Ebola virus precautions at the dental office

Due to the recent outbreak of the deadly Ebola virus in West Africa, dentists have been advised by the American Dental Association (ADA) to include a travel history in their routine medical history work-up. Any persons who have been to the West African countries Liberia, Sierra Leone or Guinea may be at risk of having contacted persons infected with Ebola. Because there is the possibility of someone being infected with Ebola and not having symptoms early in the disease process, the ADA recommends anyone who has traveled to West Africa avoid routine dental care for 21 days. Emergency care could be provided earlier after consultation with the patient’s family doctor and the local health department.

The most common signs and symptoms of Ebola infection are: Fever (greater than 38.6°C or 101.5°F) and severe headache, muscle pain, vomiting, diarrhea and stomach pain or unexplained bleeding or bruising. The Ebola virus is spread through direct contact (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit and semen) of a person who is sick withEbola, or with objects (like needles) that have been contaminated with the virus. For this reason, dental treatment can be a high-risk environment when treating someone infected with Ebola. Dentists shield their patients and themselves from infections by using what is known as universal precautions. The philosophy of universal precautions assumes that any person who comes into a dental office for treatment is potentially infectious. With this in mind, dentists wash their hands before and after each patient is seen, use a new pair of gloves for each patient, wear clean protective gowns during treatment, and put on masks and protective eyewear. During treatment, high evacuation suction is used, barriers are placed in the patient’s mouth to isolate the area treated, and sharp instruments (needles and scalpels) are discarded into special medical waste containers after a single use. Before the next patient is seated, all surfaces within the treatment area are disinfected, and new plastic barriers are placed on equipment to protect surfaces used for patient care during treatment. Many items used during routine dental care (gauze, cottonrolls, bibs, cups, saliva ejectors, etc.) are disposable (used once per patient).

Instruments that are not disposable (mouth mirrors, curettes, extraction forceps, etc.) are sterilized using either steam under pressure (autoclave), dry heat, chemical vapor, or ethylene oxide gas. Likewise, dental drills and waterlines undergo rigorous sterilization procedures. These methods effectively kill all forms of microorganisms, including viruses, bacteria, fungi, and spores.

Universal precautions and rigorous implementation of infection control protocol have drastically reduced the possibility of contacting any infection in the dental office. Even so, there is still much unknown about the Ebola virus, and fear of contracting the disease is a real concern. People returning from West Africa should avoid dental treatment until they are asymptomatic for 21 days to avoid potentially infecting other dental patients and dental office personnel.

Dr. Jerry Gordon can be reached at (215) 639-0571. Comments, questions, and second opinions are available at The Dental Comfort Zone, 2734 Street Rd. Bensalem, PA 19020 (across from the Giant supermarket). To learn more: https://dentalcomfortzone.com/ E-mail: drjdmd@comcast.net