Dentists Are Skeptical of Center’s AIDS Story

Dentists at a San Diego conference this weekend said the U.S. Centers for Disease Control was irresponsible in reporting that a young woman probably contracted AIDS during a dental procedure.

The case, the first during the 10-year epidemic where a medical worker has been suspected of transmitting the AIDS virus to a patient, made headlines and TV and radio broadcasts nationwide after it was reported by the CDC on Thursday.

Many dentists said the report’s findings were too inconclusive to be made public and that the media followed up with inflammatory reporting.

“It’s irresponsible, it puts a fear in patients that’s really unfounded,” said dentist Fred Stuart of Los Angeles. “It has set us back.”

Stuart, who says he was tested for the HIV virus after he was informed that one of his former patients has died of AIDS, said dentists now might have more to prove to their patients.

“I almost want to post (those results) on my office door,” he said.

Dentist Del Webb of St. George, Utah, said he couldn’t believe the report. “I think collectively and honestly that it borders on the impossible,” he said.

The CDC reported that the most plausible explanation for the woman’s infection was from a dentist who removed two of her molars two years before. The dentist, the CDC reported the woman said, had worn a mask and gloves.

They also said, though, that other possible causes “cannot be entirely excluded.”

The report drew criticism from American Dental Assn. officials, who said the CDC may have jumped to conclusions.

Officials from the CDC said they were obligated to publish the report because of the “public interest.”

At a CDC meeting in Atlanta in two weeks, representatives from the medical, labor, and public health sectors will discuss whether more specific and stringent guidelines should be laid out regarding the practice of AIDS-infected health professionals.

Many at the conference Saturday said the lack of disclosure regulations regarding both patients and doctors who have the virus that causes acquired immune deficiency syndrome is unsafe.

“If you have hepatitis, you have to stop (practicing), but if you have AIDS, you don’t even have to tell anybody,” said dentist Merritt Barber of San Diego.

According to Bernard Guentner, a widely-accepted tenet of the medical profession says doctors who know they have an active case of hepatitis must remove themselves from practice until they are proven to no longer be contagious, yet medical professionals with AIDS have no such guidelines.

Guentner, of the Scripps Center for Dental Care in La Jolla, said the case highlights the paradox over the desire to safeguard privacy and civil rights versus the need for protection of both doctors and patients.

“It’s just like testing an airline pilot for cocaine use,” he said.

The dentists also lamented the overhead costs from new preventive procedures that were primarily introduced after the AIDS scare began, including the gloves and masks that medical doctors have always worn but that were largely unknown in dentistry a decade ago.

“It’s a tremendous amount of money the patient has to pay for all the new things that are sanitized,” Barber said.

According to Guentner, 10%, or about $12,000, of his practice’s yearly budget for disposable supplies goes for those items--in addition to the disposable “barrier” shields that cover items in the procedure rooms and are thrown away after each patient.

The dentists did agree, as CDC officials have said, that there’s a possibility that the dentist could have cut or punctured himself with an instrument he later used on the patient.

The CDC said an investigation of the woman’s past--including two men she had dated--turned up no other links with AIDS.

DNA-virus testing had shown a likely match between the woman and the dentist, they said.

Even if blood or bodily fluids from a contaminated needle were to pass from a doctor to a patient, studies have shown there is only a chance of 0.4% that the virus itself would transfer.

Steven L. Wheeler, an oral surgeon from Encinitas who is expecting questions from patients, said, “I’m just waiting for next week in my office.”