New light on the transmissibility of viral hepatitis in dental practice and its control.

Evidence of an increase in the nonparenteral spread of viral hepatitis is of much concern in dentistry and supports the need for sterilization of all instruments used in intraoral treatments. Methods for the rapid sterilization of all dental handpieces and air-water syringes are still inadequate for routine clinical use. It may be possible to improve surface disinfection of these items by more thorough, repeated cleansing with common disinfectants and by the use of stronger germicidal agents such as aldehydes. However, for handpieces and some other equipment, effective sterilization methods must be developed or the instruments must be modified so they can be safely and rapidly sterilized. Surface disinfectants that will destroy hepatitis viruses are needed for disinfection of the dental unit. The use of gloves is also an important consideration for the protection of both the dentist and his patient. The high attack rate of hepatitis among surgeons, as well as patient protection, make the wearing of gloves during surgery imperative. Evidence that aerosolborne viruses would be removed by filtered laminar air flow or by face masks is not available, but use of these devices reduces exposure of personnel to aerosols in general and appears to be highly desirable. Sterilization of all possible instruments is advocated for use in all institutions and dental offices. Careful monitoring of the effectiveness of sterilization also is advocated. These concepts and new information on which they are based should be incorporated into dental curriculums and continuing education courses for all dentists and auxiliary personnel.