Shakespeare wrote about killing all of the lawyers and left the elimination of the dentists to someone else. That someone … or something … has arrived. Dentists and dental technicians in Virginia are succumbing to a deadly lung disease and their pulmonary physician counterparts have no idea how they became infected … or what can be done to protect other dentists in Virginia and potentially around the country and the world.
The mystery begins in April 2016 when a dentist being treated at a tertiary care center (a hospital that provides care after referral from primary care and secondary care) was diagnosed with idiopathic pulmonary fibrosis (IPF), an incurable disease with an unknown cause which starts as a dry cough and shortness of breath, then slowly and irreversibly decreases the function of the lungs, resulting in death in just 3-to-5 years. After getting the bad news, the dentist noticed that this was the same center where other dentists had been treated for the same disease and notified the Centers for Disease Control and Prevention (CDC).
It didn’t take long for the CDC to confirm what the dentist had reported. The medical records for all 894 patients treated for IPF at the Virginia center from September 1996 to June 2017 were analyzed. Between 2000 and 2015, eight dentists and one dental technician sought treatment there for IPF and seven of the nine had died. Statistically, 10% of the IPF patients at this single location were from the dental field, a rate which indicated that, at least in this area, dental professionals were 23 times more likely to have IPF than the rest of the population. Why dentists?
“It is possible that occupational exposures contributed to this cluster.”
Ya think? The CDC report also points out that the dentists and technician were male and 64 years old on average. One of the dentists who survived told the CDC that they had all spent years polishing dental appliances, preparing amalgams (fillings) and impressions without wearing the proper kind of respiratory protection to prevent them from inhaling silica, polyvinyl siloxane, alginate, airborne particulates, ionizing radiation and other nasty substances with equally nasty names that are known to cause respiratory problems. Is one of these the cause of this horrifyingly high concentration of a fatal lung disease among male dentists in this concentrated area?
“Further investigation of the risk for dental personnel and IPF is warranted to develop strategies for prevention of potentially harmful exposures.”
Open wide and say “Holy [email protected] … I’m leaving dentistry for something safer – like logging or professional football!”
These patients were professionals (yes, they were dentists, but where would we be without them?) in a highly specialized field who were most likely slowly and painfully killed by a mysterious occupational hazard. Even dentists deserve more than just “further investigation of the risk.” What does this say for the rest of us breathing who knows what on the job?
Is the answer really a mystery?