This document summarizes several blood-borne diseases of concern to dentistry, including HIV, hepatitis viruses (HAV, HBV, HCV), herpes simplex viruses 1-3, tuberculosis, and the novel coronavirus. For each disease, it describes the causative agent, signs and symptoms, mode of transmission, and recommended infection control practices in dental settings to prevent transmission. Standard precautions like use of personal protective equipment, sterilization of instruments, and proper handling of sharps are emphasized. Risk of transmission is highest during aerosol-generating procedures, so limitations or precautions during such tasks are advised.

1. BLOOD BORNE DISEASES OF CONCERN TO DENTISTRY

2. Human Immunodeficiency Virus (HIV)
HIV is classified as a
retrovirus and works by
targeting the body’s immune
system, specifically CD4 T
cells, making it difficult
for the body to fight off
infections.
Eventually the body will
succumb to opportunistic
infections, which leads to
death.

3. MODE OF TRANSMISSION
•
HIV is transmitted most commonly from anal or vaginal sex
and through the sharing of needles or syringes
Rarely transmitted through oral sex, blood transfusions, or
organ/tissue transplants
It is also possible for HIV to be transferred from an HIV-
positive mother to her baby during pregnancy, birth or
breastfeeding, although this is also rare.

4. INFECTION CONTROL
Avoiding exposure to blood and bodily fluids is the primary
way to prevent transmission of HIV in dental care settings.
During dental procedures, saliva tends to become
contaminated with blood, increasing the risk of HIV
transmission from saliva.
Standard precautions should be followed with all patients,
whether or not they have been diagnosed . Dental
personnel should wear barrier precautions (e.g., gloves,
masks, and protective eyewear).
The occupational source of greatest risk of HIV transmission
is percutaneous injuries. Dental personnel can reduce their
risk of percutaneous injuries by following the Standard
Precautions, having engineering controls and work-practice
controls for all sharps, and following safe injection
practices.

5. Hepatitis Viruses
Hepatitis A Virus (HAV)
HAV is acquired in the U.S. primarily through close personal contact with an infected person
and during foodborne outbreaks. Unlike HBV and HCV, HAV does not cause chronic
infection.
Hepatitis B Virus (HBV)
Hepatitis B (HBV) is a member of the hepadnavirus family. HBV infects mainly the liver but
can also infect the kidneys and pancreas . HBV is a small, enveloped DNA virus. It is a
particularly stable virus, making it very resistant to disinfection. This makes HBV able to
live for a long time outside of the body, therefore making cross contamination and
infection much more likely. It can survive outside the body for at least 7 days and still be
capable of causing infection.

6. Hepatitis C Virus (HCV)
Hepatitis C (HCV) is a blood-borne virus of the family Flaviviridae that often
results in chronic liver infection. HCV is a small, enveloped RNA virus that
targets human hepatocytes . For some people, the infection is acute and they
are able to clear it on their own, but in 70–85% of cases, it becomes a chronic
infection. Most people who become infected are not aware because they do not
show any signs of illness. Chronic infection can lead to more serious
complications such as liver cirrhosis, hepatocellular carcinoma, and even death.

7. Mode of Transmission
Hepatitis A Virus (HAV)
• Person to person contact
• Contaminated food or
water
• Very rarely blood
exposure

8. Hepatitis B Virus (HBV)
HBV is transmitted perinatally,
percutaneously, and through sexual
contact.
It is also spread through open cuts and
sores through individuals in close
contact
HBV infection is more commonly seen
in adulthood as a result of sexual
transmission and IV drug use .

9. Hepatitis C Virus (HCV)It can be
transmitted in blood, semen, and vaginal
secretions.
This is most commonly seen in patients
receiving transfusions or organs,
needlesticks in the healthcare setting,
sharing drug needles and through sexual
intercourse.
Almost all those infected with HIV (greater
than 90%) who are or were intravenous
drug users are also infected with HCV

10. Infection Control
barrier precautions (e.g., gloves,
masks, and protective eyewear)
whenever there is potential for
contact with body fluids or
mucous membranes.
Use work practice and
engineering controls for sharps
safety, and follow safe injection
practices
sterilization and disinfection of
dental equipment and
instruments

11. In the event of an exposure incident (e.g.,
needlestick, sharps injury), employers are
required to refer the exposed employee to a
licensed health care professional who can
provide post-exposure evaluation and follow-up
services that include: documentation of the
exposure; identification of the source individual;
testing of the source individual’s blood for
infectivity status; collection of the blood and
testing; post-exposure prophylaxis, if indicated;
counseling; and a written opinion documenting
that the employee was provided services.

12. Herpes Simplex 1-3
Infection with herpes simplex virus, commonly
known as herpes, can be due to either herpes
simplex virus type 1 (HSV-1) or herpes simplex
virus type 2 (HSV-2). HSV-1 is mainly
transmitted by oral-to-oral contact to cause
infection in or around the mouth (oral
herpes).
HSV-2 is almost exclusively transmitted
through genital-to-genital contact during
sex, causing infection in the genital or anal
area (genital herpes).
HSV-1 is a highly contagious infection. Most
HSV-1 infections are acquired during
childhood, and infection is lifelong.

13. MODE OF TRANSMISSION
HSV-1 is mainly transmitted by oral-
to-oral contact to cause oral herpes
infection, via contact with the HSV-1
virus in sores, saliva, and surfaces in
or around the mouth.
HSV-1 can be transmitted from oral
or skin surfaces that appear normal
and when there are no symptoms
present. However, the greatest risk of
transmission is when there are active
sores.

14. Infection Control
1.Limit treatment to urgent or
emergency care
2.Delay elective procedures until
lesions are healed
3.Provide treatment designed to
reduce the time of healing
4.Where the use of equipment that
produces an aerosol cannot be
avoided, use extreme caution

15. 1. Even if aerosol danger is minimal, wear appropriate
extra PPE to cover arms, hands, and to protect face
2. Be aware of the potential for sudden patient reaction
to pain. Unless needed, keep the hand that is not
holding an instrument out of the “line of fire”
3. Change gloves frequently if the procedure is lengthy,
taking care to wash the hands using soap and warm
water between glove changes
4. Provide eye protection for the patient and recommend
that the patient wash hands and face after treatment
5. Educate the patient on the nature of herpes labiali

16. Tuberculosis
is caused by infection
with Mycobacterium
tuberculosis. Infection
occurs through inhalation
of which then travel to the
alveoli of the lungs.

17. MODE OF TRANSMISSION
1. Direct contact with blood, oral fluids or other
body fluids.
2. Indirect contact with contaminated objects
including instruments, equipment or environmental
surfaces.
3. Contact of eyes, nose, mouth and / or mucous
membranes with droplets/splatter containing
microorganisms.
4. Inhalation of Airborne microorganisms that can
remain suspended in the air for longer periods of
time.

18. INFECTION CONTROL
PRACTICES
1. Limit the use of ultrasonic scalers and highspeed handpieces in actively infected patients. High
volume suction is mandatory for carrying out any procedure to minimize aerosol generation.
2. Use rubber dam isolation with high vacuum suction. However, if the patient has productive cough
it is better to avoid Rubber dam.
3. Maintenance of proper hand hygiene, personal protective equipments like eye shields,
facemasks, head caps, gloves and surgical gowns.
4. Standard face masks do not protect against TB transmission, hence particulate face
masks should be used and often changed at regular intervals. Face masks should have atleast
95% Bacterial filtration efficiency (BPE) for particles 3µm diameter. While treating patients with
symptoms of active TB, the operator should wear respirators rather than routine face masks.
5.

19. 5. TB rooms should have effective air evacuation with either exhausted or HEPA-
filtered if re circulation is necessary.
6. Regular fumigation of dental operatories. Cleaning and disinfecting critical and
semi critical contact surfaces like Dental chair and accessories. Anti bacterial sprays
may be used.
7. Use of barrier techniques.
8. Use of high efficacy filters or UV light in the exhaust air ducts.
9. All dental settings should conduct an annual risk assessment for TB transmission.

20. The Novel
Coronavirus

21. The Virus
According to the World
Health Organization
(WHO),coronaviruses make
up a large family of
viruses that can infect
birds and mammals,
including humans.

22. Signs and Symptoms
• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

23. Mode of Transmission
The virus can spread from an
infected person’s mouth or
nose in small liquid particles
when they cough, sneeze,
speak, sing or breathe heavily.
These liquid particles are
different sizes, ranging from
larger ‘respiratory droplets’
to smaller ‘aerosols’.
Aerosol transmission through
aerosol generating
procedures

24. COVID 19 and Dentistry
Dentistry iss one of the most exposed
and affected profession the Covid 19
contagion has brought. During the
height of pandemic, dental procedures
across the world were halted
as dental professionals are identified
being at high risk for nosocomial
infection and can become potential
carriers of the disease.
Telescreening and triaging is the
initial measure of precaution to
assess the urgency of the illnesses
and injuries prior to consultation.

25. Specific dental infection control
measures
Dentists should follow standard, contact, and airborne
precautions including the appropriate use of personal
protective equipment and hand hygiene practices
Preprocedural mouth rinse
Use of disposable (single-use) devices
Dentists should use a rubber dam to minimize splatter
generation
Dentists should minimize the use of ultrasonic
instruments, high-speed handpieces, and 3-way
syringes to reduce the risk of generating
contaminated aerosols
Provision of negative-pressure treatment rooms/
airborne infection isolation rooms (AIIRs)

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