The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Letter to the Editor

Editor, – We have recently been made aware of a dental note by Dr M McCullough of the Australian Dental Association in your journal (Aust Prescr 2006;29:52).

In the comment, Dr McCullough stated that, 'Dentists need to be aware that hepatitis C may be present in the saliva of infected patients. Our infection control practices therefore need to be exemplary to avoid spread of this, and other blood-borne viruses.'

We are perplexed by this comment on two levels. To the best of our knowledge, hepatitis C is a blood-borne virus and is not spread by saliva. We do not believe there has ever been a recorded case of such a transmission route. Secondly, to minimise the risks of transmission of a virus like hepatitis C between patient and health worker, adherence to standard infection control procedures is all that is required. We would be interested to know what 'exemplary' practices mean in this context, and how they differ from standard procedures.

Piergiorgio Moro
Community Development and Education Officer
Hepatitis C Council of Victoria
Melbourne

Author's comments

Dr M McCullough, author of the dental note, comments:

Firstly, I agree that hepatitis C is a blood-borne virus and there has not been a recorded case of spread via saliva. However, in my statement I did not say that it was spread by saliva, but that hepatitis C may be present in the saliva of infected patients. This was based on a recent literature search, which identified several articles on hepatitis C in saliva, and a review article.1

Secondly, the use of the term 'exemplary' was not in fact given a great deal of thought at the time. According to the Miriam-Webster dictionary, exemplary means 'deserving imitation because of excellence'. Standard infection control procedures used by Australian dentists are of course adequate to minimise the risks of transmission of a virus like hepatitis C. Furthermore, these standard procedures are at the level of international best practice and should be seen as excellent and deserving of imitation! The intention in the wording was not that we should undertake different procedures, but rather that we, as dentists, should be vigilant in adhering to these standard infection control procedures.

References

  1. Leao JC, Teo CG, Porter SR. HCV infection: aspects of epidemiology and transmission relevant to oral health care workers. Int J Oral Maxillofac Surg 2006;35:295-300.