The prevention of hepatitis B transmission in dental practice

The prevention of the spread of hepatitis B is of utmost importance to the dental profession. The mechanisms of transmission of the virus between practitioner and patient are discussed and preventive options outlined. Despite conscientious history taking, not all virus carriers can be identified without laboratory screening of the entire population. Despite specific precautions high risk exposures to practitioners still occur, putting the dental practitioner at risk for the morbidity and mortality of hepatitis B including the possibility of becoming a virus carrier. Immunoglobulin prophylaxis is available but is expensive, short-lived and is only useful for recognized exposures. The vaccine to prevent hepatitis B should emerge as the primary mode of protection in high-risk groups such as dentists. Hepatitis B virus (HBV) can exist asymptomatically in its human host and may be transmitted from this individual to others, particularly those in contact with the carrier’s blood or blood-contaminated body fluids. The use of general or selective screening of individuals for HBV coupled w.;th passive immunoprophylaxis with immune globulin can decrease the transmission of HBV to the health worker but has not eliminated the problem. A vaccine to prevent hepatitis B, now licensed in the United States, should become a major factor in further control of HBV, particularly in health care deliverers. The infectivity and modes of transmission of HBV will be discussed with particular attention to the pediatric dental practitioner. Modes of both passive and active prevention will be outlined.