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| LETTER TO THE EDITOR |
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| Year : 2014 | Volume
: 5
| Issue : 4 | Page : 177-178 |
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Vaccines, the tugboats of preventive health: Immunization for dentists
Ujwala Rohan Newadkar
Department of Oral Medicine and Radiology, Annasaheb Chudaman Patil Memorial Dental College, Dhule, Maharashtra, India
| Date of Web Publication | 12-Sep-2014 |
Correspondence Address:
Dr. Ujwala Rohan Newadkar
Department of Oral Medicine and Radiology, Annasaheb Chudaman Patil Memorial Dental College, Dhule - 424 003, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2155-8213.140611
How to cite this article:
Newadkar UR. Vaccines, the tugboats of preventive health: Immunization for dentists. Dent Hypotheses 2014;5:177-8 |
Sir,
Practitioners and staff in the dental office are at high risk of occupation hazards of infectious diseases as a result of continuous contact with infectious material during dental procedures. [1] As the dental profession involves the use of small, sharp instruments contaminated with blood or other fluids, there is ample opportunity for inadvertent skin wounds to the operator and staff. [2] Such accidents include the possibility of transmission of hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). [3] In the late 1970s, several reports found that dentists were three times more likely than general population to contract hepatitis. [4] With the emergence of the AIDS epidemic in the 1980s, even more stringent precautions became necessary to effectively protect health-care workers and the public, leading to the recommendations by the Centre for Disease Control (CDC) concerning the prevention for HIV transmission in the health-care settings and universal precautions guidelines. [5]
Prevention is ultimately the most efficient and humane means toward improved health. [6] To decrease the risk of hepatitis B virus (HBV) infection, it is recommended that dental personnel receive immunization against HBV and use individual protective equipment, such as gloves, to prevent blood-borne infection during dental procedures. [7] The hepatitis B vaccine has been available since 1982 and, since 1990, has been recommended for health-care workers whose activities frequently expose them to blood. [4],[8] However, 5% to 10% of normal subjects do not produce the anti-hepatitis B surface antibody (anti-HBs) after receiving a standard course of HBV vaccine. [4],[9] Thus, postvaccination testing 1 to 3 months following the third dose of vaccine is recommended for health-care workers who have contact with blood. [4] Previous studies carried out in other countries have revealed different proportions of self-reported vaccination, ranging from 40.3% to 97.0%. [10],[11],[12],[13],[14] The proportion of dentists who have had their antibody titer evaluated ranges from 36.5% to 47.9%. [12] In Brazil, one study found that only 73.1% of dentists had been submitted to the three doses of the vaccine. [15]
Immunization programs are highly effective, clearly protect populations and individuals at risk and are leading to the elimination of hepatitis B. However, despite being safe, efficacious, and cost-effective, hepatitis B vaccination remains consistently underemployed. [16] Reports from different countries reveal that some dentists do not engage in safe practices, such as the use of gloves, facemasks, or protective eyeglasses. Moreover, HBV vaccination coverage is not complete among dentists, as reported for countries such as Nigeria, Jordan, Iran, and the United Kingdom. [10],[11],[12],[13],[14]
According to Occupational Safety Health Administration (OSHA), all of the dental personnel should be vaccinated against hepatitis B free of charge and within 10 days of employment. [17],[18] Dental education can play an important role in the training of the dentists, helping them to adopt adequate knowledge and attitudes related to infection control measures.
Effective infection control in dentistry is unfeasible without an adequate immunization program for dental health care providers (DHCPs). Such an assumption is demonstrated for some vaccine preventable infectious diseases (VPIDs), such as hepatitis B, influenza, and varicella. However, excluding hepatitis B vaccine, immunization programs for DHCPs are few and often unclear about which vaccinations are recommended, thus leading to generally low awareness and consequent low vaccination rates. [19]
| References | |  |
| 1. | Mahdipour M, Taghavi Zenouz A, Gholizadeh N. Knowledge and attitude of dental practitioners in Tabriz regarding infection control procedures. J Dent Res Dent Clin Dent Prospects 2007;1:103-7. 
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| 2. | François G, Hallauer J, Van Damme. Hepatitis B vaccination: How to reach risk groups. Vaccine 2002;21:1-4.
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| 4. | Mosley JW, Edwards VM, Casey G, Redecker AG, White E. Hepatitis B infection in dentists. N Engl J Med 1975;293:729-34.
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| 5. | Centre for Disease Control (CDC) Recommendations for prevention for HIV transmission in health care settings. MMWR Morb Mortal Wkly Rep 1987;36:35-185.
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| 8. | WHO: World Health Organization Hepatitis C. Fact Sheets 2000. Available from: http://www.who.int/mediacentre/factsheets/en/ [Last accessed on 2009 Dec 18].
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| 10. | Sofola OO, Ui OG. Hepatitis B virus infection and prevention in the dental clinic: Knowledge and factors determining vaccine uptake in a Nigerian dental teaching hospital. Nig Q J Hosp Med 2008;18:145-8.
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| 11. | Al Negrish A, Al Momani AS, Al Sharafat F. Compliance of Jordanian dentists with infection control strategies. Int Dent J 2008;58:231-6.
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| 12. | Alavian SM, Izadi M, Zare AA, Lankarani MM, Assari S, Vardi MM. Survey of the level of anti-HBs antibody titer in vaccinated Iranian general dentists. Spec Care Dent 2008;28:265-70.
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| 13. | Rhodes A, Aw TC, Allen C, Ridout M. Immunisation status of dental practice staff in Kent. Br Dent J 2008;205:E20.
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| 14. | Suckling RM, Taegtmeyer M, Nguku PM, Al-Abri SS, Kibaru J, Chakaya JM, et al. Susceptibility of healthcare workers in Kenya to hepatitis B: New strategies for facilitating vaccination uptake. J Hosp Infect 2006;64:271-7.
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| 15. | Batista SM, Andreasi MS, Borges AM, Lindenberg AS, Silva AL, Fernandes TD, et al. Seropositivity for hepatitis B virus vaccination coverage, and vaccine response in dentists from Campo Grande, Mato Grosso do Sul, Brazil. Mem Inst Oswaldo Cruz 2006;101:263-7.
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| 16. | Mast EE, Margolis HS, Fiore AE, Brink EW, Goldstein ST, Wang SA, et al. Advisory Committee on Immunization Practices (ACIP). A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: Immunization of infants, children, and adolescents. MMWR Recomm Rep 2005;54:1-31.
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| 17. | In: Roberson TM, Heymann HO, Swift EY, editors. Art and Science of Operative Dentistry. Vol. 5. St Louis: Mosby; 2002. p. 345-85
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| 18. | Miller CH, Plaenik CJ. Infection control and management of hazardous materials for the dental team. 2 nd ed. St Louis: Mosby; 1998. p. 135-74.
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| 19. | Petti S, Messano GA, Polimeni A. Dentists′ awareness toward vaccine preventable diseases. Vaccine 2011;29:8108-12.
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