Even though at present there have only been four confirmed cases of Ebola in the United States, it is possible that hundreds of Americans have been exposed to the virus within the country and in West Africa.
Though there is little risk of an epidemic spreading across North America, the situation does put medical professionals at risk from direct and unprotected contact with blood and body fluids of an infected person, or with objects that have come in contact with blood, urine, semen, saliva, sweat, feces or breast milk of an infected individual.
What should dental offices do if they suspect a patient may have Ebola? The American Dental Association, in conjunction with the Centers for Disease Control and Prevention (CDC), has released an advisory for dental professionals.
Dental offices should not have any problems in treating people that have returned from a recent visit to West Africa because Ebola acquires a contagious form only after the symptoms appear. Asymptomatic individuals do not transmit the disease.
However, it is important to be aware that anyone who has come back from an Ebola-affected country in recent weeks or has come in contact with an Ebola patient is a potential risk. Symptoms to watch out for include fever (101.5 degrees Fahrenheit or above), headache, chest pain, internal bleeding, vomiting, pain in the abdominal area, sore throat and unexplained bruising.
As a safety measure, dental professionals have been advised by the ADA to ask for a complete medical and travel history of prospective patients. It is recommended that dentists postpone elective procedures on anyone who confirms any of the risk factors mentioned above. Such a case should be reported immediately to public health authorities.
A procedure that cannot be postponed must be carried out in a negative pressure room with the dentists wearing personal protective equipment. Aerosol-generating procedures should be avoided. Disposable equipment should be used, and the room should be thoroughly cleaned after the procedure is completed.
Exposure to ultraviolet rays and a dry environment destroys the virus. In favorable conditions, the virus has been found to remain active for up to six days. Dental offices must ensure infection control, according to guidelines laid out by the CDC. This will ensure that patients suffering from serious oral conditions and in need of palliative care are taken care of.
The movement of visitors within a dental care facility should be restricted and visitors educated on steps to reduce the risk of Ebola transfer. A log containing the names of medical staff and visitors coming in contact with an Ebola-infected patient should be maintained.
According to the ADA Principles of Ethics and Code of Professional Conduct, "A dentist has the general obligation to provide care to those in need. A decision not to provide treatment to an individual because the individual is infected with Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus or another blood-borne pathogen, based solely on that fact, is unethical."
With respect to Ebola, dental offices have it slightly easier because the debilitating nature of the disease precludes the patient from considering dental treatment.
