Key Points
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Creutzfeldt Jakob Disease (CJD) is rare, but the resistance of prions to sterilisation procedures raises concerns in dental surgery.
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Many dental practitioners do not attempt to identify patients 'at risk' of CJD.
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Most UK general dental practices do not own vacuum autoclaves, and cannot undertake stringent decontamination of instruments used to treat patients 'at risk' of CJD.
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There are requirements for further research on prion infectivity in oral tissues and for continuing education on prion diseases for dental personnel.
Abstract
Aims To determine the suitability of key infection control measures currently employed in UK dental practice for delivery of dental care to patients at risk of prion diseases.
Materials and methods Subjects: Five hundred dental surgeons currently registered with the General Dental Council of the UK. Data collection: Structured postal questionnaire. Analysis: Frequencies, cross-tabulations and chi-squared analysis.
Results The valid response rate to the questionnaire was 69%. 33% of practices had no policy on general disinfection and sterilisation procedures. Only 10 of the 327 responding practices (3%) possessed a vacuum autoclave. 49% of dentists reported using the BDA medical history form but less than 25% asked the specific questions recommended by the BDA to identify patients at risk of iatrogenic or familial CJD. However, 63% of practitioners would refer such patients, if identified, to a secondary care facility. Of the 107 practitioners who were prepared to provide dental treatment, 75 (70%) would do so using routine infection control procedures.
Conclusions Most of the dental practices surveyed were not actively seeking to identify patients at risk of prion diseases. In many cases, recommended procedures for providing safe dental care for such patients were not in place.
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Porter, S. A survey of cross infection control of CJD in the practice. Br Dent J 191, 81 (2001). https://doi.org/10.1038/sj.bdj.4801102
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DOI: https://doi.org/10.1038/sj.bdj.4801102
