Mori M
Int Dent J. 1984 Jun;34(2):115-21.
Viral hepatitis is a major public health problem, occurring endemically in all areas of the world. The prevalence of the disease is influenced by numerous factors which may be able to modulate its onset. Study of the epidemiology of viral hepatitis in different geographical, ethnic, social and genetic groups as well as immunological and individual factors has contributed much to our understanding of the disease. Hepatitis viruses are classified into A (infectious hepatitis), B (serum hepatitis) and non-A, non-B. The transmission of hepatitis B virus (HBV) is a potential hazard in dental practice. A number of reports suggest a significantly higher incidence of hepatitis among dentists than in the general population and also higher rates of hepatitis in certain specialists, especially oral surgeons, periodontists and endodontists, than in general dentists. Vectors of infection with HBV in dental practice are blood, saliva and nasopharyngeal secretions. The incidence of hepatitis B in dental practitioners is influenced by the exposure to infection, the type of practice, the number of years of professional experience and antibody response. HBV may be spread by dentists and dental students, by dental auxiliaries and by other personnel closely associated with clinical practice, who are antigen positive carriers but have no clinical symptoms. Therefore, dentists and their staff should know well the risk of infection from their patients, the risk of cross-infection between patients, and the risk of infecting each other.
病毒性肝炎是一个重大的公共卫生问题,在世界所有地区均有地方性流行。该疾病的患病率受众多因素影响,这些因素可能会调节其发病。对不同地理、种族、社会和基因群体中的病毒性肝炎流行病学以及免疫和个体因素进行研究,极大地增进了我们对该疾病的了解。肝炎病毒分为甲型(传染性肝炎)、乙型(血清性肝炎)以及非甲非乙型。在牙科诊疗中,乙型肝炎病毒(HBV)的传播是一种潜在危害。多项报告表明,牙医中肝炎的发病率显著高于普通人群,而且某些专科医生,尤其是口腔外科医生、牙周病医生和牙髓病医生的肝炎发病率高于普通牙医。牙科诊疗中HBV的感染途径包括血液、唾液和鼻咽分泌物。牙科从业者中乙型肝炎的发病率受感染暴露情况、诊疗类型、专业经验年限和抗体反应的影响。HBV可能由牙医和牙科学生、牙科辅助人员以及其他与临床诊疗密切相关的人员传播,这些人员是抗原阳性携带者但无临床症状。因此,牙医及其工作人员应充分了解来自患者的感染风险、患者之间的交叉感染风险以及相互感染的风险。