My dentist visit experience as a Hep C'er

[ScarlettOscara]

   My first visit to the dentist while I "knowingly" had Hep c was a bit embarrassing. The dentist did not ask me how i "got it" at least. But I found it ODD that  I had a filling that was old and needed to be replaced and when I asked him if he could do this he said it was better to leave it alone. He cleaned my teeth and did use the little hooik to chip away some of the tartar on my teeth but not all. I did bleed allot and of course had warned him about the hep c before hand ..so I can't really blame him. I f he didn't do a thorough job because he was afraid of becoming infected how can you not understand that. He told me I needed to see a periodontist, which didn't surprise me because I had had gum surgery when I was only 21 for gum disease. (I was about 44 at the time of THIS dentist visit). I went home but never called a periodontist because I was just too embarrassed.
   Yesterday I went back to a new dentist a co-worker kept nagging me to go to. My co-worker does not know I have Hep C. He kept bugging me to go to see his dentist ..there are not many dentists in my area that accept the insurance I now have and I really neede to see a dentist since I hadn't been in 4 years..so I finally went.
   I did the what I consider the right thing and told him right away that I had Hep C and asked him if he was alright with this. He asked me if had consulted my doctor, and said that I may need to take antibiotics first like people with heart murmurs and such, before getting dental treatment. I told him I had never heard of that for Hep C.  He then asked me how I got Hep C. This was really humililating to me since I don't see why that matters, but I told him it was probably from some tattoos I had gotten when I was younger. The truth is I USED to main line heroiin way before anyone knew about AIDS and HEP C and I probably got it back then..but I really don't feel comfortabe telling people I used to be a junky..Now i am Not but NOW i have Hep C and no matter how clean I live my life now and how STUPID i NOW know I was I will ALWAYS have this Hep C to remind me of my passt and it really *****! He looked at my x rays and told my I had a large cavity and gum disease, he said he would only polish my teeth and to talk to my doctor. Before leaving I asked him that if I talk to my doctor and he tells me it is OK to go to the dentist, I wanted to know honestly if the Hep C would be a problem with him, he said he would have to see after I spoke to my doctor.
   On the train ride home I felt so depressed and dirty. I started to think paranoid thoughts about him telling my co-worker about me, "You know that woman you reccomended to see me...she's got Hepatitis C!!!" Oh God ..I hope not, but it does worry me. When I got home I  told myself it would be alright, I will find another dentist. I went online and looked for dentists that take my insurance. I found a good dentist in my area after MUCH web surfing and am going to call tomorrow morning for an appointment.
   And now the Question that BURNS in my brain...Do I tell THIS dentist I have Hep C!!?? I know the morally correct answer is YES..YES OF COURSE! But now I think if this dentist is afraid to treat me I have just about run out of options, my dam tooth is hurting and I need to get it fixed AND then see a periodontist...AND aren't dentists SUPPOSSED to clean all their utensils THOUROUGHLY?  Also, so many people have Hep C and don't even know.
I am thinking of just asking the dentist to please be sure to thouroughly clean all the equipment because a "friend" I  know contacted Hep C from haveing dental work and thereby asking them how well they clean everything...would that be responsible enough?? I would never never want to pass this Hep C on to anyone , am I correct in thinking if the dentist is CLEAN no one will be infected from me? Would it be horrible not to tell the dentist I have Hep C?? And if I do tell the dentist and I end up losing all my teeth because I can't find a dentist how will take my insurance AND treat me...THEN have I done the right thing??
DEPRESSED AND CONFUSED.
  

[Rockerforlife]

There are densists out there that specialize i hep c patients,,,,OR...you can just go to regular denstist and keep yopur mouth shut....choice is yours.

[Andiamo1]

I always felt an obligation to be honest and I think everyone with HCV should tell anyone that could be infected about the danger.  I was always honest with any dentist and managed to get excellent dental care over the years.

Don't sweat it.  Doctors and dentists know how to deal with it.  Most importantly, they work for you.  You are paying their salary while they work.  You should demand the best care and don't feel ashamed about anything.

[lapis]

As Rocker says, the choice is yours....but I always tell all my health care providers I have HCV.  Although all health care providers in the US are required to use standard precautions (thus treating every client as if they could have a communicable disease by wearing gloves, careful handwashing, sterilizing reusable equipment, etc), still it seems my responsibility to provide that information, since my blood is contagious.  

I currently see a periodontist who has replaced several fillings, pulled a tooth to place a bridge, etc, and I get my teeth cleaned every 3 months; there has been no conversation about my HCV, although I did provide that information in my initial health history.  

Maybe you could just call your medical doctor, and ask if he/she has any specific recommendations for dental work for people with HCV.  Then maybe you could screen your next choice of dentist by phone.  At least you'd be able to tell him/her that you have spoken to your doctor first.  I'm not aware of any recommendations for HCV pts to get antibiotics before dental tx, and this has never been required of me (and I've been + for 12 years, and gotten regular dental care (at least every 6 months) this whole time.

I have also experienced that frustration of feeling judged when I told someone about my HCV.  Even though I never injected drugs, there is a stigma associated with this disease, and I'm sorry your dental experiences have reflected that.  A good and educated dentist and dental staff should know how to protect themselves against all blood-borne diseases, and should take the proper precautions to do so.  My hygienist wears a face-mask and goggles and gloves, and I do not begrudge her these protections in any way.  In fact, if someone begins to draw my blood without gloves on, I tell them to wear gloves please.

So take a deep breath, begin with the knowledge that you are deserving of excellent dental care, and find a dentist who will work for and with you.  I wish you the best of luck in pursuing this for yourself!

[pitter]

hi Scarlette,
I would just do the "I have a friend thing"
I mainly say that bcz  I have 2 avenues of where I think I got it. , and one is through dental work, and nobody there warned me!!!
Should you  bare your soul to these people.? Hah  they may charge you more money too.! I don't mean to be negative ...but just do what you have to do to take care of yourself.!  of course - not to put anyone else in jeopardy of contracting hep c  either, but I think we probably care more than they do. Just get your teeth fixed.!!!
I have had some eye opening experiences with medical people over the last few years...you have to be seriously proactive in your own health care these days.
I think most medical people are so over loaded with people, and pain in the butt people, that they just can only handle so much... I don't expect any cushy care from any health care people at all any more.
So my vote - is to only tell whom you have to tell.
all the best
Pitter

[copyman]

exactly why I would never tell my dentist or anyone not close to me. real shame but this is the stigma attached to this disease. any good dentist should be practicing the ADA standard protocol that is to protect you and themselves from hepatitis, hiv, etc

[jmjm530]

Very early on I felt a compulsion to tell people like Dentists I had HCV . From experiences like yours, I am over that compulsion now and only disclose on a need to know basis, i.e. where I feel the need for them to know :)  Dentists and all medical professionals are supposed to take universal precautions to protect all of us from those with HIV, HCV and who knows what else walks into the office on probably a daily basis. It's a shame you had to subject yourself to the stupidity of this dentist. Do yourself a favor and don't expose yourself to the stupdity of another. Hopefully most dentists know how to clean and fix teeth. Many don't know any more about Hep C than they do about brain surgery.

-- Jim

[moahunter]

It all depends on the dentist I guess. I decided to tell mine (before I was SVR). No issues at all, they didn't even blink, and proceeded to remove three wisdom teeth and replace a half dozen filings.  

I felt better telling - I mean, if your dentist reacts stupidly and ignorantly, perhaps thats not someone you want working on your teeth?

[Facta_non_verba]

I'm for telling anyone who may be exposed to my blood. I had spine surgery a few months before starting treatment, and I told my surgeon right away that I had Hep C. He had a right to know so he could take extra steps to protect himself. Also, he had a right to refuse to treat me, so he needed the facts.

It's true that we're all supposed to practice universal precautions, but knowing someone has a blood-borne communicable disease makes me extra careful with every incision I make and every stitch I place. I always take care to let the scrub nurse know that I'm placing a needle or blade on the mayo stand, but I'm even more cautious when I know the patient has hep C or any other thing that might infect me or the O.R. staff.

As for the feelings of shame that go along with having Hep C, you're not alone. Many of us had or have to face that. For myself, I just don't give a damn about that. Then again, everyone probably assumes it was from a needle stick anyway, so I would be more likely to be seen as unfortunate rather than a bad person. I didn't tell anyone at work mainly because I didn't want people constantly asking me how I was doing. I also might have faced discrimination despite the CDC and American College of Surgeons recommendations that surgeons with Hep C should face no restrictions in practice and that they need not inform their patients.

Just me two cents.

Jeff
Facta non Verba

[Proactive]

You did the right thing and I hope you continue to do so..I certainly, in clear conscience could not place having my feelings hurt, above the possibility of infecting another person with the virus. I mean my goodness, especailly at a dentist office, or where ever any chances off blood exposure are possible, how could you not inform, and still sleep well at night?
Best of luck on your decision, I did tell my dentist and all other medical professionals...only others I informed were my immediate family.
Pro

[Trinity4]

If they don't ask, I don't tell.  Heathcare provider or not and I do sleep well.
Trinity

[Proactive]

Interesting.......so let's look at pitter's case, to quote her
"I mainly say that bcz  I have 2 avenues of where I think I got it. , and one is through dentalDental cavities Tooth abscess work, and nobody there warned me!!! "
Let's say, for the sake of argument pitter did get infected at the dentist's office, and let's say you just happened to have the appointment just prior to her visit and infact through you, she did contract hcv...My belief is, that dentist may have taken extra precautions as a result of your devulging your infection, hell, that is human nature...sorry, I'm not going to take that chance..Cripes, I'm svr and still wouldn't let someone take a splinter out of my finger, I'm just not willing to that chance. To each their own I reckon , sleep well.
Pro

[justme53]

I informed my dentist and staff for their benefit as well as mine. If it's one less chance of someone else accidentally contracting HCV, it's worth it to me. And now if I need any dental work done during tx, they're aware of any challenges I may present with lowered platelets, depressed immune system and possible drug interactions.

Pam

[Trinity4]

There was a rather controversial discussion about this very same thing some months ago.  After reading many posts and seriously thinking about it I decided to tell my dentist.  No where on the medical information application was I asked if I had HCV.  When I discussed this with them I asked why they didn't require me to divulge.  They indicated they took universal precautions with everyone, regardless of health status.  They took no additional precautions with a person who had HCV.  It was standard policy within their practice and indicated all health care facilities should follow the same protocols because that is part of the training in all medical and dental schools.  My dentist said knowing my status now he would not perform any extensive dental procedures such as implants until after treatment.  I was good to hear that they are compliant with sterilization procedures regardless of health status and do not view anyone with hepc as a potential hazard to others.
Trinity

[Proactive]

It just seems to me, that along with this disease comes the huge responsibility to protect others from it, even at costs to ourselves.Sometimes inaction or our part not only could put others at risk, but could be a squandered opportunity to break the viral chain itself -who knows, right?..
Who was it, James Dean who said "the lives you might save might be mine"..
Pro...who is getting off the soapbox....;^)

[jmjm530]

Trinity: My dentist said knowing my status now he would not perform any extensive dental procedures such as implants until after treatment.
------------------------
I'm assuming because of your prior statements that the reason has to do with the side effects of treatment as opposed to your dentist being worreid about accidental transmission?

Proactive: Let's say, for the sake of argument pitter did get infected at the dentist's office, and let's say you just happened to have the appointment just prior to her visit and infact through you, she did contract hcv.
------------------------------------
I'm sure that happened. Not likely with "Trinity" and Pitter", of course, but just think how many millions of people with HIV and HCV walk into a dentists office every year and how many millions of people walk right into that dentists office right after that patient. Given this reality, how can any dentist (or doctor) treat a patient in any manner without assuming they have something like HIV or HCV, of which they must also that most will not disclose either because of privacy concerns or frankly because they just don't know their own status. Also, have you ever asked your dentist or hygenist what their HCV status is? Have they been tested? I have a feeling you will be surprised at the answer. Because statistically, a dentist (or any health care worker) has more chance of infecting the patient than the other way around. This is where hopefully universal precautions come in.

Jeff: but knowing someone has a blood-borne communicable disease makes me extra careful with every incision I make and every stitch I place. I always take care to let the scrub nurse know that I'm placing a needle or blade on the mayo stand,
------------------------------
I'm sure you're a real pro as well as your staff -- but frankly, I would prefer to have my surgeon (and support staff) giving 100% concentration to my operation and not thinking about what might happen to their viral status if they make a slip. If surgery is like other tasks I'm more familiar with, then practice makes perfect in part because we have gone beyond the "thinking" stage and more into the reflexive stage.

[Proactive]

"This is where hopefully universal precautions come in."
Jesus Christ, I almost pee'd in my pants with that comment...;^)

I have to get outside, you're killing me here..(vbg)
Pro

[Fl_Gator]

I went to the dentist today...I had my teeth cleaned like any other appt that I have had with the same hygenist over the last ten years...On my last appointment, six months ago, I told her that I had HCV she noted it in my chart and went on with business as usual...

This time she asked how my tx went and wished me well....then the same dentist came and checked my teeth afterwards...we discussed having a crown done on a tooth that had a root canal about 15 years ago from a different dentist...he has wanted to fix that tooth for many years...this year is no different

Some people are more educated than others...I feel fortunate to have such good care.

I did have a tinge of panic for a few minutes though...I still don't know how I contracted HCV...it may have been from a dentist many years ago...but I am not going to stop taking care of my teeth for fear of getting this again.

[Rockerforlife]

THE can of worms are open again...here we go

[Rockerforlife]

Simple...just go to a dentist that specilaizes with hep patients...can of worms closed....only one thing tho...a longer waiting time to see the dentist..and are only maybe one or two in one state or province

[apache1]

Hey Proactive, why not go one step further ?

Get a medical bracelet or necklace showing your HCV status. That way, god forbid, you get into an accident, are unconscious and bleeding badly, then everybody knows to leave you alone unless they are properly protected.

Imo, lots more of a chance to infect somebody like that, than at the dentist office.



====================================================
quote by Jim,
I'm sure you're a real pro as well as your staff -- but frankly, I would prefer to have my surgeon (and support staff) giving 100% concentration to my operation and not thinking about what might happen to their viral infection if they make a slip.
If surgery is like other tasks I'm more familiar with, then practice makes perfect in part because we have gone beyond the "thinking" stage and more into the reflexive stage
=======================================================

Excellent point Jim.

And another good reason to only tell only, on a need to know basis.
If medical professionals do not treat every patient as if they had a communicable disease, they are not doing their jobs correctly as their license or certification requires.

Imo, No need to get your surgeon shaking in his boots. Or preoccupied with anything but how to preform your surgery to the best of his ability. That might even make them nervous enough to make a mistake and get infected, or worse.

I wonder how many medical professionals with HCV, or Hiv, etc, tell their patients.

[Rockerforlife]

Why not get wear a t-shirt that says...".I HAVE HEPAITIS C"....

[Facta_non_verba]

Jim:

The reason surgeons and OR staff get injured in the first place is that they end up lost in concentration while taking care of their patients. It’s that reflexive part you mentioned where we get in trouble. The handing back and forth of sharp instruments is completely routine. That routine needs to be interrupted to prevent accidents, but it’s impossible to do so continually since it is, indeed, a routine task. Universal precautions are necessary, but because of human nature they are a simplistic approach to preventing the spread of infection.

That extra knowledge is to protect me, which is vital because my life is just as important as my patient's. Professionalism dictates that physicians must sometimes put their patient's interests before their own. Cancelling out on dinner plans, missing family functions and getting called in at three o'clock in the morning are all part of the deal. I just want as much information as possible to protect myself, since a surgeon is much more likely to be infected by a patient with Hep C than vice versa. There are only a handful of known cases of surgeons infecting patients, whereas hundreds of healthcare workers are infected annually. I don’t have the statistics for Hep C, but approximately 250 healthcare workers die each year from chronic Hep B infection. There’s a vaccine for Hep B with a high number of healthcare workers vaccinated and still 250 healthcare workers die from Hep B? I imagine the spread of Hep C infection from patient to surgeon is much higher.

I assume you are a good driver and take all the necessary precautions to avoid being involved in a traffic accident. Are you more careful on New Year's Eve or do you treat it like any other night? How about when it rains or snows?

Jeff

[Facta_non_verba]

Jim:

Just re-read my post. That last paragraph isn't meant to be sarcastic.

Jeff

[Bill1954]

Jeff, your insight here is invaluable; thank you very much for sharing this info. I’ve never hesitated telling any health care provider that I am HCV RNA positive for just the reasons you’ve mentioned; and I’ve never perceived any bias or prejudicial treatment (that I’m aware of) for doing so.

I’d hope that the medical profession has the sophistication to look beyond this disease as a barrier to equal care, and respect a patient for offering this knowledge, regardless of the rules of uniform precaution.

Thanks again for your input—I’ll continue to notify phlebotomists or anyone else that comes at me with a sharp object; that includes muggers, ex-wives, etc :o).

Bill