HIV Dental Management — ORE Part 1 MCQ

Correct answer: E — Standard infection control precautions; no additional measures required

Patients with well-controlled HIV (CD4 >500 cells/μL, undetectable viral load on antiretroviral therapy) have immune reconstitution equivalent to adequate immune function for routine dental procedures. UK dental guidance (SDCEP) mandates Standard Infection Control Precautions for all patients universally; no escalation is required based on HIV status alone when the patient is well-controlled. Option D is incorrect: prophylactic antibiotics are not mandatory for routine extractions in well-controlled HIV without additional risk factors (e.g., neutropenia, thrombocytopenia). Option B is incorrect: routine extractions can be performed in primary care dental settings. Option C is incorrect: double gloving and face shields are not legally mandated above standard precautions for well-controlled HIV; standard universal precautions suffice. Option A is incorrect: pre-operative blood tests are not routinely required unless clinical indicators (poor healing, low platelet count) suggest need. This item tests understanding of HIV immunological markers, transmission risk stratification, and proportionate clinical reasoning.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Practice Support Manual: Infection Prevention and Control in Dental Practice; NHS National Services Scotland, National Infection Prevention and Control Manual. https://www.psm.sdcep.org.uk/topics/infection-prevention-and-control/infection-prevention-and-control-in-dental-practice/