HEPATITIS B VACCINATION AND INFECTION AMONG U.S. DENTISTS, 1983-1992

doi:10.14219/jada.archive.1996.0457

The Journal of the American Dental Association

Volume 127, Issue 9, September 1996, Pages 1385-1390

https://doi.org/10.14219/jada.archive.1996.0457 Get rights and content

ABSTRACT

The hepatitis B vaccine became commercially available in 1982. Since then, health care workers, including dentists, have been encouraged to be vaccinated. This study examines the prevalence of hepatitis B vaccination and infection among U.S. dentists from 1983 to 1992.

References (22)

NashKD
How infection control procedures are affecting dental practice today
JADA
(1992)
FaheyBJ et al.
Frequency of nonparenteral occupational exposures to blood and body fluids before and after universal precautions training
Am J Med
(1991)
ThomasDL et al.
Occupational risk of hepatitis C infections among general dentists and oral surgeons in North America
Am J Med
(1996)
GruningerSE et al.
Human immunodeficiency virus type I. Infection among dentists
JADA
(1992)
KleinRS et al.
Occupational risk for hepatitis C virus infection among New York City dentists
Lancet
(1991)
FeldmanRE et al.
Hepatitis in dental professionals
JAMA
(1975)
MosleyJW et al.
Hepatitis B virus infection in dentists
N Engl J Med
(1975)
SmithJL et al.
Comparative risk of hepatitis B among physicians and dentists
J Infect Dis
(1976)
SiewC et al.
Survey of hepatitis B exposure and vaccination in volunteer dentists
JADA
(1987)
ReingoldAL et al.
Failure of gloves and other protective devices to prevent transmission of hepatitis B virus to oral surgeons
JAMA
(1988)

Infection control in the dental office

JADA

(1992)

Cited by (38)

Transmission of blood-borne pathogens in US dental health care settings: 2016 update
2016, Journal of the American Dental Association
Citation Excerpt :
The hepatitis B vaccine became commercially available in 1982. Between 1983 and 1992, there was a 74% increase (from 22% to 85%) in the frequency of self-reported vaccination among US dentists participating in health screenings sponsored by the American Dental Association (ADA).29 Serologic evidence of past HBV infection among dentists declined from prevaccine levels of 14% in 1972 to 9% in 1992, likely reflecting increased immunization and use of standard precautions.29
During the past decade, investigators have reported transmissions of blood-borne pathogens (BBPs) in dental settings. In this article, the authors describe these transmissions and examine the lapses in infection prevention on the basis of available information.
The authors reviewed the literature from 2003 through 2015 to identify reports of the transmission of BBPs in dental settings and related lapses in infection prevention efforts, as well as to identify reports of known or suspected health care–associated BBP infections submitted by state health departments to the Centers for Disease Control and Prevention.
The authors identified 3 published reports whose investigators described the transmission of hepatitis B virus and hepatitis C virus. In 2 of these reports, the investigators described single-transmission events (from 1 patient to another) in outpatient oral surgery practices. The authors of the third report described the possible transmission of hepatitis B virus to 3 patients and 2 dental health care personnel in a large temporary dental clinic. The authors identified lapses in infection prevention practices that occurred during 2 of the investigations; however, the investigators were not always able to link a specific lapse to a transmission event. Examples of lapses included the failure to heat-sterilize handpieces between patients, a lack of training for volunteers on BBPs, and the use of a combination of unsafe injection practices.
The authors found that reports describing the transmission of BBPs in dental settings since 2003 were rare. Failure to adhere to Centers for Disease Control and Prevention recommendations for infection control in dental settings likely led to disease transmission in these cases.
The existence of these reports emphasizes the need to improve dental health care personnel's understanding of the basic principles and implementation of standard precautions through the use of checklists, policies, and practices.
Vaccines for health care personnel
2012, Vaccines: Sixth Edition
Advancing infection control in dental care settings: Factors associated with dentists' implementation of guidelines from the Centers for Disease Control and Prevention
2012, Journal of the American Dental Association
The authors set out to identify factors associated with implementation by U.S. dentists of four practices first recommended in the Centers for Disease Control and Prevention's Guidelines for Infection Control in Dental Health-Care Settings—2003.
In 2008, the authors surveyed a stratified random sample of 6,825 U.S. dentists. The response rate was 49 percent. The authors gathered data regarding dentists' demographic and practice characteristics, attitudes toward infection control, sources of instruction regarding the guidelines and knowledge about the need to use sterile water for surgical procedures. Then they assessed the impact of those factors on the implementation of four recommendations: having an infection control coordinator, maintaining dental unit water quality, documenting percutaneous injuries and using safer medical devices, such as safer syringes and scalpels. The authors conducted bivariate analyses and proportional odds modeling.
Responding dentists in 34 percent of practices had implemented none or one of the four recommendations, 40 percent had implemented two of the recommendations and 26 percent had implemented three or four of the recommendations. The likelihood of implementation was higher among dentists who acknowledged the importance of infection control, had practiced dentistry for less than 30 years, had received more continuing dental education credits in infection control, correctly identified more surgical procedures that require the use of sterile water, worked in larger practices and had at least three sources of instruction regarding the guidelines. Dentists with practices in the South Atlantic, Middle Atlantic or East South Central U.S. Census divisions were less likely to have complied.
Implementation of the four recommendations varied among U.S. dentists. Strategies targeted at raising awareness of the importance of infection control, increasing continuing education requirements and developing multiple modes of instruction may increase implementation of current and future Centers for Disease Control and Prevention guidelines.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, Atlanta.
The authors thank Jon Ruesch, who when this study was conducted was the director, Survey Center, American Dental Association, Chicago, for his effort in the collection of the data for this research project. Mr. Ruesch is now retired.
Health Care-Associated Transmission of Hepatitis B & C Viruses in Dental Care (Dentistry)
2010, Clinics in Liver Disease
Citation Excerpt :
In fact, some of the earlier prevalence studies showed the prevalence of HBV serologic markers among dentists to range from 16% to 28%.10,11 Since the early 1980s, the transmission of HBV to DHCP has declined dramatically (prevalence of serologic markers dropped to 9% in 1992), mostly as a result of better compliance with HBV vaccination and improved infection control practices.47 Several reports, published between 1970 to 1987, described nine clusters of HBV transmission from three infected general dentists and six oral surgeons to their patients.12–21
Vaccines for health care workers
2008, Vaccines
Hepatitis B and C infections among Japanese dental health workers: Insights from vaccination rates and screening results in the Oita prefecture
2024, Clinical and Experimental Dental Research

View all citing articles on Scopus

¹: Dr. Cleveland is a dental officer and epidemiologist, Division of Oral Health, National Center for Prevention Services, Centers for Disease Control and Prevention, Atlanta.

View full text

HEPATITIS B VACCINATION AND INFECTION AMONG U.S. DENTISTS, 1983-1992

ABSTRACT

JADA

Am J Med

Am J Med

JADA

Lancet

Hepatitis in dental professionals

JAMA

Hepatitis B virus infection in dentists

N Engl J Med

Comparative risk of hepatitis B among physicians and dentists

J Infect Dis

Survey of hepatitis B exposure and vaccination in volunteer dentists

JADA

Failure of gloves and other protective devices to prevent transmission of hepatitis B virus to oral surgeons

JAMA

Infection control in the dental office

JADA