Treating a patient with an active herpetic lesion may not seem that risky, but it could have major repercussions for both the hygienist and patient.
You walk out to the reception area to greet your next patient for their prophy. Due to your attention to detail, as the patient approaches, you notice an active herpes simplex lesion on their lip (herpes labialis).
You seat them and after a few minutes of small talk you inquire about their “cold sore.” How long has it been present, do you get them often, etc.? After chatting with the patient you also have been updated that she is a new mom with an infant at home. You learned in hygiene school that elective dental procedures should be reappointed if a patient has an active herpetic lesion, so you let your patient know that treatment would be best postponed.
Then you approach your doctor to inquire about a prescription for an anti-viral and the recommendation of rescheduling the patient’s prophy appointment. However, your doctor doesn’t see the big deal with treating the patient; it’s just a cold sore and it’s no reason to lose production over.
So are you wrong in suggesting the patient reschedule? Are you remembering what you were taught in hygiene school inaccurately? Have protocols changed regarding elective dental treatment and patients with active herpetic lesions? The answer to all these questions is NO.
The only treatment a patient with active herpes virus should undergo in a dental setting is emergency treatment and direct treatment of the lesion (i.e. laser therapy).3,7 In other words, elective dental treatment such as a prophy, periodontal maintenance, debridement or non-surgical periodontal therapy/SRP should be postponed until the lesion(s) are healed. Treating this patient is not only a risk to them, but to you as the clinician.
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