What is Tuberculosis? Transmission Diagnosis TB in Pakistan Relationship of TB with dentistry Decision tree for dental management of TBpatients Safety measures by dentists
Infectious disease caused by MycobacteriumTuberculosis, which primarily affects thelungs but is also capable of involving almostany site in the body including the oral cavity.
Aerosolized droplets 5µm in diameter. Estimated 5-200 orgs required for infection Spreads through the air when a person:• Sneezes• Coughs• Speaks• Talks
Chest x-rays Air appears black inlungs (radiograph) Tuberculin skin test (TST or PPD)
TB has been prevalent in Pakistan andunfortunately it has been one of the neglectedhealth areas in the past. Pakistan ranks 6th amongst the countries with ahighest burden of TB in the world. Pakistan contributes about 44% of tuberculosisburden in the Eastern Mediterranean Region. According to WHO, the incidence of sputumpositive TB cases in Pakistan is 80/100,000 peryear and for all types it is 177/100,000. TB is responsible for 5.1 percent of the totalnational disease burden in Pakistan. The impact of TB on socio economic status issubstantial.
In dentistry, the incidence of exposureto an active TB patient is quite low. Oral lesions of TB are uncommon, withmost cases appearing as a chronicpainless ulcer. This does not mean that the dentalhealth care worker should not concernthemselves with good diagnostic andpreventive measures and realizationthat patients and other HCWs may beinfected with TB.
Patient EducationShould educate the patient regarding his/her severehealth condition and needs to make sure that thepatient should cover his/her mouth and nose whilecoughing or sneezing. BarriersDentist and dental nurse should wear gloves, eyeglasses and mask to prevent the possibility ofmicroorganism from being transferred during dentalprocedures
SterilizationProper sterilization of all the instruments shouldbe done before and after the treatment of thatpatient. The dentist should also disinfect his/herhand after treatment.