'No AIDS danger for girl treated with unsterilized dental equipment'

Expert says girl treated by dentist after AIDS patient, with equipment the dentist had not sterilized, did not have to receive an anti-retroviral "cocktail."

By JUDY SIEGEL-ITZKOVICH
aids ribbon 88 (photo credit: )
aids ribbon 88
(photo credit: )
A 17-year-old girl treated by a Jerusalem dentist immediately after an AIDS patient, with equipment the dentist had only disinfected and not sterilized, did not have to receive an anti-retroviral "cocktail" to protect her, according to AIDS expert Prof. Shlomo Ma'ayan. The dentist had not informed the girl what had happened for more than a week after he called Ma'ayan for advice about the treatment, which had occurred a few days before - even though the "cocktail" is effective protection for a maximum of 48 hours after exposure to the virus, the AIDS expert told The Jerusalem Post Sunday. Ma'ayan, head of the AIDS center at Hadassah University Medical Center in Ein Kerem, said the second patient was in "no danger," but that the dentist was obligated to inform the teenager in any case. "She did not need to take the cocktail, as he said he used a different drill bit than the one he used on the AIDS patient, and he cleaned the handle of the suction device for 25 minutes in a proper disinfectant, which neutralizes any virus, including HIV. "According to Health Ministry regulations, however, he should have used an autoclave heating device for the handle between patients. But nevertheless, the second patient was not endangered." "I asked him if he had informed the girl, and he said he would," Ma'ayan said. But the Hadassah expert said he would not reveal the dentist's name for ethical reasons and because he was not authorized to do so. "I understand the hysteria about the case and the desire of dental patients in Jerusalem to want to know the dentist's name, but the hysteria is not justified," said Ma'ayan. "I don't have to disclose his name... But the girl had to be informed immediately about what happened." The Health Ministry had previously refused to divulge the name of the "prominent" Jerusalem dentist who, according to a Channel 2 report on Thursday night, had failed to sterilize his equipment between the two patients. On Thursday night, ministry spokeswoman Einav Shimron-Greenboim refused to identify the dentist, saying only, "We are dealing with the case." She added that the ministry would make sure the dentist contacted the second patient. The spokeswoman also refused on Sunday to let the Post interview Dr. Shlomo Zusman, head of the ministry's dental service, about the case. When this reporter called ministry director-general Prof. Avi Yisraeli to protest the spokeswoman's decision, Yisraeli said it was wrong and that the Post had a right to interview Zusman. According to Health Ministry rules, all dentists must take "universal precautions" and regard every patient as having an infectious disease, using all means to protect both himself and subsequent patients. Ma'ayan said the dentist should have used the autoclave for sterilizing equipment used on any patient. "I don't know if he has the device," he said. "I told him he must immediately tell the girl. But I said then and I say now that there was no need for the girl to take the anti-retrovirals prophylactically... even if she decided to ask for the anti-AIDS 'cocktail,' it would have been too late for it to have protected her."