Investigating dental treatment as a possible risk factor for variant Creutzfeldt-Jakob disease (vCID) in the UK

Introduction
The potential for vCJD transmission in the healthcare setting has raised concerns over the risk posed by dental surgery. The aim of this study was to determine whether dental treatment was a possible risk factor for vCJD, by looking for links between vCJD cases and whether there was an excess of dental treatment in vCJD cases compared with general population controls.

Methods
Dental treatment records were collected from general dental practitioners or, where this was not possible, from NHS Dental Practice Board payment schedules.

Results
Data were available for 49% (79/162) of cases and 82% (503/610) of controls. Two pairs of cases had received dental treatment at the same dental practice, however the type and timing of recorded interventions did not provide strong evidence that this was how vCJD was acquired. The review of specific dental treatments also showed that there was no evidence that vCJD cases experienced an excess of any type of dental treatment compared with controls.

Conclusions
This study provided no compelling evidence of a strong association between dental treatment and vCJD, however because of the limited availability of dental information, and the possibility of undetected asymptomatic infection, we cannot exclude dental treatment as a possible risk factor for vCJD. We recommend the development of more portable and robust mechanisms for dental record keeping in the UK that are also useable for public health purposes, and support current health policy to ensure that high standards of cleaning and sterilisation of re-usable dental instruments are maintained.