Patients & Families
As health care professionals, dentists have the moral, ethical and legal obligation to attend to the oral health needs of all patients. One of the earliest findings in the 20-year history of the HIV epidemic is that oral health was a frequent problem among HIV-infected individuals, with oral complaints. In fact, opportunistic oral lesions and infections are often the first manifestations of HIV. There are more that 16 conditions that can occur in the oral cavity of HIV-positive persons, among them infections and malignancies that are potentially life threatening. Thus, health experts agree that HIV-positive individuals (as well as those at increased risk for the disease) should see a dentist regularly. HIV-infected individuals with more-advanced disease are more likely to need dental care than those in the earlier stages of the disease. But people in the advanced stages of HIV also tend to have more medical and mental health problems, which might make them less likely or able to seek needed dental care. Those who reported poorer physical and mental health were less likely to have visited a dentist. Additionally the socioeconomic status associated with the growing HIV AIDS population of North Carolina exhibits a number of the characteristics that affect the likelihood of perceiving an unmet need for dental care. The HIV population in North Carolina is largely African American, low income and low education. People who are low income are more that twice as likely to have tooth decay (CDC 2005). Less educated adults are more likely to experience destructive periodontal disease and eventually loose all of their teeth. HIV exacerbates these conditions.
Oral manifestations of HIV/AIDS and poor oral health are deleterious to the morbidity of the systemic illness. Often times patients who are self referred and/or are referred by their physicians enter dental treatment after oral disease development and progression. Provision of education and comprehensive treatment at the inception of HIV/AIDS treatment should significantly decrease oral morbidity in this population and should positively impact oral quality of life.
In 2004, 1,641 new individuals were diagnosed with HIV in North Carolina with recent data reporting an average increase of 1,700 new cases each year. The project will involve a collaboration effort between UNC Hospitals’ Infectious disease and dental clinics, Chapel Hill, NC, Moses Cone Hospital, Greensboro, NC, and Lincoln Community Health Center, Durham, NC, henceforth referred to as the UNC HIV Network. Combined, these areas accounted for 452 cumulative HIV cases in 2005. A total of 200 HIV patients will be recruited into this study, 100 newly diagnosed HIV patients identified in the UNC HIV Care Network will be referred to UNC for consent, initial oral examination, and baseline data collection. In addition, 100 HIV patients currently in active dental treatment will be recruited for comparison data. We will evaluate the benefits to overall health of these patients by providing comprehensive dental care, dental prophylaxis, and education services to 200 HIV-infected patients as well as evaluate improvement of systemic markers of disease progression. This model will help create an infrastructure to promote a comprehensive and continuous oral health care plan for HIV infected individuals at diagnosis and throughout their illness and life.