I'm a general dental practitioner facing a dilemma over the treatment of a patient, who has hepatitis C. I was aware of the patient's status but I didn't tell the implant surgeon to whom I referred the patient, or the lab I sent the impressions to for study models, because I wasn't sure if it would be a breach of confidentiality to do so.
Patient confidentiality is key, but there are several actions to take in handling this situation. First, you need to separate the infection control aspect of the situation from the appropriate treatment of the patient. The one shouldn't adversely affect the other, and it's important that the patient is properly treated regardless of their status.
It's important to highlight and consider the use of universal infection control procedures in the practice. If these are adopted and correctly applied for all patients, the lab shouldn't need to know the patient's status because the risk of infection should have already been addressed and contained.
This particular patient declared their infective status, but bear in mind that others may choose not to do so, or may not even know themselves. Because of this, it's vital that infection control protocols are applied to patients across the board.
While the lab might not need to be informed, this might not be the case for others involved in the patient's care. A patient's status may have some influence on the appropriate treatment plan and treatment of the patient, so those involved in the front line care should know, including the implant surgeon. Because this means disclosing confidential information about the patient, seek their consent before you do so.
For further advice on putting in place policies and protocols relating to infection control, consider approaching the British Dental Association or CODE for guidance.
This is a fictional case compiled from the DDU's files.