Dr. SHABIN UL HASSAN
Inflammation in Liver medically called “Hepatitis” is silent epidemic worldwide. It is the major cause of liver cirrhosis and liver carcinoma. In a dental office, infections can be expedited through several routes, including direct or indirect contact with blood, oral fluids, droplet splatter, aerosols, etc. The aim of the present article is to increase the awareness among dental practitioners, so as to reduce the burden of hepatitis in our community. Besides apparent approach towards my patients personally Electronic databases like PubMed, Medline, ProQuest, Elsevier etc. were searched to bring this article into its existence.
The results revealed that the dentists were among the high-risk groups for hepatitis, and they have little information on the factors associated with adherence to hepatitis B vaccination. A dentist can play a major role in the prevention of hepatitis by considering each and every patient as a potential carrier of hepatitis. Proper infection control-Screening of Hepatitis Virus, sterilization, and prophylactic vaccination protocols must be followed in order to reduce the risk of hepatitis. Pervasive increases in serious transmissible diseases over the last few decades have created global concern and affected the treatment approach of all health care practitioners. Patients with liver disorders are of significant interest to the dentist because liver plays a pivotal role in metabolic functions.
Dental health care professionals are said to be at a risk of infections caused by various microorganisms including Mycobacterium tuberculosis, hepatitis B and hepatitis C viruses (HBV and HCV, respectively), streptococci, staphylococci, herpes simplex virus type 1, HIV, mumps, influenza, and rubella. HBV and HCV infections are the major causes of liver disease worldwide and the health policy makers with their strategies try to control these infections in the communities.
Most investigators believe that dentists acquire the virus through a cut in the fingers contaminated by the patient’s blood or saliva. Because nasopharyngeal secretions carry the virus, the possibility that infection may be acquired by aerosol, although remote, still exists. Dental surgeons have a great risk of exposure to hepatitis because of their numerous encounters involving the use and disposal of sharp instruments. Every health care specialty that involves contact with mucosa, blood, or blood contaminated with body fluids should have the goal of ensuring compliance with standard precautions and other methods to minimize infection risks.
Viral hepatitis is almost always caused by one of the specific hepatitis viruses. All these viruses give rise to illnesses which are similar in their clinical and pathological features and are frequently anicteric or asymptomatic.
The term “viral hepatitis” is usually applied to the acute stage of the disease which is characterized by fever, malaise, and jaundice, but seldom causes death. Chronic manifestations of the disease are classified either as chronic hepatitis or massive liver necrosis. In mild forms of the disease, the patient has flu-like symptoms of nausea and vomiting and a smoker may develop distaste for cigarettes. The patient may have arthritis or rash involving distal joints.
Infectious hepatitis (hepatitis A) was thought to be orally acquired, with a short incubation period of about 50 days and tending to occur primarily in children and young adults, sporadically and in epidemics. The course runs from 6 to 8 weeks and the disease normally resolves with no sequelae. Serum hepatitis (hepatitis B) was thought to be parenterally transmitted, with an incubation period of 50–100 days. It occurs sporadically in any age group, but older individuals are more affected.
HCV was identified as the causative agent of 95% of cases of non-A non-B hepatitis in 1989. The exact mechanisms by which the HCV causes liver damage are not completely understood. However, it appears that a person’s own immunological response to the HCV contributes significantly to this process. The incubation period is variable, ranging from 3 to 20 weeks, with a mean of 7 weeks. Most infected individuals have a transient alanine aminotransferase (ALT) level elevated greater than tenfold before the symptoms develop.
Hepatitis D virus (HDV) is an RNA defective virus which has no independent existence. It requires HBV for replication and has the same sources and modes of spread as HBV. It can infect simultaneously with HBV or it can super infect those who are already chronic carriers of HBV. Thus, prevention of HDV infection is similar to prevention for HBV and relies strongly on HBV vaccination.
Hepatitis E virus (HEV) is an RNA virus which is excreted in the stools and spreads by the fecal–oral route. The clinical illness resembles acute Hepatitis A virus (HAV) infection and recovery is the rule. Chronic infection does not occur. Hepatitis G virus (HGV) is an RNA virus that rarely occurs as a solitary infection and usually appears as a co-infection with hepatitis A, B, or C. HGV is known to be transmitted through the blood and has frequently been associated with transfusions.
(To be continued…)
(Author is Dental Surgeon, BioDentis Dental Clinic Magarmal Bagh, Srinagar. Email: [email protected])
