The Unsolved Mystery Of The AIDS Dentist

By Alan Boyle on Friday, October 25, 2013
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“My curse upon thy venom’d stang, / That shoots my tortured gums alang.” —Robert Burns, Address to the Toothache

In A Nutshell

In the late 1980s, Dr. David Acer, a dentist working in Florida, passed an HIV infection to six of his patients. There have only been three other instances worldwide since, making Dr. Acer responsible for two-thirds of people ever infected by a healthcare worker. No one has any idea how it happened. Some suggest he did it deliberately, but there is neither evidence nor a plausible method that anyone can think of. It is a medical mystery that will probably remain unsolved.

The Whole Bushel

In 1991, a young Floridian woman named Kimberly Bergalis died as a result of AIDS. She is recorded as the first person in history to have been infected by a healthcare worker, her dentist Dr. David Acer. He had pulled two teeth from Kimberly and in the process passed on his infection. Hundreds of Dr. Acer’s other patients were tested and ultimately five more were found with the infection. Emily’s family sought to put things right by fighting for a ban on healthcare workers with the virus performing invasive procedures. Her father said, “someone who has AIDS and continues to practice is nothing better than a murderer.”

George Bergalis’s anger was understandable, but the intervening decades have shown it was misplaced. At the time, 19,000 patients of 57 other infected healthcare professionals were tested—none had caught the virus from their treatment. The risk of transfer of infection to a patient undergoing a highly invasive procedure (such as an open-heart transplant) from an infected doctor is around 1 in 5 million. That’s about the risk of being struck by lightning. The odds of one dentist infecting six people by accident are, therefore, ridiculous.

Acer might have infected his patients on purpose. A former colleague suggested a motive; Dr. Acer was angry that mainstream America struggled to care about HIV because it was seen as a disease that impacted homosexual men and drug addicts. The colleague says Acer told him, “when it starts affecting grandmothers and younger people, then you’ll see something done.” Yet this theory also has its own weaknesses: How could he have done it?

Almost the only plausible way that Acer could have done it is to have injected his own blood into patients. Yet contact with HIV-positive blood only passes on the infection only one time in 300 and none of his colleagues or patients ever noticed anything unusual. Acer would have only been able to pass on small amounts of his own fluids—his infection rate is high even if he was doing it on purpose. In addition, a review by the Federal General Accounting Office ordered by Congress found “no good evidence” that Acer made any effort to infect anyone.

So what could have happened? There are many theories. His strain of the disease may have been particularly virulent, or he may have had a particularly high viral load. Alternatively, he may not have caused the infections at all. An investigation by an insurance company called into question the CDC’s investigation, claiming that the patients all had alternative sources of infection risk. In a town of just 10,000 people, it’s not hard to imagine how a bunch of people could pass the disease among themselves. Those infected also had financial incentive in the form of compensation that may have altered their testimony.

Acer and most of his infected patients have since died. It seems likely we will never know whether it was an astonishing cluster of accidents, an ingenious murder plot or a whole lot of misplaced blame.

Show Me The Proof

HIV/AIDS: Four cases of transmission
UK Dept. of Health: Consultation on HIV positive healthcare workers launched
NY Times: AIDS and a Dentist’s Secrets

  • WhiteExodus

    The only explanation is the AIDS fairy, the cousin of the Tooth Fairy.

  • CariHislop

    It’s completely illogical to assume the dentist is the common denominator, just because he was their dentist (who had aids). The truth is probably way more bizarre. His reception room might have become a meeting place for tooth-fetished swingers to meet. In a town that small (10,000) which depending on its isolation is certain to have a certain extent of inbreeding – I could come up with endless scenarios.

    • WhiteExodus

      The AIDS fairy being one of them?

    • Carla Kirkland

      You’re a nut, CariHislop.

  • Hadeskabir

    We all know who was responsible. It was Cartman from South Park! I saw him giving AIDS to Kyle the other day.

  • The Ou7law

    I blame it on aliens, George bush and the crazy cat lady

  • Sweet-Sativa

    Went in to get a tooth removed, and came out with aids. Brutal.

    • gillybean

      Yeah, more than a rough day, that. Dentists are all sadists anyway. Why else would you take a job that involves causing people pain, wearing a scary mask n using some scary as toolbox to boot?

      • Sweet-Sativa

        Yeah im suspicious about dentists too.

        • DreaTheGreat

          You have obviously never met an oral surgeon.

          • Sweet-Sativa

            No, cant say that I have but im willing to wager they are fine folks.

  • truevijay

    I dont know about patients getting aids from healthcare professionals, but the vice versa is a scary prospect especially for those of us working in the government health sector of a third world country. Sometimes even protective gloves are scarce.

  • paul marchand

    Good article.

  • Private_Eyescream

    Horny Dentist + nitrous oxide = passed out rape
    Plenty of cases of that combo documented in the news already.

  • Private_Eyescream

    Next highest probable option
    Dental drilling tool + oral blood + insufficient sterilization = Blood borne disease spreading to every patient that follows the infected patient.

    Plenty of documented cases of that oversight or incompetence causing human suffering.

  • Carla Kirkland

    Well, allow me to sweeten the story. I was one of his patients. Why? I already had a dentist…. I went to him because the town WELCOME WAGON brought me a COUPON in their “WELCOME to Jensen Beach” basket! Top that one! Dr. Acer FILLED my wisdom tooth cavity and next appointment wanted to EXTRACT the same tooth. I thank God every year that I found that odd and never went back to him. Imagine my reaction when I read about him in the newspaper before the CDC even contacted me. And yes, I was tested, MORE than once. He was doing it on purpose. I will never be convinced otherwise.

    • Lizzie Beth

      @Carla,

      I always suspected he did it on purpose as well but hearing your story just cements the fact. Why would a dentist fill a tooth then want to extract the same tooth!!!

      He definitely had it all planned and seemed to target based on an array of diverse characteristics. I read those infected by him were ages 15 to 65 so he definitely knew what he was doing.

      How low can a person be to take anybody’s life is beyond me.

    • Forbidden Fruit

      Holy crap! Glad you listened to your intuition. I’ve never heard of filling a wisdom tooth. They’re usually just extracted or left alone, as they tend to grow in rotten/crooked or not at all. The fact that he wanted to extract it THE NEXT VISIT after filling it is what’s scary. :-O

      Acer sounds incredibly shady. The HIV transmission seems to have occurred during extractions, which makes sense as tooth extraction leaves an open hole for the virus to enter. Maybe he was filling needles with his own blood when nobody was around, or cutting his finger while patients were sedated. Blech. {Shudders}

      Thanks for chiming in. This story has always fascinated me. I’d love to hear from other ex-patients.

  • ARIK KATZENBERG

    Ill clear up this mystery for you right now. The HIV passed from Acer to the 6 patients was determined thru phylogenic studies to be identical to Acer’s strain, thus proving definitively that Acer was the sole cause of their HIV infection. Acer was diagnosed with AIDS in ’87, thus his viral titers were incredibly high. Acer’s HIV manifested in Kapok’s Sarcoma including KS on the roof of his mouth. His oral surgeon noted oozing of his KS lesions, which is not uncommon. Its very likely Acer used his own dental equipment to inspect or probe his mouth, and his bleeding gums prior to his AIDS diagnosis. Studies have demonstrated the survivability of HIV on surfaces for up to 6 days, and up to 6 weeks in injection needles. Acer’s office did not have an autoclave and according to most reports was not very good at steam cleaning dental equipment. The most likely route of transmission was during invasive procedures using HIV tainted equipment. Alternatively, AIDS often results in neuropathy and its possible Acer had unknowingly cut a finger which then transmitted blood into the open wounds of his patient’s mouth.