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Is it really possible to get infected with HIV by your Dentist?

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Yesterday (July 2015), breaking news in Sydney reported that “up to 12,000 people” were asked to got for HIV and Hepatitis testing after it was revealed that the dental practices they received treatment at were under investigation for “poor hygiene practices.”

Apparently, the dentists were using “poor cleaning and sterilisation techniques.” Of course, one of the dentists claimed that the complaint was made by a patient whom he had an argument with and wanted to put him out of business.

So as usual, all of us wait with bated breath as the patients are tested and meanwhile, postpone our dental appointments.

This is sounding all too familiar. The Internet is awash with news on HIV infection scares from dentists. Here are just 2 examples:

- In 2013, a Scottish dentist was found to be HIV +ve and 3000 of his patients were asked to undergo HIV testing.

- In 2014, a lady named Amy Duffield mysteriously died from a viral heart infection after a visit to her dentist Dr. D’Mello. It was later found that her dentist had “poor hygiene practices.” This is actually putting it mildly. What he did was he did not change gloves between patients, used the same equipment and gloves for 32 years and stored his dental equipment in the toilet! More than 20,000 of his patients were asked to come back for HIV and hepatitis testing.

In spite of so many scary stories, one common thread runs through all of them. Although thousands upon thousands of patients had to undergo a very heart pounding and anxiety causing HIV test, the fact was NONE of them were found to be HIV +ve.

So is it really possible to get infected with HIV from your dentist?

So far, there have been 2 “proven” cases of HIV infection from dental treatments. I have the word “proven” in quotation marks because although these cases are rather convincing, there are many sceptics who still believe these patients did NOT get infected with HIV from their dentists and that investigations by the US CDC were flawed. Let’s put that aside for now and look a little more closely at the cases.

The case of the Florida Dentist

This is by far the most famous case of HIV infection from a dentist. In 1990, the US CDC published a case report on a lady named Kimberly Bergalis. She was diagnosed with HIV but denied doing anything that would put her at risk of HIV. She never had any tattoos, blood transfusion, intra-venous drug use or even acupuncture. She had 2 boyfriends and both of them tested negative for HIV.

It was later found that she had 2 teeth pulled out 2 years before she was diagnosed with AIDS and that the dentists who pulled her teeth out was himself diagnosed with AIDS 3 months before that! This now infamous dentist was called Dr. David Acer. Genetic testing on Kimberly’s and Dr. Acer’s HIV strains were not a perfect match but according to the CDC “were closer than what has been observed for pair-wise comparisons of sequences taken from the other North American isolates studied.” In other words, close enough to prove that Dr. Acer was the one who infected Kimberly.

What was more chilling was that after a huge investigation, 5 more patients of Dr. Acer were found to be infected with HIV!

Read the CDC reports here:

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001679.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/00014428.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001877.htm

The case of the Tulsa Dentist

In 2013, a patient was found to be infected with Hepatitis C after visiting his dentist Dr. Scott Harrington. This prompted the state health department to raid his office. And lo and behold, they found what can only be described as nightmarish conditions. Dr. Harrington was found to be using old and rusty instruments and had the habit of pouring bleach on his patients’ wounds until “they turn white”!

More than 7,000 of his ex-patients were tested and 3 were found to have HIV, 4 had Hepatitis B and 70 had Hepatitis C!

When they finally found him, he was hiding out at his second home in Arizona.

My own experience

In my career, I have seen 2 cases of possible HIV infection from dentist visits.

One was a young lady from Malaysia. She tested positive for HIV during a routine annual medical checkup to renew her work permit. Just like Kimberly Bergalis who was infected by the Florida Dentist, she too denied any activities that could put her at risk of HIV. She never had any blood transfusions, never did drugs, never had any tattoos and in fact, she never even had sex before! Prior to her HIV diagnosis, she visited 2 dentists. One was in Singapore and one was in Malaysia. The dentist in Singapore was investigated by the Ministry of Health and was found to be clear of HIV and had good infection control practices.

Another case was that of a young man also from Malaysia. Just like the young lady, he denied any risky behaviour that would expose him to HIV. And just like the young lady, he visited a dentist prior to being diagnosed.

These 2 cases were never properly investigated by the authorities so were never proven.

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