Dirty dentists putting patients at risk of infection

[Anonymous]

 

Dirty dentists putting patients at risk of infection

Patients are being put at risk of infection by dentists who fail to clean surgical equipment properly, research reveals.

One in nine dentists are in breach of strict rules designed to halt the spread of blood-borne diseases, inspectors found. Photo: ALAMY

One in nine dentists inspected by the health care watchdog were found to be in breach of strict guidelines on cleanliness and infection control designed to prevent the spread of conditions such as HIV, hepatitis and vCJD.

Under Freedom of Information laws, The Daily Telegraph obtained a copy of a database detailing the results of inspections by the Care Quality Commission (CQC), the healthcare regulator.

An analysis reveals that of the 1,667 dental practices inspected by the CQC last year, 189 were found to not be following Department of Health instructions on how to clean instruments and surgeries. Some 8,100 dentists are registered in England.

In order to prevent the spread of blood-borne disease, experts recommend instruments are prepared in a separate room to the dentist’s surgery. They should be scrubbed in one sink, rinsed in a second, inspected for any fragments under an microscope and processed through an ultrasonic bath or an autoclave steam cleaner.

They must then be stored for up to three weeks in sterile and dated packets.

Some equipment cannot be cleaned and re-used safely and most be thrown away after each patient.

But dozens are practices are disregarding the rules, inspectors found.

At one “cluttered and dirty” practice in Haringey, North London, inspectors in February found staff could not tell the difference between single-use and re-usable equipment, and they “could not be sure” that equipment in drawers ready for use in surgery had been cleaned.

Inspectors found an opened intravenous needle kit and out-of-date medicine stored in a fridge alongside the staff’s packed lunches, while used gloves and tissues, and a packet of porridge oats, were stored on top of the sterilisation machine.

The practice has since been given a clean bill of health.

At Lydiate Dental Surgery, Merseyside, the autoclave used for sterilizing equipment was found to be “unclean, felt ‘oily’ and had debris on it”, inspectors wrote. They found dust, dirt and cobwebs and overflowing bins in the surgery.

A spokesman said the surgery was “very concerned” by the report and had “reviewed arrangements” as a result.

Inspectors found staff at Wilton Dental Practice, Wiltshire, attempting to sterilize and re-use equipment that was single-use only.The practice did not respond to requests for comment.

At ADP Dental Company’s branch in Bath, staff told inspectors that broken ultrasonic equipment meant they “could not clean the equipment quickly enough”. They admitted they did not use a magnifying light to check whether instruments were clean, and sometimes “did not bother” to wash their hands.

Inspectors warned: “People may not be fully protected against the risks of cross infection.”

A spokesman said: “The issues highlighted have been immediately addressed and rectified to the correct standards.

“We have also delivered additional training and checking mechanisms since the report was published to ensure we maintain the highest standards for all our patients.”

The risk of patients catching blood-borne infections through inadequately sterilised equipment is low but not without precedent. In 2009 5,000 patients in Bristol and Bournemouth were offered blood tests for HIV and hepatitis after a dentist was found to have not sterilised equipment properly.

Katherine Murphy, chief executive of the charity The Patient’s Association, said: “Infection control practices in dentistry must be given the highest priority. All too often patients tell our helpline that they have concerns about cleanliness.”

Dr Martin Fallowfield, chair of the British Dental Association’s executive committee, which represents dentists, said earlier studies had shown around one in 17 practices were in breach of infection control rules. He added the sector had a better track record of infection control than that found in nursing homes and NHS hospitals.

        

[drmithila]

Tall, with dark-green pointy leaves, the neem tree of India is known as the “village pharmacy.” As a child growing up in metropolitan New Delhi, Sonia Arora recalls on visits to rural areas seeing villagers using neem bark to clean their teeth. Arora’s childhood memories have developed into a scientific fascination with natural products and their power to cure illnesses.
Now an assistant professor at Kean University in New Jersey, Arora is delving into understanding the curative properties of the neem tree in fighting the virus that causes AIDS. She presented her data at a poster session on April 22, at the Experimental Biology 2012 meeting in San Diego. Her preliminary results seem to indicate that there are compounds in neem extracts that target a protein essential for HIV to replicate. If further studies support her findings, Arora’s work may give clinicians and drug developers a new HIV-AIDS therapy to pursue.
Extracts from neem leaves, bark and flowers are used throughout the Indian subcontinent to fight against pathogenic bacteria and fungi. “The farther you go into the villages of India, the more uses of neem you see,” says Arora. Tree branches are used instead of toothpaste and toothbrushes to keep teeth and gums healthy, and neem extracts are used to control the spread of malaria.
Practitioners of Ayurvedic medicine, a form of traditional Indian alternative medicine, even prescribe neem extracts, in combination with other herbs, to treat cardiovascular diseases and control diabetes. The neem tree, whose species name is Azadirachta indica and which belongs to the mahogany family, also grows in east Africa.
Arora’s scientific training gave her expertise in the cellular biology of cancer, pharmacology, bioinformatics and structural biology. When she established her laboratory with a new research direction at Kean University in 2008, Arora decided to combine her knowledge with her long-time fascination with natural products. The neem tree beckoned.
Arora dived into the scientific literature to see what was known about neem extracts. During the course of her reading, Arora stumbled across two reports that showed that when HIV-AIDS patients in Nigeria and India were given neem extracts, the amount of HIV particles in their blood dropped. Intrigued, Arora decided to see if she could figure out what was in the neem extract that seemed to fight off the virus.
She turned to bioinformatics and structural biology to see what insights could be gleaned from making computer models of HIV proteins with compounds known to be in neem extracts. From the literature, she and her students found 20 compounds present in various types of neem extracts. When they modeled these compounds against the proteins critical for the HIV life-cycle, Arora and her team discovered that most of the neem compounds attacked the HIV protease, a protein essential for making new copies of the virus.
Arora’s group is now working on test-tube experiments to see if the computer models hold up with actual samples. If her work bears out, Arora is hopeful that the neem tree will give a cheaper and more accessible way to fight the HIV-AIDS epidemic in developing countries, where current therapies are priced at levels out of reach of many people. “And, of course,” she notes, “there is the potential of discovering new drugs based on the molecules present in neem.”

        

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