Infection control in dental practice-A critical public health responsibility

Dear Editor,

The recent incident reported in Tamil Nadu, where multiple patient deaths have been reportedly linked to a dental clinic, has deeply unsettled the healthcare community and the public at large.^[1] Ongoing investigations suggest that contaminated saline solutions administered during dental procedures may have led to a rare but serious bacterial infection – neuromyelitis-like illness, affecting the central nervous system. This tragedy has once again brought the spotlight onto a long-standing but often under-discussed issue: The urgent need for robust infection control practices in dental clinics across India.

Dental procedures are inherently invasive. Even routine treatments such as scaling, restorations, or root canals involve contact with blood, saliva, and mucosal tissues. These biological fluids can serve as carriers for a wide range of pathogenic microorganisms, including bacteria, viruses, and fungi. Inadequate sterilization of dental instruments, improper handling of materials, and lapses in surface disinfection can all contribute to iatrogenic infections – infections caused by medical or dental intervention.

Globally, infection control in dentistry is governed by well-established guidelines. The Centers for Disease Control and Prevention emphasize strict adherence to standard precautions, including hand hygiene, personal protective equipment, safe injection practices, and the sterilization of reusable instruments.^[2] In India, the Dental Council of India (DCI) has outlined similar expectations in its Code of Ethics Regulations.^[3] However, the ground reality is that many private dental clinics – particularly in resource-limited settings – either lack awareness of these protocols or fail to implement them due to insufficient regulatory oversight.

While this may be an isolated incident, it raises concerns about possible systemic gaps in infection control compliance, especially in private dental practices operating in resource-constrained settings. While dental curricula do include infection control protocols, continuing education and real-world enforcement remain grossly inadequate. Furthermore, patients often remain unaware of their rights to demand safe and sterile treatment environments. Moving forward, there is an urgent need for empirical research to assess infection control practices across diverse clinical settings, which can better inform regulatory action and policy design.

In light of this, I urge the DCI, state dental councils, and health authorities to take comprehensive action:

• Mandate regular infection control audits in private and public dental facilities

• Enforce continuing professional development requirements, focusing on infection prevention

• Publish clinic ratings based on compliance with infection control norms to increase transparency

• Launch public awareness campaigns to educate patients about safe dental practices.

The integrity of our profession and the safety of our patients depend on our ability to uphold the highest standards of care. Let this unfortunate episode be a catalyst for reform rather than a missed opportunity.

Sincerely,

Dr. Rezhat Abbas,

Maulana Azad Institute of Dental Sciences

New Delhi