Home | Contact Us | FAQ | Search & Site Map | Link to Us
Sign In | Join | Other 45 Sites in Network
Home
Discussion Groups
General
GeneralCardiologyVisionDentistryPharmacyLaboratoryNutritionAlternative
Diseases and Disorders
AIDSAlzheimer'sArthritisAsthmaCancerBreast CancerDiabetesEpilepsyGlaucomaHepatitisHerpesLupusProstate BPHProstate CancerProstatitisSinusitisTinnitus

Medical Forum / General / Dentistry / November 2007

Tip: Looking for answers? Try searching our database.

Handpiece "injury" from ill patient

Thread view: 
Enable EMail Alerts  Start New Thread
Thread rating: 
dacconverter - 17 Nov 2007 13:49 GMT
The incident occurred three days ago. I was trimming a saliva-infected
temporary crown ( previously in the mouth of a patient )with my
handpiece burrs, which eventually contacted my left glove, tore the
glove, and made an indentation on the tip of my left index finger.
Before the incident, the skin on that finger was a bit abraded from
doing some tool work at home. Anyway, the finger tip looked red but
there was no bleeding and I didn't see any visible tear from it.

A day later, I noticed a 1-mm scab there but I can't tell if it was
from the handpiece burr injury or from when I abraded the skin during
some hardware task at home.

The day after the incident, on the exact same patient, I was feeling
for something in his mouth. I had gloves on at the time. His mouth was
pooling with saliva and felt a bit cold. Once my gloves ( particularly
my left index finger ) got soaked with his saliva, the site of recent
accident on my left index finger began to hurt. ( like the way it
hurts when you wash a wound ).

The patient is HIV and Hep C positive. His HIV viral load is about
56,000, with CD4 count at ~400. These were from blood tests 4 months
ago but I have reasons to suspect they're now far worse. He appears
symptomatic from HIV, as I always see him sweating heavily and his
overall gait isn't presentive of a healthy, stable person. He has hep
C but his viral load isn't known and, as of 4 months ago, his ALT and
AST were normal. Along with his HIV status, I am also suspecting his
hep c state to be worse than what his previous blood work indicated.

Are either, or both, of the above incidents considered an occupational
exposure? How likely is it for an HIV or Hep C transmission? Are they
worth reporting? ( I'm already being tested within a 6 month window
for another HIV exposure as of 2 weeks ago. Surely, there isn't a
point for me in being testing for another souce patient in the same
time period )
Mark & Steven Bornfeld - 17 Nov 2007 15:02 GMT
> The incident occurred three days ago. I was trimming a saliva-infected
> temporary crown ( previously in the mouth of a patient )with my
[quoted text clipped - 30 lines]
> point for me in being testing for another souce patient in the same
> time period )

    I don't think anyone can tell you with any degree of accuracy the
chances you will be infected by this individual exposure.  Viral load in
the saliva is much lower than in the blood, but of course saliva  may be
contaminated with blood.  The old figures I'd heard was that a
percutaneous exposure to HIV carried a risk of seroconversion on the
order of 1%, and for Hep B about 50%, but this is blood exposure.  I
haven't heard anything specifically about Hep. C.
    You may wish to look at your technique if you're being nipped by burs
so often.  It happens to all of us, but...

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

 
Sign In
Join
My Latest Posts
My Monitored Threads
My Blog
My Photo Gallery
My Profile
My Homepage

Start New Thread
Enable EMail Alerts
Rate this Thread



©2008 Advenet LLC   Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.