Dentists' perspectives on infection control in relation to blood-borne viruses

The prevalence of blood-borne viruses (BBV) continues to increase in Australia, as does the need for vigilant infection control. Despite this, some Australian health practitioners demonstrate poor compliance with recommended infection control practices, The aim of this study was to examine the experiences and attitudes of dentists regarding infection control, patients with BBV, occupational risk, and related matters, and identify reasons for non-compliance with infection control guidelines. A purposive sample of 25 Victorian dentists took part in semi-structured interviews between November 2003 and November 2004. Interviews were taped, transcribed and coded for thematic analysis. The majority of participants expressed compliance with standard precautions, however, many admitted to changing their routine infection control practices for patients known or assumed to have a BBV. Approximately half disclosed minor changes, such as double gloving; a small minority reported having treated people with a BBV at the end of a session. Most participants experienced apprehension about the risk of occupational exposure to BBV and admitted this as the reason for changing infection control practices. Reasons offered by participants for poor compliance included ignorance of either the effectiveness of standard precautions or BBV transmission, or confusion and frustration regarding inadequate or impractical infection control guidelines. It is suggested that infection control guidelines be specifically designed for dental practice and that these be promoted in both undergraduate dental education and professional development.