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The HIV/AIDS Program: Part F Community Based Dental Partnership Program

 
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Section 1: Filling Gaps in HIV Dental Care

Ryan White Community
Based Dental Partnerships
  • Twelve Dental Partnerships in 13 states have formed networks of community-based HIV dental care, comprised largely of University-based dental schools and 50-plus agencies to extend access to oral health.

  • Dental care was provided to 4,328 people living with HIV in 2006—an increase of 34 percent from 2004, the first full year of program operations.

  • In 2006, there were 22,566 service visits for a range of comprehensive dental care services—an increase from 13,705 in 2004.

  • In 2006, 943 dental providers were trained—primarily, dental school students, residents, dental hygienists, and others— an increase from 766 in 2004.

Oral Care: An Essential HIV Service

The vast majority of dental care that an HIV infected person requires is no different than what an uninfected person would typically need. However, good dental care for PLWH is not a routine matter because oral health is a crucial component of overall health care for an infected person. The potential outcomes of getting such care, or not receiving it, are notable.

  • A significant number of HIV-infected individuals have oral health conditions due to their diminished immune system. [ 8 ] These manifestations usually decrease once HIV antiretroviral therapy has begun. However, PLWH who have persistent or recurring oral lesions, tooth decay, and gum disease may experience a decline in their overall health and diminished effectiveness of antiretroviral therapy. These problems can be caused by compromised nutritional intake, poor absorption of HIV medications, and decreased adherence to treatment regimens. PLWH who are on antiretroviral medications should see a dentist regularly to check for cavities and gum disease, to receive oral soft tissue examinations, and to monitor the state of their overall health.
  • Encounters in oral health care provide opportunities to address lifestyle behavior practices and prevent disease, such as smoking cessation assistance and nutrition counseling.
  • A visit to the dentist may be a health care milestone for the patient. The dental professional, properly trained, can address oral health concerns and, improve the quality of doctor-patient communication, and even play a role in helping engage or re-introduce patients into the health care system and coordinating their care with other primary care providers.

Increasing access to dental services for low-income and at risk populations can also translate into a greater role for dentists in linking people with HIV to care earlier. Consider that the first indication of HIV infection is often through an oral condition such as a thrush infection, ulcers, warts, or oral cancer. [ 9 ] Dentists are well positioned to pick up on signs like these and help link more people with HIV into care earlier, which continues to be challenging despite years of outreach efforts across the nation. Recent data indicate that 38 percent of HIV-infected individuals in the U.S. learn their HIV status late, within one year of a late-stage AIDS diagnosis.[ 10 ]