Sir, I want to congratulate you and David Croser for your editorial and article on dentists suffering from blood-borne infections, and specifically HIV (BDJ 2006; 201: 485, 497–499). I was very involved in many of the dental HIV related issues of the 1990s, and while most of the policies developed then reflected the best available science at that time, much has been learned in the intervening years.

Virtually all of the currently available evidence indicates a much lower risk of HIV transmission in dentistry from providers to patients and from patients to providers than we had feared immediately after the Dr David Acer case surfaced. There was a concern in those early years that we may be witnessing the 'tip of a yet to be recognised' mode of HIV transmission in dentistry and in health care in general. Numerous 'look back investigations or exercises' were conducted as well as improved surveillance activities to even better characterise the risks of HIV transmission in dentistry and all of healthcare. We now have the benefit of those many studies and can, with a high degree of certainty, describe those risks as being so low as to be virtually impossible to detect despite a much improved surveillance system.

It is rare for public health policy development to keep pace with rapidly advancing science. In the early 1990s those of us responsible for the protection of the public's health were by necessity required to develop policies based on incomplete and in some cases inadequate science. That is not the case today. Protection of the health of the public and healthcare providers is no small responsibility. I hope that in all areas, public health policies continue to reflect the best and most current science and are reviewed and modified when appropriate. Balancing of risks and the perception of risk is not easy but it is necessary. I agree that the time has come to review and revise those well intentioned policies of so long ago.