Miami Herald (MH) - Saturday July 13, 1991
Jeffrey Kleinman; Herald Staff Writer

"It's one of a number of possibilities that we're considering," said Dr. Harold Jaffe, deputy director for science in the HIV-AIDS Division of the CDC. "It's something we thought about all along with many other possibilities."

Acer was not able to sterilize the inside of the handpiece, where blood might collect, Jaffe said. The sterilization of newer model handpieces is now part of the infection-control guidelines of the American Dental Association.

"All the dentist could do would be to simply wipe down the outside," Jaffe said.

Dental association spokesman Philip Weintraub says it's possible, but unlikely that Acer spread the HIV virus with a handpiece, on which a drill bit, toothbrush or other instruments are attached. If handpieces were a common route of AIDS between dentist and patient, there would have been more instances of hepatitis, a virus more easily transmittable than HIV, Weintraub said.

The last dentist-patient hepatitis case was recorded in 1987, according to the CDC.

A University of Georgia researcher, who studied the drill equipment last year, said there's no doubt that Acer's handpiece infected five of his patients.

Kimberly Bergalis of Fort Pierce was the first of Acer's patients to be diagnosed with the disease. Acer died last year. Bergalis is close to death.

Dr. David Lewis, a senior research associate at the University of Georgia, said the internal parts of the six-inch-long handpiece -- which can enter a patient's mouth -- collect bone, saliva, tooth fragments and blood.

"It's a major risk," he said.

Lewis surmises that either contaminated blood from an HIV-infected patient, one of Acer's sexual partners, or even Acer's own blood, got into the handpiece and spread to other patients. Despite its name, a handpiece frequently ends up in a patient's mouth, he said.

The CDC has said that Acer, who died of AIDS, was treated in his office with the same tools he used on patients.

The July issue of the newsletter AIDS Alert blamed Acer for sloppy infection-control practices. According to the newsletter, the dentist left old syringes lying around and left tool trays in the open long enough to gather dust.

The Centers for Disease Control has said that Acer most likely spread the virus through blood-to-blood contract, though the agency has not yet detailed exactly how.

Jaffe said the CDC has been unable to determine what sequence patients were seen or even what chairs and equipment they used because Acer's logs have been discarded.

"I'm not optimistic if I'll ever know for sure what happened," he said. "The dentist is dead, his practice is closed and many of the original records were destroyed."

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