Ebola Precautions for Dental Practices

A person infected with Ebola is not considered contagious until symptoms appear. Due to the virulent nature of the disease, it is highly unlikely that someone with Ebola symptoms will seek dental care when they are severely ill. However, according to the Centers for Disease Control and Prevention and the ADA Division of Science, dental professionals are advised to take a medical history, including a travel history from their patients with symptoms in which a viral infection is suspected.

As recommended by the ADA Division of Science, any person within 21 days of returning from the West African countries Liberia, Sierra Leone and Guinea may be at risk of having contacted persons infected with Ebola and may not exhibit symptoms. If this is the case, dental professionals are advised to delay routine dental care of the patient until 21 days have elapsed from their trip. Palliative care for serious oral health conditions, dental infections and pain can be provided if necessary after consulting with the patient’s physician and conforming to standard precautions and physical barriers, as well as making use of suitable Personal Protective Equipment to ensure the spread is kept minimal between patients and medical staff.

An elevated temperature (fever) is often a consequence of infection, but Ebola is not the only infection that may have similar signs and symptoms. The most common signs and symptoms of Ebola infection are:

• fever (greater than 38.6°C or 101.5°F) and severe headache
• muscle pain
• vomiting
• diarrhea
• stomach pain or unexplained bleeding or bruising

You are advised not to treat dental patients if they have these signs and symptoms for Ebola. If a patient is feeling feverish and their travel history indicates they may be at risk of Ebola, dental professionals and staff in contact with the patient should:

• immediately protect themselves by using standard precautions with physical barriers (gowns, masks, face protection, and gloves – a procedure mask would be a good place to start)
• immediately call 911 on behalf of the patient
• notify the appropriate state or local health department authorities
• ask the health department to provide you and your staff with the most up-to-date guidance on removing and disposing of potentially contaminated materials and equipment, including the physical barriers.

The Ebola virus is spread through direct contact (through broken skin or mucous membranes) with blood and body fluids (urine, feces, saliva, vomit and semen) of a person who is sick with Ebola, or with objects (like needles) that have been contaminated with the virus. Ebola is not spread through the air or by water or, in general, by food. Again, there is no reported risk of transmission of Ebola from asymptomatic infected patients.

Information and resources on Ebola are posted on the CDC’s website at cdc.gov. A checklist for healthcare providers (PDF) specific to Ebola is included on the site.

To view this article and other American Dental Association Recommendations please visit: www.ada.org