Beware dentists

[Guest guest]

Advisers warn of vCJD risk to dental patients

 

· Reused instruments present 'plausible' risk

· Department of Health to consider new advice

Tuesday May 9, 2006

Patients undergoing routine dental treatments for root

canal problems may have been exposed to infection by

the human form of BSE because instruments have been

previously used on patients unwittingly carrying the

incurable disease, government scientific advisers said

yesterday.

About 3m such treatments are conducted every year in

England and Wales alone. The scientists have told

health ministers to consider banning the reuse of the

equipment needed because of " hypothetical but

plausible scenarios " which suggest that person-to

person cases of variant CJD might follow the shrinking

number of animal-to-human cases.

The first wave of cases caused by infected food has so

far struck only 190 people, mostly Britons, since the

first death was announced in March 1996. But it has

caused huge changes in animal rearing, food

preparation, blood transfusions and surgical

procedures.

Now the independent expert committee on BSE and

variant CJD, known as Seac, says " sufficiently

rigorous " decontamination is difficult for the

relatively unsophisticated dental instruments used to

examine the pulp in teeth cavities. Seac says

disposable, single use replacements " would eliminate

this risk, should it exist " . At the moment, around six

instruments are used for each procedure and each can

be reused eight to 10 times.

The suggested precautions followed Department of

Health risk assessments which also say vCJD

transmission via dentistry is plausible. Health

officials have been cautious about recommending too

many sweeping changes since a switch to single-use

instruments for tonsillectomies in 2001 resulted in a

big increase in bleeding complications and had to be

reversed.

Three people are thought to have contracted vCJD

infection through contaminated blood transfusions, a

risk that had previously been described as

theoretical. A recent study published in Lancet

Neurology suggested as many as 14,000 people may be

carrying prions, the rogue proteins implicated in

diseases such as vCJD, without showing symptoms. Seac

has urged the government to consider screening people

through postmortems for hidden vCJD.

Seac, in a statement posted on its website yesterday,

stressed there were still " no definite or suspected

cases of vCJD transmission " but said prions were more

resistant to disinfection and sterilisation than other

infectious agents and there was no data on vCJD

infectivity in dental pulp.

The Department of Health said last night that it would

consider Seac's " precautionary " advice " and then begin

discussions with the relevant bodies ... there is a

small but hypothetical risk that vCJD could be

transmitted through [these] procedures. This is a

complex area and Seac will review new evidence as it

emerges. "