title: What are the costs and benefits of patient notification exercises following poor infection control practices in dentistry?
abstract: BACKGROUND
  Allegations of serious failures in infection control practice were made against a dentist practicing in the South West of England. The dentist (who tested negative for Blood Borne Viruses (BBVs)) was immediately suspended.
  
  
  METHODS
  Because inadequate infection control presents a potential risk of transmitting BBVs between patients, a notification exercise was undertaken. Of 7625 patients contacted, 2780 (37%) were tested.
  
  
  RESULTS
  Nine cases of Hepatitis B (HBV) and four cases of Hepatitis C (HCV) were identified, of which seven were previously diagnosed. None of these were children. All of the six newly diagnosed cases had recognized risk factors for BBVs. The costs of the notification exercise were estimated at £311,500 of which £165,000 was staff costs, (£51,916 per newly diagnosed case).
  
  
  CONCLUSIONS
  This study did not demonstrate any patient-to-patient transmission of blood-borne viruses but the response rate was relatively low. There are significant costs associated with undertaking notification exercises. These findings should inform future recommendations and practice in this area.
authors.affiliation: Regional Epidemiology Unit, Health Protection Agency South West, Gloucester, UK. Electronic address: rebecca.close@phe.gov.uk.
authors.forename: R M
authors.initials: RM
authors.lastname: Close
authors.forename: S
authors.initials: S
authors.lastname: Gray
authors.forename: S
authors.initials: S
authors.lastname: Bennett
authors.forename: S
authors.initials: S
authors.lastname: Appleby
authors.forename: F
authors.initials: F
authors.lastname: Khan
authors.forename: C
authors.initials: C
authors.lastname: Payne
authors.forename: I
authors.initials: I
authors.lastname: Oliver
mesh_terms: D017848:Blood-Borne Pathogens; D016358:Contact Tracing / Q000191:economics; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000635:transmission*; D018563:Disease Notification / Q000191:economics*; D004739:England; D006509:Hepatitis B / Q000635:transmission*; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D019552:Infection Control, Dental / Q000592:standards*; D008403:Mass Screening / Q000191:economics; D012307:Risk Factors; D013218:State Dentistry / Q000191:economics
keywords: BBV; Blood borne viruses; Economic evaluation; Look back; Notification exercise