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 Wilkins did say that cavitrons were contraindicated due to aerosols but I was told that statement was retracted in a newer edition.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.

The Hepatitis virus would be the more concerning virus. I would think though that if you wear your PPE’ s, including a disposable gown and disinfect all areas that might have aerosol contact,all should be fine.

I agree with Sue Halverson. Hep is the concern not HIV. PPE is the key!

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’ve used the cavitron with both hep and HIV patients with no issues. We were told in school to treat every patient (as far as using PPE’s) as if they had something such as hep or HIV/AIDS because you may be treating someone that doesn’t even know they have a disease/condition.

I was at a CE meeting where we asked about this and were told that Hep and HIV are not a problem with the aerosol as long as you are using precautions.

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).

Link: http://www.cdc.gov/oralhealth/infectioncontrol/faq/aerosols.htm

Yes. Obviously wear all your PPE and use universal precautions.

Use the cavitron! Standard of care with PPE. HIV has never been documented to be contracted by aerosols. I agree with seltd, you won’t always know what the client may or may not have.

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!

Thanks Mykalardh for your input. Will tuck that info away for later reference. Thinking about it, what antibiotic does your dentist normally RX? Amox? [Remember, the only stupid ?s are the ones not asked]. I agree that we should treat everyone as if they have hep or HIV.

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.

Link: http://

In school we weren’t allowed to use piezo’s or cavitrons on HIV or Hep patients. However, I’m sure there are many people who lie on thei health history out of shame, or simply don’t know that they are infected.

I understand the concern to the patient in regard to bacteria. What I don’t understand is what about all the patients we don’t know have hep or hiv ? Aren’t we supposed to tx all as if the do?

I mean..what about everyone’s aerosol?

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