Dental Clinic Offers Care to AIDS Patients

Malcolm Queen risked his life the other day by visiting Temple University’s infectious disease dental center, which treats AIDS patients.

But it was the drive that put Queen’s life in immediate danger, not undergoing any dental procedure.

The risk of a patient contracting the AIDS virus while in a dental chair is about 1 in 263,158 procedures, a much lower risk than dying in a traffic accident, according to the Centers for Disease Control. A driver’s risk of being killed in a car crash in one year is 1 in 6,500.

Only one health-care provider is known to have infected a patient. CDC researchers have said they still have not learned how Florida dentist David Acer transmitted the virus to five patients before dying in 1990.

The Temple clinic’s director, Dr. Michael Glick, reminds dental students and faculty of the greater hazards of dying in a car accident or being struck by lightning.

But Glick admits emotion often overrules reason.

“HIV has very little to do with logic,” he said.

Glick, Temple graduate Dr. Brian Muzyka and as many as 72 students a semester treat the clinic’s 800 infectious patients. Most of the patients are HIV infected, some have tuberculosis, and one has leprosy. A few have hepatitis B.

The clinic provides the same procedures with the same precautions that all dentists should use, according to Glick. The clinic’s dentists and students wear surgical gowns, masks, rubber gloves and goggles with side barriers.

The precautions protect the dentist as well as the patient, although only 47 of the 7,652 infected health-care workers in the United States contracted the disease through their work.

Glick began the clinic at Temple’s request in July, 1988, and he has been asked by others for advice in setting up similar programs. The American Dental Assn. said it was unaware of any other university-related dental clinics dedicated to treating infectious disease patients.

But there’s no need for dental centers dedicated to treating infectious patients, he said.

“It’s a sad reflection on the dentists out there. We do the same type of dentistry and take the same precautions. There’s actually no reason why we should be here,” Glick said.

Many of Glick’s patients go to the clinic because they don’t want to risk someone else’s life, they appreciate the precautions the clinic takes or no other dentist will care for them.

“I’d rather be here where they know what they’re doing,” said Kevin, a young father from suburban Philadelphia who spoke on condition of anonymity.

Queen, who has hepatitis C, doesn’t worry about getting infected with AIDS from a dentist or from other patients. But he’s somewhat bothered that the clinic’s staff asks him at every visit if he is still HIV negative.

“I think everyone, everywhere, should be treated as potentially infectious,” Queen said.

Muzyka, who doesn’t get tested for HIV infection, isn’t concerned so much about the potential risk as he is about treating his patients with the professional care they deserve.

“There is a chance (of infection), but the way I look at it, I know this patient and I’ll have my guard up,” he said.

But he gets frustrated because he sometimes has to rush the dental work at a patient’s request. “People say to me, ‘I want to die with a nice smile.’ ”