Hepatitis B

Question 1

What is it?

Answer 1

inflammation of the liver caused by a virus. its effect varies from a mild attack of jaundice to a severe or fatal illness. Over 50% are undiagnosed. 80% of primary liver cancers are as a result of Hep B
Always present in the blood of sufferers and also carriers who have no symptoms (1 in 100)
Highly infective and resistant to destruction as can survive boiling up to 30mins, immersion in chlorhexidene and can live outside the body for some weeks.

Question 2

what is it?

Answer 2

Hypochlorite kills HBV. Has been found in all body fluids including including breast milk and transmitted by sufferers and carriers. Diagnosed by blood test.
(inoculation injury, high speed equipment - releases cloud of water and saliva particles in air which may be contaminated with blood)
must be vaccinated against

Question 3

High risk groups

Answer 3

the main modes of transmission of HBV are childbirth, needle sharing by drug addicts and sexual contact

• drug addicts
• the sexually promiscuous
• long term regular blood transfusions such as haemophiliacs, dialysis and transplant patients
• instituions (special needs/rehab)
• close contact with carriers, not always by sexual contact

Question 4

Prevention of cross infection

Answer 4

estimated 400 are treated daily in the dental practice.
high risk groups emphasises the importance of obtaining an adequate medical history before trt.
Vaccination available under the NHS - series of 3 injections and a blood test to check its success. Booster injections may be required at a later date. documentary evidence must be kept.

Question 5

Treatment of known carriers

Answer 5

• for operation involving extensive loss of blood (multiple extractions) or if disease is in active state, refer pt to hospital where full sterile surgical facilities are available.
• reserve last appt of the day
• move all unnecessary equipment and material away from chair side and barrier protect essentials
• avoid inoculation injury
• regard steel burs and matrix bands as disposable, flush aspiration with hypochlorite and leave solution in collection jar over night
• sensitive items immersed in suitable disinfectant
• launder in hot wash of 90c for 10 mins
• pregnant staff or those without vaccination should not have any contact