AIDS and Dental Care

Publication of the “Dental Patient Bill of Rights” by the California Dental Assn., a constructive policy on access to care and appropriate professional information, has coincided with a troubling report from AIDS Project Los Angeles on the number of persons with AIDS and AIDS-related illnesses who are being refused dental care.

Leaders of the dental association have expressed their regret regarding the report from the AIDS project, and are committed to working with the dentists who are refusing to provide care. The association’s goal would be to educate them both on their ethical responsibility and on the appropriate safeguards adopted by the profession. The fact that a majority of dentists are treating infected patients is reassuring.

Almost 40% of the 350 persons now using the AIDS Project Los Angeles dental clinic have been refused access to dentists in private practice, according to Dr. Jim Formaker, who directs the clinic. A substantial number of them were refused care by dentists whom they had been seeing regularly, and in most cases the patients had voluntarily informed the dentists of the fact that they carried the AIDS infection.

A civil action has been filed in Encino as a result of alleged refusal of dental service, and at least one other case is under litigation in New York, according to dental association officials. A better course, it seems to us, would be to ensure access by using education to overcome the fears of dentists. Research recently published in the New England Journal of Medicine found no incident of infection of dental-care workers who followed the prescribed safety procedures. Officers of the California association remain confident that these procedures will result in “a risk that is minimal or zero.” But, as one said, “We face a continuing job influencing both our members and the public.”

One useful response has come from AIDS Project Los Angeles itself, which is conducting at least two training sessions a month for dentists, dental hygienists and dental assistants, using Formaker and Mimi Robins, a registered dental assistant, who is the clinic’s manager. Many of the fears that are associated with the deadly disease fade in the face of facts and information about appropriate professional procedures.