Dentistry as a possible route of hepatitis C transmission in Pakistan

AIMS AND OBJECTIVES: To identify the role of dental surgical procedures in contributing to the transmission of hepatitis C. DESIGN: Prospective observational pilot study. SETTING: Shaikh Zayed Federal Postgraduate Medical Institute Lahore, Pakistan. METHODS: Exposure to dental procedures, injections, tattooing, surgical intervention, blood transfusions, family history of hepatitis, diabetes mellitus and contact with jaundiced patients was evaluated in 78 consecutive adult patients of both sexes suffering from chronic hepatitis C. MAIN OUTCOME MEASURES: Distribution of risk factors for acquiring hepatitis C with emphasis on role of dentistry as a possible route of transmission. RESULTS: Dental procedures were the major source of exposure (39.7%) followed by injections (16.6%), surgical procedures (16.6%), diabetes (12.8%), family history of hepatitis (9%), blood transfusions (7%), tattooing (5.1%) and history of contact with a jaundiced patient (2.6%). There was a statistically significant difference in distribution of risk factors, with dental procedures being the commonest factor (p < 0.001). CONCLUSIONS: The high prevalence of dental procedures in patients with chronic hepatitis C stresses the importance of ineffective infection control methods practiced by dental surgeons as a risk factor for acquiring hepatitis C and which were probably the source of infection. Large epidemiological studies are needed to elucidate the role of dentistry in transmitting hepatitis C.