Hygiene risk for dental patients

ANDREW DENHOLM
POLITICAL CORRESPONDENT

DENTAL patients across Scotland are being put at risk of infection from
blood diseases such as HIV and hepatitis because of poor standards of
hygiene.

Dr Mac Armstrong, the Chief Medical Officer for Scotland, has written
to
all dentists calling for urgent action to improve basic sterilisation
techniques. Dr Armstrong has also written to all GPs and health boards
calling on them to ensure high standards are maintained.

The move follows a Scottish Executive study which found that dental
surgeries routinely failed to meet basic hygiene standards.

According to the study, three quarters of practices do not change the
water
in their sterilisers on a daily basis.

Half do not have a dedicated sink for the cleaning of drills, probes
and
tweezers, while 70 per cent have no record of staff training for
sterilisation techniques. A further 60 per cent have no instruction
manuals
for sterilising equipment.

Deadly viruses, including HIV, hepatitis C and vCJD, the human form of
mad
cow disease, can all be spread through contact with infected blood.

In September, a helpline was set up for 3,500 patients of an Inverness
dentist after claims he failed to sterilise equipment.

Dr Armstrong said yesterday that standards had slipped due to a
combination
of ignorance and complacency.

And while he stressed that there was no evidence that any hepatitis
infections had taken place as a result of poor hygiene, he said that
without higher standards there was always a risk of such
cross-contamination.

"We have written to all dentists, GPs and health boards in Scotland to
highlight the concerns identified in this study and to make clear that
we
expect action on ten priority areas as a matter of urgency," he said.

"It is the legal and professional responsibility of all dentists,
doctors
and nurses working with re-usable instruments in primary care to ensure
that this happens."

The Chief Dental Officer, Ray Watkins, echoed the concerns and
highlighted
a £150,000 training programme which has been set up for the profession.

"We have now set up an expert group to take this forward," Mr Watkins
said.

"As well as providing training for staff in their practices, it will
provide clear and consistent information and help them systematically
audit
their decontamination practices.

"We have asked NHS Boards to provide us with action plans detailing how
they plan to address any shortcomings identified through this process."

The British Dental Association said: "Infection control is a core
element
of dental practice and the BDA fully supports its members in achieving
excellence in this area.

"We provide both written and one-to-one guidance on infection-control
issues and work closely with the relevant government departments to
ensure
the profession has the most appropriate and up-to-date advice."

A spokeswoman for the British Medical Association added: "We support
the
aims of the chief medical officer in highlighting this issue to all
GPs."

The Executive report was carried out by the Glennie Group, chaired by
John
Glennie, chief executive of NHS Borders. The report was commissioned
after
concern in the 1990s that CJD could be transmitted via surgical
instruments.

While dental procedures are categorised as low risk for such
transmissions,
there remains a risk for HIV, hepatitis B and C and other bacterial and
viral infections.

"The survey has highlighted that the cleaning of instruments has
several
shortcomings and is poorly controlled," states the report. "The problem
is
compounded by the lack of clear instructions from manufacturers on the
use
of dental devices."

That could lead to disposable instruments being used more than once,
the
report added.




Sandra Tara Balduf (Ane)

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