Review of the herpesviruses and hepatitis A: the potential hazards in dental care.

There is now an increased awareness of the risk of transmission of viral infections via blood and saliva after the publicity given to the human immunodeficiency viruses responsible for the acquired immunodeficiency syndrome. The herpesviruses have been found in blood, in blood products, and in saliva, and information with respect to these routes of transmission is convincing. Although hepatitis A virus is spread predominantly by water contaminated with feces (fecal-oral route), the virus is also found in saliva. On these grounds alone, these viruses must be considered a potential hazard in dentistry. Information in regard to the actual risks of their transmission in the context of dental practice is not yet available, primarily because a high proportion of infections are asymptomatic. Serologic studies of their prevalence suggest that all are widespread in the population. They are particularly common in many of the groups known to be at high risk for hepatitis B virus and human immunodeficiency virus, including promiscuous homosexuals, bisexuals, and intravenous drug abusers. In addition, pregnant women and their babies are particularly at risk from the herpesviruses. It is important to identify members of these high-risk groups as a potential source of transmission of infection through dental practice and in addition, it is important to identify them because they are prone to chronic sequelae.