Herpes Simplex and Dental Treatment

As many of you are aware cold sores are caused by the Herpes simplex virus (in particular - HSV1)

They are highly contagious and tend to predominantly affect the mouth and surrounding areas.

HSV1 can be acquired in childhood and adulthood and once you have contracted the virus it remains with you throughout the rest of your life.The virus lies dormant within the nerve ganglion and can be triggered by certain stimuli (sunlight, stress, lowered immune system etc.) which can then re-activate the virus leading to a secondary infection which presents as blisters that are teaming with live virus on, in or around the mouth. Some sufferers may never have any re-occurrence of these secondary sores where as others may have frequent bouts of infection and episodes.

So what are the risks of treating patients who present with cold sores for dental treatment?

The HSV1 poses dangerous health risks not only for the patient who presents with the virus but for the dental care professionals whom treat the patient.

The virus can not only affect and cause infection in and around the mouth but it can be further spread to the eyes and other body parts including the fingers (Herpetic whitlow).There have been reported incidences where health care professionals and patients have gone blind due to the herpes virus being transmitted to the tissues of the eye, causing an infection.

During routine dental treatment the cold sore can be pulled and may burst or tear which will not only lead to discomfort but can lead to the spread of the infection via direct contact i.e. from the operator spreading the virus to other areas of the patients face or this virus can infect the aerosols produced from the equipment used (ultrasonic scalers, drills) which can then land on the patient infecting his or her skin and clothing, the operators skin and clothing, and the surrounding dental environment.It has been reported that the virus can then survive outside of the host for hours. You could then unknowingly infect family members if they come in to contact with your skin or clothes following your dental treatment.

It is always best practice to avoid any routine dental treatment if you have symptoms of a cold sore.You can be highly contagious roughly a week before (some patients get warning triggers i.e. tingling prior to a blister), during when the blister is present and even when it has scabbed over and is healing and a week after a cold sore disappears.

What to do if you have a cold sore or know that you are going to get one?

Please inform your dental practice as soon as you are aware you are getting, or have a cold sore and re-schedule your routine dental appointment for at least 2 weeks after this has healed fully.Obviously if you have a dental emergency and you present with a cold sore then we can offer emergency treatment as this would be in your best interests.

If you attend the practice and have a cold sore unknowingly our policy would be to re-appoint your appointment for another time allowing time for the healing process to reduce the risks.

If you have any questions or require further information please call York Place Dental on 01228 533431.

References

World Health organisation. 2018. herpes simplex virus. [ONLINE] Available at: http://www.who.int/en/news-room/fact-sheets/detail/herpes-simplex-virus#hsv1. [Accessed 17 July 2018].

Herpes Virus Association. 2018. Cold sores. [ONLINE] Available at: https://herpes.org.uk/cold-sores/. [Accessed 17 July 2018].

Progressive dentistry. 2018. Should you visit the dentist with a cold sore. [ONLINE] Available at: https://www.progressivedentistry.co.uk/the-news/should-you-visit-the-dentist-with-a-cold-sore/. [Accessed 17 July 2018].