Is there still a risk of HIV transmission at the dentist's office? I remember that was a big issue several years back. My new dentist is a gay man, and although I am not biased and think he's a great dentist, I wonder if HIV transmission during dental procedures is still a worry.

C.S.

The risk of a health-care worker transmitting HIV (human immunodeficiency virus, which causes AIDS) to a patient is extremely low. Several years ago, there was a report of HIV transmission from a Florida dentist to six patients. DNA studies provided excellent evidence that the transmission indeed occurred in that manner, because they showed the patients were infected with the same strain of virus the dentist had. After this episode, multiple research studies have examined whether HIV transmission has occurred in similar settings. The results have not yielded any proof of further transmission. That is not to say that it has never or will never occur -- only that it is extremely rare.

Here is what you should watch out for in the dentist's office, or any other health-care setting. You should always make sure your dentist wears gloves when he or she puts hands in your mouth or performs any procedure. If there are any small cuts or sores on his or her hands, the gloves should protect you. You should ask how the office sterilizes the instruments, and you should ensure that any needles used come from an unopened, sterile package.

At a physician's office, it is not necessary that gloves be used for a routine examination. If a procedure is performed, even a gynecologic exam, the doctor should wear gloves at all times. Do not be afraid to ask your doctor the questions about instruments that I mentioned above. A physician should never be offended, and if he or she is, maybe you should get another doctor. Your life is more important than his or her ego.

I noted your comment that the dentist is a gay man. We all know that HIV has been very common in the gay community. In the early part of the AIDS epidemic, the vast majority of cases were among homosexual men. In the United States, men who have sex with men still account for the largest number of people reported with AIDS each year. The percentage of cases in this group has fallen, but it is still the highest of any group. That said, it is inappropriate to worry that each homosexual male in the community could give you HIV. You should certainly worry if your sexual partner or needle-sharing partner may have HIV -- everyone should. But I would not be concerned that your health-care provider is a male homosexual.