Dentists linked to hepatitis C

THOUSANDS of people infected with the life-threatening hepatitis C virus may have caught it during routine dental treatment, it was claimed yesterday.

Health campaigners warned that current practices in dental surgery, including the way tools are sterilised, 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 per cent 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 sterilise 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 sterilised 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 Centre for Infection and Environmental Health, 58 per cent of hepatitis C sufferers are known to have injected drugs. About 7 per cent 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 per cent 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 sterilised. There’s always a distinct possibility, especially if the dental practice session is very busy ."

A spokesman for the British Dental Association said: "The hepatitis C virus is easily killed in a steriliser. Providing dentists follow guidelines laid down for infection control, there should be no risk of the virus being transmitted during dental treatment."

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?"

Kate Foster Health Correspondent
Tuesday, 24th July 2001
The Scotsman