Dental care of infectious patients in Denmark, 1986-1993: theoretical considerations and empirical findings

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Abstract
Changes in infection control and behavior and attitudes towards HIV-infected patients from 1986 to 1992/93 were studied among a random sample of 335 Danish dentists; previous studies among random samples of Danish dentists served as references. 249 (74.3%) returned a mailed questionnaire together with a time, steam, temperature (TST) control indicator strip processed in their steam autoclaves, 3.4% of the autoclaves had not sterilized properly, which was an insignificant decrease compared to 1986. Overall, infection control had improved since 1986. In 1992/93 17.3% of dentists surveyed reported use of gloves always: in 1986 0.8% did so. Many (60.2%) reported at least one needlestick or cut accident within the last year. The number of dentists who were willing to treat HIV-infected patients and the number of clinics that found they could treat infectious patients safely had increased from 56.1% to 78.7% and from 43.0% to 66.8%, respectively. Other attitudinal dimensions, for example views on secrecy of HIV test results and HIV screening policy, had not changed. A conceptual model based on the theory of reasoned action formed the framework for multiple logistic regression analysis with two different outcomes: Willingness to treat HIV-infected individuals and Treatment of HIV-infected patients. In particular, expected staff problems turned out to have a high explanatory value (odds ratio = 18.2) if HIV-infected patients were received. In both models Certainty about hygienic precautions had some explanatory value. The findings may give some clues about how to plan and implement future continuing education on infection control and attitudinal and behavioral aspects of caring for infectious patients.