Objectives: The number of confirmed cases of transmissible spongiform encephalopathies (TSEs) in humans in the United Kingdom has greatly increased in the wake of the epidemic of TSE in cattle. This study investigated what the dental and public health leaders were doing to control the spread of TSEs. TSEs are highly resistant to current dental infection control practices, and are not easily inactivated, even with today’s routine autoclaving.
Methods: Leaders and experts (n=15) in the United Kingdom were asked a standard series of interview questions pertaining to dental instrumentation, infection control protocols, and public health issues.
Results: The results from the interview data, combined with published information about TSEs in the United States, suggest that there is a real, yet theoretical, risk of TSE transmission through dental treatment, although the magnitude of that risk has not yet been determined.
Conclusions: Experts suggest that dental instruments should be disposable wherever possible, and that non-disposable instruments should undergo a thorough physical cleansing, followed with autoclaving in a vacuum or porous load autoclave at 134-137 degrees Celcius for 1 hour, and then soaking in hot 1N NaOH for 1 hour. The data suggest that the leukocytes of whole blood are an infection control risk for TSEs, although the magnitude is believed to be small. There is a great need for educating current and future healthcare workers about the current knowledge base of TSEs, and a need for universal implementation of recommended changes to
dental public health and infection control policies.
Sponsored by UT-Houston Dental Branch Alumni Association