PUBLIC HEALTH
From Barber’s Shop, to Clinic: How Dentistry has Evolved to Reduce the Spread of Infection. Eleanor Rea, UK
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n every day practice, as students and professionals, we take for granted the measures that we have for infection control. They are simply the rules of our workplace, and without them we would be in a completely different position as a profession. But have you ever thought about how these measures came about? How did dentistry move from a nonsterile barbers’ shop to a clinical setting? In modern day dentistry, the challenge of disease transmission has brought about the innovation of exceptional infection control. Historical outbreaks and the discovery of new disease containing particles has led to a whole host of measures, which, for us, have become normal. Covid-19 has come to be the new challenge, bringing along a new chapter of hygienic and precautionary practice, with the prospect of reshaping dentistry as we know it- for how long? - We just don’t know…
8 | EDSA Magazine
Creutzfeldt Jacob Disease and Endodontic Treatment
Creutzfeldt Jacob Disease, CJD, is a fatal prion disease, causing gradual degeneration of neural tissue, as the prion proteins survive in nervous tissue. It is thought to have been acquired by humans through consumption of Bovine Spongiform Encephalopathy (BSE) infected meat products. CJD became a worry to dental professionals in the early 2000s when it was discovered that with inadequate decontamination procedures, CJD could be transmitted through endodontic treatment when a reusable instrument had been used. This has led to a high increase in the use of single use endodontic files, as well as more advanced sterilisation procedures used on dental instruments. It is an example of how dentistry has evolved to reduce infection spread in practice.
Explaining the theory of how endodontic treatment could result in CJD transmission
A patient who had eaten BSE infected meat products could consequently develop CJD. Symptoms take a while to develop, as the disease has a long, yet still unclear incubation period; according to the UK National Health Service, there is thought to be an incubation period of more than 10 years in some people. If this asymptomatic infectious patient needed endodontic treatment, the endodontic file used for the treatment would become contaminated with CJD prions existing in the patient’s nervous system, from the pulp chamber as dental pulp originates from neural crest cells during tooth development. That instrument would then be decontaminated, however standard decontamination procedures are theoretically insuf-
