the drive mechanisms of tools, which could lead to
transmission.
"In order for there to be no risk
of infection, dentists would have to have two or three spare
sets of tools in order to ensure all equipment was sterilized
properly, and at the moment that is not the case.
"This
is a public health concern of immense proportions."
According to figures from the Scottish
Center for Infection and Environmental Health, 58 per cent
of hepatitis C sufferers are known to have injected drugs.
About 7 percent are thought to have picked up the virus during
surgery, from blood transfusions, from sex with an infected
partner or from receiving tattoos.
For 38 percent of sufferers, no information
on the source of infection is available and campaigners believe
that some people in this category may have been infected during
dental treatment.
Mr. Frew added: "There are people
who are infected who were not injecting drug users, who have
not had blood transfusions, who do not have tattoos or pierced
ears and who have only ever had one sexual partner. They must
have got it from somewhere, but at the moment we do not know
what the other sources are. I believe that most
of them caught it during dental treatment, or at
least the potential is there."
Mr. Hughes said: "One problem lies
with the mechanical dental handpiece which sucks fluid, including
blood and other matter, from the mouth . After treatment,
if the dentist adheres to guidelines, it is flushed through
very rigorously and left to rest for some time.
"It would be possible to catch hepatitis
C in this way if the equipment is not rigorously
cleaned and sterilized. There's always a distinct
possibility, especially if the dental practice session is
very busy."
However, Mr. Frew believes the day-to-day
practice of dentists should be reviewed. He said: " It
is up to the dental profession to prove
that there is no risk and until they do we must
assume that there is a risk. We can trust dentists to adhere
to guidelines, but how can we keep track of how they carry
out their day-to-day surgeries?"
The
Scotsman July 25, 2001
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