Variant Creutzfeldt-Jakob disease--a problem for general dental practitioners?

Over a hundred deaths from variant Creutzfeldt-Jakob disease (vCJD) have now been recorded. The incubation period for vCJD may be up to 40 years and the number of asymptomatic carriers in the population could be as many as 100,000. Confirmed iatrogenic transmission of other human transmissible spongiform encephalopathies raises the possibility of cross-infection from apparently healthy persons who are incubating vCJD. Decontamination techniques routinely used in general dental practice are incapable of inactivating the infective protein responsible for transmitting the disease. So far, no evidence exists to preclude the risk of iatrogenic infection occurring during dental procedures. The author reviews present knowledge of the infective agent, its transmissibility, its origins, current guidelines and the implications for dental practice.