DePaola Louis G
Department of Oral Medicine and Diagnostic Sciences, Dental School, University of Maryland at Baltimore 21201, USA.
J Am Dent Assoc. 2003 Mar;134(3):350-8. doi: 10.14219/jada.archive.2003.0166.
The emergence of the bloodborne pathogens HIV, the cause of AIDS; hepatitis B virus, or HBV; and hepatitis C virus, or HCV, has been a milestone in the history of the dental profession. In the early 1980s, new cases of AIDS increased dramatically, and fear of acquiring this disease compelled clinicians to modify the delivery of medical and dental care to allay fears of transmission on the part of both patients and health care workers. Arguably, the AIDS pandemic has been the most significant factor in the evolution and delivery of modern medical and dental care in the last century.
To help ally fears and remove barriers to caring for the HIV population, the Centers for Disease Control and Prevention, or CDC, introduced the concept of universal precautions in 1983. This was followed by the Occupational Safety and Health Administration's Bloodborne Pathogens Standard in 1991. Specific to the dental profession was the development of the principles of infection control in dentistry recommended by the CDC (1993); the American Dental Association (1995) and the Organization for Safety & Asepsis Procedures (1997). While initially difficult for some clinicians to acknowledge, these recommendations now are universally accepted throughout the profession, and provision of oral health care to patients infected with bloodborne disease is becoming commonplace. Compliance with recommended infection control practices remains an important component of dental practice. But it must be accompanied by an understanding of infectious and bloodborne diseases and the medical/dental management of the care of infected dental patients.
The emergence of the bloodborne pathogens and the increasing number of infected patients who seek oral health care compel clinicians to have a thorough knowledge about bloodborne diseases and the medical/dental management of the care of patients presenting with HIV, HBV or HCV infection.
血源性病原体——导致艾滋病的人类免疫缺陷病毒（HIV）、乙肝病毒（HBV）和丙肝病毒（HCV）的出现，是牙科行业历史上的一个里程碑。20世纪80年代初，艾滋病新病例急剧增加，对感染这种疾病的恐惧促使临床医生改变医疗和牙科护理方式，以减轻患者和医护人员对传播的担忧。可以说，艾滋病大流行是上个世纪现代医疗和牙科护理发展及提供过程中最重要的因素。
为了帮助减轻恐惧并消除为感染HIV人群提供护理的障碍，疾病控制与预防中心（CDC）于1983年引入了普遍预防措施的概念。随后，职业安全与健康管理局于1991年发布了《血源性病原体标准》。针对牙科行业的是CDC（1993年）、美国牙科协会（1995年）和安全与无菌操作组织（1997年）推荐的牙科感染控制原则的制定。虽然这些建议最初让一些临床医生难以接受，但现在已被整个行业普遍接受，为感染血源性病的患者提供口腔保健正变得越来越普遍。遵守推荐的感染控制措施仍然是牙科实践的一个重要组成部分。但这必须伴随着对传染病和血源性病的了解以及对感染牙科患者护理的医疗/牙科管理。
血源性病原体的出现以及寻求口腔保健的感染患者数量不断增加，迫使临床医生全面了解血源性病以及对感染HIV、HBV或HCV的患者护理的医疗/牙科管理。
