Prion diseases: risks, characteristics, and infection control considerations in dentistry

Bali, Zarina; Bali, Rishi; Nagrath, Saurabh

doi:10.1111/j.2041-1626.2011.00080.x

Cited by 10 publications

(15 citation statements)

References 21 publications

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“…Dental teams and their clinical work places are among the most affected by exposure to airborne and bloodborne infectious agents and therefore at the forefront of pandemicrelated changes how dental care is organized and provided to patients (9)(10)(11)(12). Early reports from China highlighted the risks of droplet and aerosol transmission in dental care, which led to service limitations or shut-downs in many countries worldwide, following governmental restrictions (13)(14)(15).…”

Section: Safety Of Dental Care Under Covid-19mentioning

confidence: 99%

Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry

2021

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Dental teams and their workplaces are among the most exposed to airborne and bloodborne infectious agents, and therefore at the forefront of pandemic-related changes to how dental care is organized and provided to patients. The increasing complexity of guidelines makes is challenging for clinicians to navigate the multitude of COVID-19 guidelines issued by different agencies. A comparative analysis of guidance issued for managing COVID-19 in dental settings leading U.S. agencies was conducted, including documents of the Occupational Safety and Health Administration (OSHA), an agency of the U.S. Secretary of Labor, and of the U.S. Centers for Disease Prevention and Control (CDC), an agency of the U.S. Secretary of Health and Human Services. Details of infection control and other risk mitigation measures were reviewed for consistency, overlaps and similarities, then clustered according to thematic areas covering all domains of managing a dental healthcare setting. The analysis revealed five distinct areas of pandemic control, comprising (1) planning and protocols, (2) patient screening, (3) preparation of facilities, (4) PPE and infection control, and (5) procedures and aerosol control; thereby covering systematically all aspects requiring adaptation in a pandemic context. The “Pandemic-5 Framework for COVID-19 Control in Dentistry” provides an opportunity to simplify comprehensive decision-making from a clinical practitioner perspective. The framework supports a comprehensive systems-driven approach by using dental clinics as a setting to integrate pandemic clinical responses with the implementation of appropriate infection control protocols. Traditionally these two aspects are addressed independently from each other in separate concepts.

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Section: Safety Of Dental Care Under Covid-19mentioning

confidence: 99%

Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry

2021

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“…There has been no reported case of definitive dental transmission of prion disease, but since it is theoretically possible to transmit it through medical instrument, sufficient information from all patients before any dental procedures on the medical and family history of prion disease should be provided ( 15 ). Given the experiences of the possibility of transmitting the disease in animal models through dental procedures, it seems possible to endanger the transmission of the disease by endodontic instruments if there is no effective prion decontamination ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Creutzfeldt-Jakob Disease after Dental Procedure Along with the Initial Manifestations of Psychiatric Disorder: A Case Report

Badrfam¹,

Noorbala²,

Vahabi³

et al. 2021

IJPS

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Introduction: Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures. Case Report: The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI. Discussion: Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.

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“…First of all, there is the issue of prion cross-infection. the term "prion" has been first used in 1982 defining an infectious agent which has no nucleic acid, like viruses or bacteria have [5]. The cause of the prion diseases is that the typical cell glycoprotein transforms into a modified infectious isoform, named PrP.…”

Section: Discussionmentioning

confidence: 99%

“…there were reported cases of infected laboratory animals that developed a certain contagiousness in the oral tissues [12,13]. It was stressed that even if the oral tissues are of merely not detectable contagiousness and the presence of PrP in these tissues has not been confirmed in humans, we cannot rule out the nosocomial transmission of prions during dental treatments [5].…”

Section: Discussionmentioning

confidence: 99%

Endodontic Instrument’s Single use Policy. A Literature Review

2020

Open Access J Dent Oral Surg

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Over the last quarter of the century, the place of the stainless steel endodontic instruments was taken slowly and surely by nickel–titanium files, becoming a “must have” instrument “for root canal treatments, even if steel instruments are still being used, mainly at the inception of the root canal treatment. Dentists increasingly use Nickel-Titanium (Ni-Ti) files for their properties that overlap those of stainless steel instruments in cleaning and giving a proper shape to the canal and the filling subsequently. It is well known the fragility and the rigidity of the steel instruments compared with the Ni-Ti ones. These new instruments also increased the speed of the treatment. In the opinion of the majority of the dentists root canal preparation represents a very important and challenging treatment being in close relationship with the following maneuvers like irrigation and filling [1,2]. The primary reason for instrumentation in case of root canals is that the bulk material contained within it needs to be removed [2] that can be ether pulp tissue, infected root dentine or necrotic debris. Hulsmann considers that these two processes, mechanical instrumentation and chemical treatment, cannot be separated and must go hand in hand, referred to as chemo-mechanical treatment [3,4]. Therefore, root canal instruments are indispensable in root canal therapy, even today in the age of implants, stem cells, biologic 3D printers and lasers. Being so useful, reliable, resistant and ultimately, not cheap, the initially single-use instruments got to be reused by a vast number of practitioners because the legislation wide world is not prohibiting it nor imposing the single-use, with very few exceptions.

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Prion diseases: risks, characteristics, and infection control considerations in dentistry

Cited by 10 publications

References 21 publications

Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry

Systemic Management of Pandemic Risks in Dental Practice: A Consolidated Framework for COVID-19 Control in Dentistry

Creutzfeldt-Jakob Disease after Dental Procedure Along with the Initial Manifestations of Psychiatric Disorder: A Case Report

Endodontic Instrument’s Single use Policy. A Literature Review

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