McCarthy G M, Mamandras A H, MacDonald J K
Division of Oral Biology, Faculty of Dentistry, University of Western Ontario London, Canada.
Am J Orthod Dentofacial Orthop. 1997 Sep;112(3):275-81. doi: 10.1016/S0889-5406(97)70256-7.
Because of the difficulty of identifying infected persons, current recommendations for infection control are to treat all patients as if they are infected with blood-borne pathogens such as human immunodeficiency virus (HIV) and the hepatitis viruses. Dentists' compliance with these recommendations has been investigated previously, however, there are few data related to orthodontists. The objective of this study was to measure the proportion of orthodontists who report the use of recommended infection control procedures and to compare the infection control practices of orthodontists and general dentists. A mailed survey with three follow-up attempts was administered to all orthodontists and general dentists in Ontario (N = 5441) in 1994. There were significant differences in the routine use of gloves (orthodontists 85%, general dentists 92%); masks (orthodontists 38%, general dentists 75%); protective eyewear (orthodontists 60%, general dentists 84%); changing gloves after each patient (orthodontists 84%, general dentists 96%); and heat sterilization of handpieces (orthodontists 57%, general dentists 84%). Hepatitis B virus (HBV) vaccination of all clinical staff was reported by 46% of orthodontists, compared with 61% of general dentists (p < 0.001). Reports of HBV vaccination of orthodontists (94%) and general dentists (92%) were not significantly different. The use of additional precautions for patients with HIV was reported by 80% of orthodontists and 78% of general dentists. More education is required to promote the use of universal precautions by both general practitioners and orthodontists. Increased use of barrier methods, HBV vaccination of clinical staff, and heat sterilization of handpieces is required to reduce the potential for cross infection in the orthodontic practice. This is particularly important with the increasing number of microorganisms that are resistant to antibiotics.
由于难以识别感染者，目前感染控制的建议是将所有患者都当作感染了血源性病原体，如人类免疫缺陷病毒（HIV）和肝炎病毒来对待。此前已对牙医遵守这些建议的情况进行过调查，然而，与正畸医生相关的数据却很少。本研究的目的是测定报告使用推荐感染控制程序的正畸医生的比例，并比较正畸医生和普通牙医的感染控制措施。1994年，对安大略省的所有正畸医生和普通牙医（N = 5441）进行了一项邮寄调查，并进行了三次跟进尝试。在常规使用手套方面（正畸医生85%，普通牙医92%）；口罩方面（正畸医生38%，普通牙医75%）；防护眼镜方面（正畸医生60%，普通牙医84%）；每位患者后更换手套方面（正畸医生84%，普通牙医96%）；以及手机的热消毒方面（正畸医生57%，普通牙医84%）存在显著差异。46%的正畸医生报告对所有临床工作人员进行了乙肝病毒（HBV）疫苗接种，相比之下，普通牙医为61%（p < 0.001）。正畸医生（94%）和普通牙医（92%）的HBV疫苗接种报告无显著差异。80%的正畸医生和78%的普通牙医报告对HIV患者采取了额外的预防措施。需要更多教育来促进全科医生和正畸医生使用普遍预防措施。需要增加屏障方法的使用、对临床工作人员进行HBV疫苗接种以及对手机构进行热消毒，以降低正畸诊疗中交叉感染的可能性。随着对抗生素耐药的微生物数量不断增加，这一点尤为重要。
