Working in a clinic with many patients who haven’t had care in years. The calculus is very tenacious and takes forever and lots of sharp instruments to just dent it. The Cavitron is a life saver in these instances but my boss says I can’t use it due to the aerosols.
At my school we see a lot of HIV/AIDS patients and we use the Cavitron. I asked the same question myself and didn’t really get a clear answer. Wilkins did say that cavitrons were contraindicated due to aerosols but I was told that statement was retracted in a newer edition. I do know at my school with over 10+ years serving HIV patients that no one has ever contracted HIV due to any circumstances.
If your properly protected I wouldnt think it would be an issue. There is always the chance that you treat a patient who didnt tell you they had it on their medical history so how would it be any different. Just because you know doesnt give you the right to treat the patient any differently. If your treating them differently its discrimination.
I recently looked this up on the CDC website. They did studies looking at the aerosol on HepB patients since it is the most transmissible of the three and there was no detectable virus in the aerosol. It states that the presence of HIV must be considered theoretical at this time. I took that to mean it is most likely safe to use an ultrasonic on these patients but the CDC will not commit to such a statement just in case (CYA).
Yes you should use the cavitron. If you feel uncomfortable like I do with aerosols all day start wearing a face shield! I love mine because there is always some accidental splatter with what we do and you don’t have to worry. The only thing is that you still have to wear your mask even though hygienists have told me otherwise. I did read in school that masks were still required.
The Cavitrin is contraindicated in HIV patients because of the bacteria being produced in the aerosol in regards to the patient, not us. It is also recommended if the Cavitron is used to prescribe an antibiotic post treatment. When I see and HIV patient I always make sure that I ask what doctor they see, when they had CD4s tested and are they within normal range. If I do SRP with an HIV patient or the patient had a lot of buildup I will use the Cavitron but I will make sure the DDS prescribes an antibiotic. Hope this helps!
I was at a CE course last week and they said not to use cavitron on hep c pts because the virus will travel trough the aerosol and spread all over the room. They also said the HIV is too big to travel though the aerosol therefore cavitron is not contraindicated.
I agree that you will be fine using the proper precautions that is expected for every patient and the addition of antibiotics for their well being is a great idea if their physician deems necessary! There may be legal repercussions if they are not given the same treatment as anyone else? I worked with a Doc who early on, (early 1980’s) before the research and knowledge that we now have, he had a Hygienist who refused to treat an HIV patient so he had to deny the patient care. Many years of back and forth he ended up having to pay a settlement after the patient had already passed away. So legally and professionally I believe all of our patients deserve the same care.
This is a ridiculous thought since we cannot know with confidence who does and does not have any disease. If it is not safe for use on HIV or hepatitis infected patients then it is not safe period. I bet the doctor in question still uses a high speed hand piece to treat these patients which is a huge source of aerosol. In my opinion it is perfectly fine to use the ultrasonic and even safer than trying to hand scale heavy calculus. I am however a fan of the piezo over the cavitron due to the decreased Amount of aerosol on all patients diseased or not