MEDICINE

Dentistry and AIDS

MARY McIVER November 16 1987
MEDICINE

Dentistry and AIDS

MARY McIVER November 16 1987

Dentistry and AIDS

MEDICINE

At the first Ontario convention to discuss how dental care workers should deal with patients with acquired immune deficiency syndrome (AIDS), held in Toronto last month, Theresa Dobko, a counsellor at the AIDS Committee of Toronto, described the case of a man whom she could identify,

pending an Ontario Human Rights Commission inquiry, only as “J.” J, she said, badly needed to have his teeth cleaned. But because he had AIDS, the staff at a Toronto hospital clinic did not use their electric equipment because of their concerns about contamination and insisted on cleaning his teeth with hand

instruments—a slow and painful process. Dobko added that they also refused to give J a bowl to spit into, and it was only when he started to choke on his saliva that a staff member gave him a ' disposable gauze pad.

J’s treatment underscored the concern shared by many dental care workers about the possible risk of infection through the intimate nature of their work, which involves close contact with a patient’s saliva and blood. But Dr. * Richard Denney, the Toronto dentist | who organized the meeting of 200 people, said that the apparent unfeeling behavior on the part of some of his colleagues can also be attributed to strict guidelines that the Royal College of Dental Surgeons in Ontario suggested^, last year for the treatment of AIDS patients. Among the precautions: that dentists should use gowns, caps, gloves, masks and eyeglasses; that the use of drills should be minimized; and that protective clothing and towels should be sterilized before laundering. Meeting those guidelines, said Denney, is especially difficult for dentists whose offices L are not set up to comply with such conditions. As a result, dentists frequently refer AIDS patients to hospital clinics, which are better equipped. The recommended practices, he added, “are so stringent, they make it impossible for dentists in private practice.”

For his part, Dr. Kenneth Pownall, registrar at the college, said that a special committee is reviewing those guidelines—which he emphasized were only suggestions—and that the college will issue new recommendations within a month. Dentists can also anticipate more information on how to deal with AIDS patients from the Canadian Dental Association: according to Brian Henderson, director of education and accreditation, the association will be issuing comprehensive guidelines following a conference planned for next March.

Meanwhile, at the Toronto conference, the AIDS Committee’s Dobko asked a group of 50 dentists from across the country whether they would treat a person with AIDS. Only seven said that they would. As well, Dobko has estimated that 90 per cent of dentists in Toronto alone refuse to treat AIDS patients. Such reluctance, she said, could have dangerous implications: “People are going to > start going underground with their infections, and then dentists really won’t know what they’re dealing with.” And that, she added, leads to the most practical reason for dentists to accept patients who have AIDS: each time a denI tist refuses to treat an AIDS patient, the 1 victim has greater cause to hide the truth.

-MARY McIVER with LINDA PRESS and SHARON DOYLE DRIEDGER in Toronto

LINDA PRESS

SHARON DOYLE DRIEDGER