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If you live in the United States and you watch any of the national news programs, you could not have missed the story of the Tulsa, Oklahoma dentist, Dr. W. Scott Harrington, whose sloppy office practices may have exposed up to 7,000 of his patients to HIV, hepatitis C, and other blood-borne infections.
Executive director of the Oklahoma Board of Dentistry Susan Rogers told the Los Angeles Times that Dr. Harrington's practice was the "perfect storm" for massive transmission of infectious disease:
- Many of Dr. Harrington's patients in Tulsa and suburban Owasso, Oklahoma, are known to be already at high risk for HIV and viral hepatitis.
- Dr. Harrington specialized in oral surgery, including pulling teeth, and other procedures involving heavy bleeding.
- The dentist allowed his assistants to perform procedures that require puncturing veins, such as the administration of intravenous (IV) anesthetics.
- Inspectors from the Board of Dentistry raiding the offices found rusty surgical instruments and evidence that dental tools were cleaned with bleach, which erodes the stainless steel surface of the sharp instruments and creates cavities in which bacteria can accumulate.
News reports state that Harrington has been criminally charged with 17 counts of performing dentistry in an unsafe or unsanitary manner that could endanger public health. The investigation of Dr. Harrington was triggered by a report that one of his patients who was not in a high-risk group for HIV had tested positive for the disease, although the test was later discovered to be a false positive. To date, only one of Dr. Harrington's patients has officially tested positive for an infection likely to have been acquired in the office. This patient has hepatitis C.
The Need for Universal Precautions
Dr. Harrington's case may be the worst incident of dentist-caused infections, but it is not the first. In the late 1980's and 1990's, a Florida dentist named David Acer was found to have infected six of his patients with HIV. The Florida case led to the imposition of Universal Precautions on dental practice. As a result of the six cases of HIV, dentists are now required to wear face masks, gloves, and face shields, protecting both them and their patients from blood.
Dr. Harrington had been practicing dentistry for over 16 years before Universal Precautions became standard practice in the profession. However, it's not possible that he just "didn't get the memo." The move for Universal Precautions began in the mid-1980's, a number of years before the infamous Acer case in Florida.