Hepatitis: still a concern?

Abstract

Although some forms of viral hepatitis were identified more than 50 years ago, hepatitis continues to have an impact on the practice of dentistry. Possible transmission in the dental setting, management of the chronically ill, and legal issues related to treatment of infectious patients combine to emphasize that hepatitis is still an important issue for dental health care workers. Currently, 7 viral forms are recognized. Those with predominantly enteral modes of transmission--including HAV, HEV, and HFV--are of minor concern in the dental environment. HBV, the most infectious blood-borne pathogen, has been largely controlled in this country by vaccination and the use of universal precautions. HDV is an incomplete virus that has HBV infection as a prerequisite. HCV is of great concern today for several reasons. A high percentage of HCV infections results in chronic disease. Most cases remain asymptomatic for an extended period of time, and many have no identifiable risk factors. Currently, no vaccination is available for HCV. Patients infected with HCV present a management challenge, because they may ultimately develop serious liver dysfunction. In fact, HCV infection is presently the most common reason for liver transplantation. By understanding the various forms of viral hepatitis and following recommended infection control and vaccination protocols, the dental healthcare worker can treat infected patients in a manner that is safe for both patients and dental health care workers.