Conference quark::mennotes-v1

 Putting dental tools in an autoclave is standard practice. You have little
if anything to worry about.

    In case Dwight doesn't know what an autoclave is, it's a machine that
    disinfects things by subjecting them to steam heat at elevated
    pressures, thus raising their temperature to something over 250 degrees
    F.  Stop worrying, Dwight.  You're safe.
    
    -dick

There is some basis to the story.  Though most dentists use an autoclave,
some might have relied on chemical disinfectants, and there have been a few
known to use unsafe practices.  Many dentists nowadays make a big point of
letting you know how they sterilize their instruments; I even saw an ad to this
effect in the paper the other day.

If you have any concerns, just ask your dentist.

			Steve

    Worry, Dwight, you're NOT safe...the report he is referring to is
    probably the same show I watched on TV a few nights ago...it clearly
    illustrated how just about ANYTHING, from ANYBODY'S mouth can get
    "sucked" into the handtools that dentists use and then SPIT out again
    in YOUR mouth.  A couple of examples of what they've actually FOUND in
    these instruments, off the top of my head, is bacteria, viruses
    (living) and blood cells.  The report stated that, in most "EXPERTS"
    opinions, the risk of getting infected with, say, HIV, or something
    like that from an improperly disinfected handtool was small.  The
    report however DID NOT DENY THAT THE POSSIBILITY EXISTS THAT THE
    DENTISTS HANDTOOL COULD TRANSMIT VIRUSES FROM ONE PATIENT TO THE NEXT. 
    The report CLEARLY stated that the ONLY way to be SURE that this would
    NOT happen is to use the autoclave (or similar) method to disinfect the
    handtools with HEAT, in between each patient.
    
    The report also CLEARLY stated that the large majority of dentists
    (something like 90%???) do NOT properly disinfect their handtools
    between patients.  The reasons are mainly economic and just plain
    laziness...the heat disinfecting machines are expensive, as are the
    handtools.  And if the handtools were to be properly disinfecte BETWEEN
    patients, then each dentist would have to buy several EXTRA to keep on
    hand so that they wouldn't have to WAIT for the tools to get
    disinfected to treat the next patient.
    
    The report did not say that this was a MAJOR health-related concern at
    this time, nor did it deny that the danger exists of the handtools
    passing viruses, even AIDS from one patient to the next.  It said that
    a recent memo from (agency reviewing current dental practices?) had
    strongly recommended that dentists start disinfecting their handtools
    with heat (autoclaving) between patients...the general feeling was,
    hey, if we can't PROVE that viruses CAN'T be passed by these handtools,
    maybe it would be a good idea for dentists to take the proper
    precautionary measure to ensure that their patients are safe.  (Hey,
    properly disinfecting the handtools between patients won't HURT any...)
    
    They also interviewed several dentists and asked them if they used
    autoclaving or similar methods to disinfect their tools between
    patients.  The ATTITUDES displayed by these dentists really pissed me
    off...it's like they didn't care about their patients at all...they
    stated that they did NOT, because they didn't have the right equipment,
    or they didn't feel it was necessary (they were too lazy)...ONE even
    said that the reason HE didn't disinfect his tools with heat is that
    the heat SHORTENED the lifespan of the HANDTOOL...!!!  (and meanwhile,
    what would AIDS do to the lifespan of his next patient???)  Hey, if all
    your patients die of AIDS, then I guess you REALLY won't be able to
    AFFORD to buy new tools, so I guess you better worry about making the
    tools you got last as long as possible, right?  (!?!?!)
    
    As you can tell, this report SLIGHTLY upset me...I couldn't believe the
    attitude of the dentists they interviewed!!!!!!!!!!!!!!!!!!!!!!!!!!
    Now, obviously, any report could be biased one way or the other,
    especially if they only chose to AIR certain interviews that they
    conducted.
    
    BUT...the possibility exists that viruses, even AIDS can be transmitted
    from patient to patient and the facts are that MOST dentists don't seem
    to give a damn at the present time.  At least, that was the feeling I
    got from watching the report on TV a few nights ago...it scared the
    HELL out of me.

    Thanks.  I knew there was something to it.  Of course, most PC folks
    would blow this off too.  There is a lot to worry about!
    

 Then don't go to the dentist if you're so paralyzed with fear. It's a fine
excuse.

 And as for me being PC, I can't help but get a hearty chortle. Imagine
that. Me being PC. I guess this belongs in "laff for the day"...

    
    Its not about being PC. Its about the disclaimer at the end of the
    show.
    
    It was on 60 minutes or something like that. And all of those episodes
    are done months in advance. After the show was completed, they did a
    double check. In the show, the ADA was blowing off the whole thing, but
    after the investigation, they reversed their opinion and said:
    autoclave (its just a pressure cooker!) is the right thing to do.
    Similarly, while during the show, only 1 in 10 dentists were using the
    Autoclave, I believe the figure substantially rose in the polls taken
    after the show was taped.
    
    SO: the dental industry is NOW acknowledging the risk, and many
    dentists are responding by autoclaving their drills. If you have
    questions, ask your dentist.
    
    The one down side that I remember hearing is that because autoclaving
    takes an hour or two, you should have 2-3 back up drills. And the drill
    companies have not reported a substantial increase in sales which would
    correspond to more dentists autoclaving. So, NO, not every dentist is
    following this practice. That's why its good to ask.

    A good friend of mine is a dental hygenist.  She's very cautious
    when cleaning teeth.  If there's a lot of blood, she will wear
    two sets of gloves.  She wears an eye shield and a mask at all times.
    She's aware of the dangers of blood.
    
    Patients are supposed to inform the dentist if they're HIV+, but
    most don't.  
    
    The degree of cleanliness varies from office to office.  My friend
    worked in one office that was dirty.  She only stayed for a short
    while. During her time there, the Dentist did work on an HIV+
    patient one evening.  The hygenists left the dirty instruments
    out all night. When my friend came in the next morning, she was told
    to clean them.  She walked out.  
    
    My friend has been working with a Dentist that she highly recommends.
    I followed her recommendation and go to this dentist, even though
    he is not near me. 
    
    Kathy

    re:.0

    About a year or two ago, an article appeared in a magazine I get
    about sterlization of dental instruments.  Seems the ADA or some
    other professional dental orgranization polled dentists regarding
    their sterilization practices.

    A lot of them used chemical disnfectants, either alcohol or alkaline
    glutaraldehyde, because they were cheaper and faster that heating in
    an autoclave.

    Well, as it turns out, some tools, like the drill heads, have crevices
    that are nearly impossible to sterilize chemically.  Also, many dentists
    were not keeping their tools in the solutions for the recommended time.

    From what I understand, by the time that story hot the newsstands,
    dentists had already gone back to autoclaves for all instruments,
    fearing lawsuits and a loss of business.

    As soon as I read the story, I called my dentist and asked what they
    were using ... autoclaves.  I could come in and see them if I wanted
    to.  They were used for everything they told me.  Last time I had my
    teeth cleaned, the hygienist took the picks and things right out of
    the autoclave while I was getting adjusted in the torture chair.

    I think this was newsworthy about 12 months ago, and if it was on a
    news show recently, it was probably a rerun from earlier in the TV
    season.

    There's been no recent mention of this in any medical journals or
    periodicals that I read, so I would think it's no longer a problem.

    Here's a related note from 3 years ago, so you can see, this is not
    ground-breaking news ...
    
              <<< VMSZOO::FOLKD$:[NOTES$LIBRARY]MEDICAL.NOTE;1 >>>
                       -< MEDICAL questions and answers >-
================================================================================
Note 221.6                        AIDS question                          6 of 17
ANT::ZARLENGA "radios pumpin' to the way she walked" 17 lines  13-AUG-1989 20:18
           -< Edell Health Letter, Jul 89, p3 (AIDS, disinfectants) >-
--------------------------------------------------------------------------------

	When doctors disinfect their medical equipment they normally use
    either 70% alcohol or 2% alkaline glutaraldehyde solution.
    
    	To find out whether these disinfectants kill the AIDS virus,
    doctors in London immersed 100,000 AIDS infected cells in both
    solutions for up to 10 minutes.
    
    	They found that the glutaraldehyde killed the virus, but not
    the 70% alcohol.
    
    	If these findings are correct, we need to change how we disinfect
    medical instruments, and a few other things.  Everything from mani-
    curing scissors to electrolysis equipment is sterilized in alcohol.
    This study obviously need to be verified quickly.
    
                 [ British Medical Journal 298(1898):862-64 ]

    when in doubt, ask your dentist.  Autoclaving must be used to properly
    sterilize.  If the dentist doesn't use this process, don't use the
    dentist.  If you aren't sure you believe the dentist, ask to see their
    sterilization setup.  
    
    It is sane to be cautious about this disease....it isn't sane to
    avoid proper health care because of fear of this disease.  Work
    WITH your dentist and doctor to address your concerns.

    re: .6  
    
    Doctah,
    
    >  And as for me being PC, I can't help but get a hearty chortle
    
    You'll note that although this was apparently a politics-free medical
    question, Dwight's response to those who apparently disagreed with his
    analysis was to dismiss them as PC.
    
    This is the point of the term PC -- squash discussion with a
    pejorative.
    
    Kit      

 That's one use of the term. The other is to describe a readily documentable
phenomenon. But you knew that. And, FWIW, I already agreed that _a_ use of
the term was to dismiss arguments by using it as a pejorative.

    
                      Now who's nibbling on my hook?