Hepatitis B and HIV infections in dental professionals: effectiveness of infection control procedures

In a survey carried out in 1987 and 1988 in Vancouver British Columbia, 704 dental professionals filled out an anonymous questionnaire and submitted a blood sample. Of those not immunized, 11% had infection with Hepatitis B, with dentists having a rate of 18%, significantly higher than other dental workers. Two carriers of HBsAg were detected and no individuals showed evidence of HIV infection. There were no differences in infection rates by the specific infection control practices. Oriental dental-care workers had a significantly higher rate of infection than other races surveyed. In a multivariate model, race and the number of years in practice were the only significant factors in predicting infection. The use of gloves did not show a protective effect, although a threefold protection rate for gloves is the smallest difference that could be reliably detected. The immunization rate with Hepatitis B vaccine averaged 46%, with fewer dentists being immunized than hygienists. Seroconversion rates were lower in older individuals. Dental professionals had a high risk of Hepatitis B and had not been adequately immunized. Reliance on gloves for operator protection appears to be inadequate.