Unit 19 - HIV Oral Manifestations (Dentists!)

Question 1

How many people exist that don’t know they are infected with HIV?

Answer 1

16% of those infected don’t know it!

Question 2

Is saliva ever infectious?

Answer 2

Saliva itself if NOT infectious.

Saliva + blood can be infectious…BLOOD.

Question 3

What risk of exposure to HIV is there from a shallow, accidental needle-stick?

Answer 3

About 0.2 - 0.4%

Question 4

What risk of exposure to HIV is there from an infected transfusion?

Answer 4

About 100%

Question 5

How many people in the US are infected by:
HIV
Hep C
Hep B

and what are their risks of exposure from a needle-stick?

Answer 5

HIV: 1.1 million –> risk = 0.3%
Hep C: 3.9 million –> risk = 3 - 10%
Hep B: 750,000 carriers –> risk = 5 - 35%

BUT, most of us are now vaccinated against Hep B

Question 6

How many documented cases are there of HIV being acquired from a patient?

Answer 6

Zero

Question 7

Who is David Acer?

Answer 7

Dentist in FL that transmitted HIV to 6 patients.

Question 8

What is PEP?

Answer 8

Post Exposure Prophylaxis.

Can have side effects, but IT WORKS

Question 9

What are the 4 steps if you have an exposure?

Answer 9

1. Stop…maybe cry a little
2. Wash with soap and water
3. Go to Employee Health or ER - BRING PATIENT WITH YOU
4. Complete an evaluation and start PEP

Question 10

What is the evaluation encompass after an exposure?

Answer 10

What was the nature of the exposure (was there visible blood, etc)
What is the serology of the patient
Complete a rapid HIV test on the patient

Question 11

What must take place during PEP treatment?

Answer 11

There are 3 drugs taken for 4 weeks
Must monitor drug toxicity
Complete an HIV test at 6 & 16 weeks
Use lifestyle modifications

Question 12

What do you say to a patient that notifies you they have HIV?

Answer 12

Thank you for confiding in me

Tell them you use same precautions with all your patients

Question 13

Why do dentists need to know about HIV, other than to protect themselves and patients?

Answer 13

90% of HIV patients have an oral lesion at some point

Question 14

What are examples of oral manifestations/diseases of HIV?

Answer 14

Oral candidiasis/angular cheilitis
Oral hairy leukoplakia
Aphthous Ulcer
Herpes Simplex
HPV
Kaposi's Sarcoma
Bacterial Disease

Question 15

What do you tell your patient if you suspect HIV?

Answer 15

Suggest they get tested:
privately
non-judgemental
with concern for their health
note that the CDC recommends that everyone is tested