Tuberculosis and oral healthcare provision

Key Points

  • Discusses tuberculosis disease and its management in the UK.

  • Provides an overview of key concepts to support the delivery of oral healthcare for this patient group.

  • Provides greater awareness of health and safety responsibilities for both employers and employees.

Abstract

Tuberculosis (TB) is a preventable and curable infection, but remains a significant cause of death. The dental team is likely to encounter patients with a history of TB, however, at present there is limited guidance available to inform the provision of oral healthcare for this patient group. This may lead to confusion with delays in care. There is a potential health risk posed to patients and co-workers by a member of the dental team who becomes infected. TB has the potential to be a major issue for oral healthcare in the United Kingdom (UK). This paper discusses the implications for both patient care and management of the dental team.

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References

  1. 1

    World Health Organization. Tuberculosis. Fact Sheet No. 104. 2018. Available at http://www.who.int/mediacentre/factsheets/fs104/en/ (accessed March 2018).

  2. 2

    Public Health England. Infectious Diseases and Health Protection: Tuberculosis (TB) and other mycobacterial diseases: diagnosis, screening, management and data. 2017. Available at https://www.gov.uk/government/collections/tuberculosis-and-other-mycobacterial-diseases-diagnosis-screening-management-and-data (accessed March 2018).

  3. 3

    Public Health England. Chapter 32: Tuberculosis. In Immunisation Against Infectious Disease. The Green Book. 2013. Available at https://www.gov.uk/government/publications/tuberculosis-the-green-book-chapter-32 (accessed March 2018).

  4. 4

    Longmore M. Wilkinson I B. Baldwin A. Wallin E. Chapter 9: Infectious Diseases: Tuberculosis (TB). In Oxford Handbook of Clinical Medicine. Ninth Edition. pp. 372–447. Oxford University Press, 2014.

  5. 5

    Bagg J. Tuberculosis: a re-emerging problem for health care workers. Br Dent J 1996; 180: 376–381.

    Article  Google Scholar 

  6. 6

    Public Health England. Tuberculosis in England 2017 report (presenting data to end of 2016). 2017. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/686185/TB_Annual_Report_2017_v1.1.pdf (accessed June 2018).

  7. 7

    Public Health England. WHO estimates of tuberculosis incidence by country, 2016. 2018. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/677927/WHO_estimates_of_tuberculosis_incidence_by_country__2016.pdf (accessed June 2018).

  8. 8

    Public Health England. Tuberculosis mortality and mortality rate, England and Wales, 1913–2013. 2014. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/363056/Tuberculosis_mortality_and_mortality_rate.pdf (accessed March 2018)

  9. 9

    Lönnroth K. Jaramillo E, Williams B G. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med 2009; 68: 2240–2246.

    Article  Google Scholar 

  10. 10

    Centre for Disease Control and Prevention. TB Elimination: The Difference between Latent Infection and TB Disease. 2014. Available at http://www.cdc.gov/tb/publications/factsheets/general/ltbiandactivetb.pdf (accessed March 2018).

  11. 11

    Lawn S D, Alimuddin Z I. Tuberculosis. Lancet 2011; 378: 57–72.

    Article  Google Scholar 

  12. 12

    Carter E, Chandarana P, Duggineni S, Nasser N, Bridle C. . Case Series of extra-pulmonary tuberculosis presenting as facial swelling. Br Dent J 2015; 218: 519–522.

    Article  Google Scholar 

  13. 13

    Hoa N B, Sy D N, Nhung N V, Tiemersma E W, Borgdorff M W, Cobelens F G . National Survey of tuberculosis prevalence in Vietnam. Bull World Health Organ 2010; 88: 273–280.

    Article  Google Scholar 

  14. 14

    National Institute for Health and Care Excellence. Tuberculosis. 2016. Available at http://www.nice.org.uk/guidance/ng33 (accessed March 2018).

  15. 15

    Health Protection Network. Tuberculosis: Clinical diagnosis and management of tuberculosis, and measures for its prevention and control in Scotland. Health Protection Network Scottish Guidance 5. Glasgow: Health Protection Scotland, 2008.

  16. 16

    Centre for Disease Control and Prevention. Fact Sheet. Testing for Tuberculosis. Available at http://www.cdc.gov/tb/publications/factsheets/testing/tb_factsheet.pdf (accessed March 2018).

  17. 17

    Centre for Disease Control and Prevention. Fact Sheet. TB Elimination: Tuberculin Skin Testing. Available at http://www.cdc.gov/tb/publications/factsheets/testing/skintesting.pdf (accessed March 2018).

  18. 18

    Centre for Disease Control and Prevention. Fact Sheet. TB Elimination: Interferon-Gamma Release Assays (IGRAs) – Blood Tests for TB Infection. Available at http://www.cdc.gov/tb/publications/factsheets/testing/igra.pdf (accessed March 2018).

  19. 19

    British Dental Association. Infection Control. 2017. Available at https://bda.org/dentists/advice/ba/Documents/Infection%20control.pdf#search=infection%2520control (accessed March 2018).

  20. 20

    Cleveland J, Robison V A, Panlili A . Tuberculosis epidemiology, diagnosis and infection control recommendations for dental settings. An update on the Centres for Disease Control and Prevention guidelines. J Am Dent Assoc 2009; 140: 1092–1099.

    Article  Google Scholar 

  21. 21

    Merte, J L, Kroll C.M, Collins, A S, Melnick A L . An epidemiologic investigation of occupational transmission of Mycobacterium tuberculosis infection to dental health care personnel Infection prevention and control implications. J Am Dent Assoc 2014; 145: 5.

    Article  Google Scholar 

  22. 22

    Department of Health. Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers. 2007. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/382152/health_clearance_tuberculosis_hepatitis_hiv.pdf (accessed March 2018).

  23. 23

    Jensen P A . Lambert L A . Iademarco M F . Ridzon R . Centres for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep 2005; 54: 1–142.

    PubMed  Google Scholar 

  24. 24

    Lamm D L . Bacillus Calmette-Guerin immunotherapy for bladder cancer. J Urol 1985; 134: 40–47.

    Article  Google Scholar 

  25. 25

    Department of Health. Health Building Note 01–04. Supplement 1. Isolation facilities for infectious patients in acute settings. 2013. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/148503/HBN_04-01_Supp_1_Final.pdf (accessed March 2018).

  26. 26

    Department of Health. Health Building Note 00–09. Infection control in the built environment. 2013. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/170705/HBN_00-09_infection_control.pdf (accessed March 2018).

  27. 27

    Scully, C, Dios, P D, Kumar N . Special Care in Dentistry. First Edition. Oxford: Elsevier, 2007.

    Google Scholar 

  28. 28

    Joint Formulary Committee. British National Formulary. 2018. Available at https://www.bnf.org/ (accessed March 2018).

  29. 29

    Gibson N . Ferguson J W . Steroid cover for dental patients on long-term steroid medication: proposed clinical guidelines based upon a critical review of the literature. Br Dent J. 2004; 197: 681–685.

    Article  Google Scholar 

  30. 30

    World Health Organisation. WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households. 2009. Available at http://apps.who.int/iris/bitstream/handle/10665/44148/9789241598323_eng.pdf;jsessionid=CCD8A70AF02DA08BB8592C9AB3787A29?sequence=1 (accessed March 2018).

  31. 31

    NHS. Universal: Standard surgical mask image. 2018. NHS Supply Chain. Available online: http://my.supplychain.nhs.uk/Catalogue/product/bwm114 (accessed June 2018).

  32. 32

    Health and Safety Executive. Respiratory protective equipment at work. 2013. Available at http://www.hse.gov.uk/pUbns/priced/hsg53.pdf (accessed March 2018).

  33. 33

    Universal: FFP3 with exhalation valve. 2018. NHS Supply Chain. Available online: http://my.supplychain.nhs.uk/Catalogue/product/btp182 (accessed June 2018).

  34. 34

    Universal: FFP3 without exhalation valve. 2018. NHS Supply Chain. Available online: http://my.supplychain.nhs.uk/Catalogue/product/btp180 (accessed June 2018).

  35. 35

    Department of Health. Decontamination Health Technical Memorandum 01–05: Decontamination in primary care dental practices. 2013. Available online: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170689/HTM_01-05_2013.pdf (accessed March 2018).

  36. 36

    Jackson T A . Thomas J M . Tuberculosis: The Implications for Anaesthesia. South Afr J Anaesth Analgesia 2013; 19: 301–305.

    Google Scholar 

  37. 37

    Mercer M . Update in Anaesthesia. Anaesthesia for the patient with respiratory disease. Available at http://e-safe-anaesthesia.org/sessions/02_05/pdf/Respiratory-Disease-and-Anaesthesia.pdf (accessed March 2018).

  38. 38

    Association of Anaesthetists of Great Britain and Northern Ireland. Infection Control in Anaesthesia. 2008. Available at https://www.aagbi.org/sites/default/files/infection_control_08.pdf (accessed March 2018).

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Correspondence to S. Clough.

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Clough, S., Shaw, A. & Morgan, C. Tuberculosis and oral healthcare provision. Br Dent J 224, 931–936 (2018). https://doi.org/10.1038/sj.bdj.2018.430

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