Safety at the doctor's appointment

vladimirpolenichkin
Vladimir Polenichkin

Honored Doctor of the Russian Federation, Doctor of Medical Sciences, Professor, Head of the Department of Maxillofacial Surgery and General Dentistry, GBOU DPO Novokuznetsk State Medical University. General Director of the Dental Clinic Center for Dental Implantation LLC, Novokuznetsk

Dentists are the most frequently visited doctors after general therapists. The problem of the spread of HIV infection and viral hepatitis remains relevant for the international community. The spread of viral hepatitis C and the human immunodeficiency virus has become global and poses a real threat to the socio-economic development in our country. Tens of thousands of people become infected with HIV each year and hundreds of thousands with viral hepatitis. More than a million people die from these diseases per year.
A.
We, doctors, cannot know which carrier of the disease came to see us; dentists do not conduct an immunological immunological blood test for patients. Infection with HIV infection and viral hepatitis can occur not only during dental treatment, surgery and when using poorly sterilized instruments, but also through contact with saliva through damaged skin and mucous membranes.
A.
Currently, private dental clinics, municipal dental clinics and departments of maxillofacial surgery can be equipped with modern methods of rapid diagnosis for HIV-1/2 antibodies: OraQuick ADVANCE and for hepatitis C virus antibodies OraQuick HCV Rapid Antibody Test. This system is very convenient at an outpatient dental appointment. The virus does not select people according to their social status, lifestyle and habits and can enter the body of any person. I also remind you that people may not be aware of their infection, since the incubation period for hepatitis A, B and C is from 2 weeks to 5 months, and the symptoms of the acquired immunodeficiency syndrome appear only a few years after infection.

Timely detection and modern methods of treating the disease can significantly increase the life expectancy of the carriers of the virus, improve their quality of life, and organize the prevention of the spread of infection.
A.
Infectious safety of the dentist and patient should be the basis in the work of dental clinics. In the informed consent for dental manipulations that the patient gives, there is a clause about the viral and infectious diseases he has suffered. A person who has a disease that poses a danger to others and does not inform the doctor about the presence of this disease is criminally liable in accordance with the current legislation of the Russian Federation (Decree of the Government of the Russian Federation No. 710 of July 13, 2012).

In cases of difficulty in answering the questions posed, the patient can be asked to undergo express control by saliva. Test systems for HIV-1/2 and for hepatitis C virus in terms of perimenal fluid are a disposable device designed for the qualitative determination of antibodies to human immunodeficiency virus types 1 and 2 and antibodies to hepatitis C virus. One smear is taken from the outside of the upper and lower gums using a testing device, then the device is inserted into the vial and after 20 minutes the readings are taken, providing reliable results about the presence or absence of infection without the use of laboratory equipment. The advantages for patients are obvious: there is no risk of infection, psychological and physical comfort during testing is ensured.

The test is packaged in a sterile bag and consists of a testing device and a tube with a developing solution. This is a very simple procedure that does not require blood sampling. The simplicity and convenience of the system allows you to use it in any dental office or clinic. The employees of the dental clinic of the Center for Dental Implantation LLC of Novokuznetsk since January 2013, upon the initial request for medical help from a dentist with a therapeutic, orthopedic or surgical profile, the patient fills out an information consent. In cases where the patient finds it difficult to answer the question about the transmitted infectious diseases, he is invited to optionally undergo express diagnostics for hepatitis C and HIV 1/2 infection by peri-gingival fluid.
A.
The instructions attached to the tests describe in detail the algorithm of the testing, therefore, additional training of personnel is not required. Yes, and testing is carried out with the consent of the patient, and the cost of testing is included in the price list. Rapid test data are discussed in detail with your doctor.

Step1

STEP 1

A sample of a fluidized liquid. Take a swab from the upper and lower gums once.

Step2

STEP 2

Place the device in a buffer tube.

Step3

STEP 3

Place the device in a buffer tube.

In cases of a positive analysis, the doctor should recommend that the patient contact the regional center for the prevention, research and control of HIV infection and hepatitis C for additional testing. The specialists of the center for the prevention of infections should prepare teaching materials for dentists. By conducting testing data, dental clinics will be able to guarantee their patients and employees the opportunity to protect themselves from HIV and hepatitis C infections at a dental appointment and significantly increase their rating.
A.

OraQuick ADVANCE® rapid HIV test ½

Clinical effect of OraQuick® for HIV 1/2
Sample Sensitivity Specificity
Gum fluid (saliva) 99,7% (95% CI: 99,0-100.0) 99,9% (95% CI: 99,3-100.0)
Capillary blood 99,9% (95% CI: 99,6-100.0) 99,9% (95% CI: 99,5-100.0)
Plasma 99,9% (95% CI: 99,6-100.0) 99,9% (95% CI: 99,5-100.0)

OraQuick® Hepatitis C Rapid Test

Clinical effect of OraQuick® for hepatitis C1
Sample Sensitivity Specificity
Gum fluid (saliva) 98,1% (95% CI: 96,9-99,0) 99,6% (95% CI: 99,2-99.9)
Capillary blood 99,7% (95% CI: 99,0-100.0) 99,9% (95% CI: 99,6-100.0)
Venous blood 99,7% (95% CI: 99,0-100.0) 99,9% (95% CI: 99,5-100.0)
Plasma 99,9% (95% CI: 99,3-100.0) 99,9% (95% CI: 99,5-100.0)
Serum 99,9% (95% CI: 99,3-100.0) 99,9% (95% CI: 99,6-100.0)

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