[The problem of cross infection and risk of infection for the practitioner]

Epidemiologic data show that in Belgium, the number of HIV-infected persons increases with an average of 3 a day. This increase will pose a real problem to all health workers including the dentists. The chance that the general dental practitioner comes in contact with HIV-infected patients will increase in the years to come. Therefore, each dental practitioner should have a scheme in his office to prevent cross infection. The transmission of HIV is analogue to HBV: blood, blood products, injury, wound, use of non-sterile instruments and needles... Transmission of HIV by saliva has not been proved yet. Both viruses have the same route of transmission but with a different probability, due to the difference of viral particles per ml plasma. The average chance of transmission from patient to health care worker for HIV is 0.5%, for HBV 6 to 30%. The probability of HIV transmission from a HIV-infected dentist to his patient during one invasive procedure is 3.8 x 10(-6) - 3.8 x 10(-8). In spite of this (low) chance precautions are a prerequisite. On one hand the health care worker has to protect himself and the assistant, on the other hand it's his duty to protect the patient whose immune system is deficient for infection. In this paper a practical approach for the general dental practitioner is proposed. The authors stress the use of exact sterilisation technics, the use of sterile clothes and gloves and the routine uses of glasses and a mask. One of the most important problems, the handling of the infected and contaminated waste, has not been properly solved. Only for medical institutions and hospitals, strict rules have been adopted by the Belgian Government. However, rules and laws for the handling of contaminated material of dental offices have not been published yet.