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Pizzitola, L., DDS. (2017). HIV Testing In The Dental Setting.

​Dimensions of Dental

Hygiene,​ 15(10), 49-52.

Infectious Disease

In this article, it discusses the possibility of HIV testing in dental offices around

the country. The HIV infected recipient count has been increasing and is estimated to

jump to an extreme level of new cases in just one year in the United States. If dental

offices begin to offer screenings we might be able to help lower that number by early

detection. An individual can be transmitted with HIV in one of two ways: sexual behavior

exposure or parenteral exposure. A blood transfusion would be an example of

parenteral exposure and is also one of the greatest risks to getting exposed to HIV. The

risk of exposure to HIV during sexual practices varies on the individuals involved and

their CD4 cell count present in each person and the viral load of the virus. When it

comes to testing in a dental setting there are many opposing views on whether or not it

should be done. Arguing against HIV testing includes the fact that the test is beyond the

range of dental practice, productivity in the office and patient perception. On the other

spectrum of things, some are conversing that doing the tests will help identify HIV in its

early stages and patients visit their dentist more frequently than their physician making

us more likely to catch signs or symptoms of HIV by our routine intra/extra oral exam

during appointments. Rapid testing for HIV can be done in the office by doing a salivary

test and can get results as quickly as 20-30 minutes. If positive it is the hygienists'
responsibility to ensure that the patient is directed somewhere for further testing. HIV

does not always mean the patient automatically has AIDS and it is crucial to know the

difference and assess the situation in a professional, comforting way considering the

patient with a positive test may be feeling a wide range of emotions. HIV is common for

showing no symptoms and may even take up to 3 months before blood will display a

change in the individual's antibodies to the invading HIV antigen. If an office administers

HIV testing they must follow the proper protocol under CLIA and CDC to maintain safety

in the dental setting. This virus is dangerous and can easily be transmitted therefore it is

incredibly important everyone in the office, including patients, are considering the

precautions and following the test instructions step-by-step in order to receive the most

accurate results.

There are many things that we dental hygienist are intended to detect by our

intra/extra oral exams including lumps or potentially harmful tumors, changes in the oral

cavity, changes in the patient's’ appearance in general, and so much more. Anything

abnormal must be documented and I think we have multiple multiple things to observe

that adding HIV screening is unnecessary in dental offices. It is not safe for the clinician,

surrounding hygienists or doctors, and also every patient in the office. There are many

harmful objects that could be covered in blood, saliva, and other OPIM that increases

the risk of becoming exposed to the HIV virus. If the test is done and it is positive we are

to direct them to another specialty office to continue further tests, so my question is why

can’t they direct them to get tested if we suspect they may have HIV? There are multiple
testing clinics in every hospital setting with healthcare workers that specialize in treated

viruses like HIV. Detecting early stages of potentially harmful diseases, tumors, viruses,

etc and pointing them in the direction for proper treatment is a huge responsibility as

hygienist and I believe that we should put forth our best intentions for every patient, but

when it comes to putting ourselves at risk for exposure at our place of work in my

opinion is not the time or place to do so.