Ministry fears dental surgery link to CJD

Ministry fears dental surgery link to CJD

July 13, 2001 Asahi News Service

Hospitals are being told to check the records of people who have contracted the brain-wasting disease.

Concerned that the use of dura mater during dental surgery could pose a risk of Creutzfeldt-Jakob disease (CJD), the health ministry is telling hospitals to check the records of people suffering from the deadly disease.

Dura mater, the thick, fibrous membrane that surrounds the brain and spinal cord, has been used by dentists to cover up incisions left after the removal of tumors in the mouth or to protect tissue damaged by gum disease. It may have also been used in the treatment of dental implants.

There have so far been no reported cases anywhere in the world of people developing CJD as a result of receiving dura mater in dental treatment. But CJD researchers say the risk of contracting the disease, although lower for dental patients than for those who have had dura mater transplanted directly into the brain, remains, and warrants further study.

The health ministry has alerted hospitals nationwide to the possible danger.

The Japanese importer of dura mater has already submitted to the Ministry of Health, Labor and Welfare a list of hospitals to which the material was sold. At least 30 hospitals nationwide have purchased dura mater.

Ministry officials said the dura mater most likely infected with the agent believed to cause CJD was sold until the early 1990s. The importer, however, said it has no list of hospitals to which it sold the material before 1987.

Ministry officials began contacting the hospitals on the importer's list in late May. A number of those hospitals, meanwhile, had already started checking the medical records of patients who may have received dura mater.

A hospital in Kyushu affiliated with a dental college reported three such cases between 1985 and 1988. The dura mater was used in the treatment of a disease affecting tooth sockets.

At a Kanto region hospital affiliated with another dental college, a number of cases were discovered between the early 1980s and around 1992. A professor at the dental college said he recalled using dura mater in the removal of mouth tumors from two or three patients.

The professor said the possibility of danger did not occur to him, as the material had been approved by the ministry. He added that he was surprised when he first heard about cases in which people contracted CJD after having dura mater implanted directly into the brain.

The ministry currently asks doctors of consenting CJD patients to provide details of past surgery the patients have received. Although the doctors are only asked to provide information regarding four types of surgery, officials are now considering adding a fifth category-dental surgery.

CJD is a fatal brain disorder that causes dementia and neuromuscular disturbances. There is no known cure and researchers have yet to determine its cause. About one person in a million develops the disease. In Japan, about 120 people develop CJD each year.

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