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The human transmissible spongiform encephalopathies (TSEs): implications for dental practitioners
S Porter1, C Scully, G L Ridgway
1Eastman Dental Institute for Oral Health Care Sciences, University College London, University of London. S.Porter@eastman.ucl.ac.uk
British Dental Journal
|August 23, 2000
Summary
Transmissible spongiform encephalopathies (TSEs) are fatal prion diseases affecting the brain. Specific sterilization methods are crucial for dental management due to prion resistance to conventional disinfection.
Area of Science:
- Neurology
- Infectious Diseases
- Biochemistry
Background:
- Transmissible spongiform encephalopathies (TSEs) are rare, fatal neurodegenerative diseases caused by prions.
- TSEs encompass inherited forms like FFI and GSS, and acquired forms including sporadic, iatrogenic, and variant Creutzfeldt-Jakob disease (vCJD).
- Prions are primarily found in neural tissues and spinal fluid, and lymphoreticular tissues in vCJD cases.
Purpose of the Study:
- To review current knowledge on the clinical aspects of prion diseases.
- To provide guidance on essential cross-infection control modifications for dental management of patients with or at risk of TSEs.
Main Methods:
- Literature review of existing scientific and epidemiological data on TSEs.
- Analysis of prion characteristics and resistance to sterilization methods.
- Evaluation of cross-infection risks in healthcare settings, particularly dentistry.
Main Results:
- Normal social or routine clinical contact does not pose a significant risk for healthcare workers, relatives, or the community.
- Prions are highly resistant to standard sterilization procedures (chemical, irradiation, heat).
- Specific, enhanced cross-infection control measures are imperative for dental procedures involving at-risk patients.
Conclusions:
- While casual contact is low-risk, the resistance of prions necessitates stringent infection control in dentistry.
- Dental professionals must adapt their practices to prevent iatrogenic transmission of prion diseases.
- Updated protocols are essential for the safe dental management of individuals affected by or susceptible to TSEs.