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Q. Can I get herpes from the use of unsterilized instruments?

Answered by
Dr. Rakesh Kumar Bahunuthula
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 06, 2017

Hello doctor,

I required deep cleaning my teeth. So I came to my hometown and started seeing my family dentist to whom my entire family is going for a couple of years. One week ago, I started the treatment which was deep cleaning on one side of the teeth. I always dreaded about cross-contamination and I explained this to my doctor who showed me their autoclaving procedure and also the instruments used by him was removed from a sealed pouch by him in front of me and so were the gloves and I was happy about the safety protocol. Yesterday, I went for my second sitting and during the part where the anesthesia was given to my gums, the instruments used was as usual removed from a sealed pouch by him but for the actual cleaning part which was done in an adjacent clinic, the nurse who helped him gave the dental motor probe and the tweezer in an open tray. I immediately asked both the nurse and the doctor about this and both assured and swore that those instruments were the ones that were removed from the sealed pouch and the nurse had brought it to this room with the help of a tissue paper and I need not be scared about the cross-contamination as they do not ever use the instruments on others. He even took me to the autoclave room and showed me how the procedures are done and explained to me how the attendees and nurses are instructed to adhere to the rules. Since I have cross-contamination phobia, I am unable to believe him though I want to. The time difference between the last patient and me was about 10 to 15 minutes. It was an airconditioned room. I have no idea about the last patient's medical history. He was a middle-aged person and a laser treatment was done for him but again I have no clue what sort of treatment he had. I would like to know how long does the herpes virus survive. I am so scared that I just cannot sleep, breathe or do anything. Please help me as I am petrified.

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome to icliniq.com.

  • The doctors do use adequate asepsis before any procedure.
  • I am sure in your case too, all strict precautions of sepsis would have been followed.
  • Reusing the same instruments is unethical and I do not think that it would be done in good clinics.
  • Moreover, as most of your family members have been visiting the same doctor and have never complained, I believe there should be no issues.
  • Herpes virus can survive up to two hours on instruments. However, this could happen only if the person before has had any active lesions of herpes.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

In some websites, especially the herpes website, they claim that since the virus is very fragile it cannot survive more than 10 seconds. Also, since the last patient before me had laser process but I do not know for what reason, the dental mirror probe, and tweezer all would have come in contact with the laser. My simple question is while the laser beam light was used in the area inside the mouth, will not the instruments that were used along with the procedure would come in contact with the laser beam? If so, there could be saliva and the wetness from the procedure that the laser should have dried them up. Because nowadays, the dental clinics claim that laser light can kill virus lesions?. Honestly doctor, could you please tell me the risk factor I have in this case? I assure you I will not panic but I need to know the truth. I am saying this because many doctors claim that by using laser they reduce the chance of post-operative surgery. If that is the case then the instruments that were used in the process should also have been exposed to a certain level of laser light though not fully destroying the virus or bacteria present on the instruments but still to a certain level reducing them.

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • It is tough to ascertain the risk if at all there was any such possibility.
  • There are no data available to specify the percentage of risk in case of herpes. This is because most of us would have had a subclinical infection early on in our life itself and almost 85% of the population would test positive for antibodies.
  • There cannot be any definitive way to quantify the risk; however, I would believe that no doctor would use an already used equipment without sterilisation atleast in good clinics.
  • Hence you need to have faith and keep moving on rather than upsetting yourself.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

Because of this fear, last year I did check myself for antibodies. All the tests were negative. Believe me, from that moment, I have never ever kissed anyone even if it was a child or drank from anyone's bottle, used a spoon, used plate or had any juice from hotel tumblers nor had food from hotel spoons. I rather wash my hands and use my hands to eat when I am in a hotel. Today when I was checking my lower lips, I saw this red spot on the left side of my lower lip area. It was in this area that they did the deep cleaning but I should tell you that even before using the instruments when the doctor pulled my lower lips for placing the injection and numbing solution, it felt burning like you feel when someone pull and tweeze your lips. Then no pain or anything. Even today, no burning sensation but I feel a slight pain if I press my lips in that area. Even the lip balm I use is exclusive to me and I wash my hands two times before touching my lip balm every time. I have attached photographs for your reference. Could you please help me?

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • The clinical images that you have attached (attachment removed to protect patient identity) are not in favor of herpes.
  • It just looks a little bit of erythema and I cannot make out any blisters.
  • The incubation period of herpes is usually two to five days. So, in case it was the viral infection it would have developed vesicles by now.
  • Moreover, as your test result is negative, it absolutely rules out the chance of an infection.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

So, you say that if yesterday the instruments used on me would have been used once then the incubation period for that would be two to five days and since it is only 24 hours it cannot be that? Also since my previous test results were negative, it cannot be herpes at all right? So what can I apply for that? I have hydrocortisone acetate cream with me. Can I apply that? Is it safe? I have the cream with me always since I have cheilitis problem and sometimes the doctors in this forum and the doctor that I see recommend me to use it. I have attached photos which I took just now. The time between the earlier photos and the ones that I have taken now is five hours.

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • Yes, it looks mostly like a bit of early cheilitis.
  • I suggest you use a little of petrolatum or Vaseline (Glycerin, Stearic Acid, Isopropyl Palmitate, Glycol Stearate, Peg-100 Stearate, etc.) and Hydrocortisone cream for five days only at night.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

Can you please explain to me more in detail about this incubation period you were talking about? You said in the earlier answers that the incubation period is two to five days and if it was that infection then the vesicles must have formed by now? Can you please explain me? I do not want to confuse myself with the possibility of explanation with this.

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • I meant that once there has been a suspected exposure, the disease manifests itself within two to five days.
  • In case of already infected people, the reactivation occurs much quicker due to the stress of any procedure.
  • In your case, as your procedure had started a week back and had a repeat session yesterday, there should have been manifestations of blisters by today, which is not the case.
  • Moreover, your test results are also negative.
  • There is nothing to confuse, you can stay assured that you have not acquired any herpes as of now.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

Last week the instruments used were all sealed and removed in front of me whereas only on the second sitting during the injection part, the instruments were sealed and during the cleaning part, the instruments were in open. Thus, I suspect that they would have used instruments given to the last patient. So now what to do you think of this scenario? Also when you say incubation period of two to five days, How are the days calculated?

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • You could then wait until this weekend and see if you have developed any lesions. There is no available test to confirm if you are infected at this point in time.
  • Moreover, the stress of being infected could itself lead to reactivation of subclinical herpes infection.
  • So it would get really tough to say what led to the disease, the instruments or your mental stress?
  • And there is no way to prove that the instruments were not sterilized as it is very unlikely to happen so.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

I request you to please answer my questions in detail. 1) I have another session of dental cleaning (deep cleaning) of the upper set of teeth tomorrow. If I postpone it to another week and until that time no symptoms appear then can I be sure that I have not got exposed to the virus? 2) Apart from the IgG tests which can be taken four to six weeks after the possible exposure, can you please give me some knowledge on IgM. In many forums, they say that you can take those tests after a few days. Is it true? 3) If the person did not have an active flare then how long will the virus stay on dental equipment? 4) In some websites, they have mentioned that the virus is very fragile so it will not stay more than 10 seconds outside the body unless it is damp. So, my question is how long does the saliva take to dry?

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • Yes, if you do not develop any symptoms in the next five days then you can assume you have not been infected.
  • The IgM levels are more helpful in detecting acute or active infections and are the investigations of choice. IgG only suggest past immunity.
  • If the previous patient did not have any active flare, it is unlikely he would be shedding any herpes virus. He would not be a source of infection at all.
  • The saliva would dry up within minutes and the virus usually cannot survive for long on fomites.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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Thank you doctor,

If four days ago was the day of exposure then tomorrow is the fifth day of exposure. Am I right? So even if I did not have any infection can I still get an IgM test done to rule out my fear. If so, how many days later I can take the test? You said saliva will dry in minutes. It was around 20 minutes after the last patient that my appointment started. So, would the will the saliva dried out that soon. if saliva us dried out then no need for fear right? and when you meant fomites did you mean the dental instruments? Lastly, I amsorry for disturbing you in your busy schedule but I amhelpless and I am in need of help from someone who has extensive knowledge. This is the reason I have been asking you.

Dr. Rakesh Kumar Bahunuthula

Cosmetology Dermatology HIV/AIDS Specialist Venereology
#

Hello,

Welcome back to icliniq.com.

  • Yes, five days is the usual upper limit for herpes infection.
  • The IgM levels would be positive by one week after a suspected infection. So if you are worried, you could still go for it.
  • It is highly unlikely that herpes would get transmitted by sharing things especially when the person does not have any active infection at all.
  • There are no documented studies either to suggest that the virus can survive outside the human body.
  • There is no way to prove that instruments could lead to a transmission of herpes too.

Regards.

For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist


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