I read with interest Dr. Michael Glick’s June JADA editorial, "Vaccines, Epidemics, Pandemics and Us" (JADA 2006;137[6]:706–10). He clearly pointed out the weakness of depending on vaccines to protect us from an emerging infection.
An infectious agent must be positively identified and isolated before meaningful development of a vaccine can even begin. In the case of avian flu, it is unlikely that a vaccine developed before the virus makes the projected jump from birds to routine human-to-human transmission will be effective.
The example of the recent mumps outbreak that was traced to apparent aerosol transmission during domestic air travel has far-reaching implications for dentistry. There are well-documented cases of airborne transmission of tuberculosis during air travel,1 the airborne spread of measles through the heating, ventilating and air conditioning system in a medical office,2 and the long-range airborne spread of the severe acute respiratory syndrome virus during the Amoy Gardens outbreak in Hong Kong.3
The potential for any of these organisms, probably including a human variant of avian flu, to be spread by dental aerosols/ splatter arising from the mouth of an infected person to dental personnel and other patients was discussed in a JADA 2004 article written by me and Dr. John Molinari.4
While vaccines are a long-term answer to many public health threats, they usually are available only after the threat has been isolated. Until an effective vaccine exists, the use of simple and inexpensive infection-control procedures for the control of dental aerosols/ splatter is dentistry’s only defense against potentially being implicated as a source of infection in the rapidly expanding area of emerging and re-emerging infections. Unfortunately, this facet of dental infection control often is ignored.
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