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The Role of Dental Care in HIV

HIV and the Need for Regular Dental Care


Updated June 13, 2014

Dental care is the forgotten part of a healthy lifestyle. But while its importance is often underestimated, the need for regular dental care can not be overstated. Our set of teeth will last us a lifetime with the proper preventative dental care. For the HIV positive patient, regular dental care is not only to maintain the health of your teeth but also your entire body. Poor oral and dental health can result in serious infections of the mouth, the teeth, and the entire body. Let's take a look at oral health and dental care and how it relates to the HIV positive patient.

Functional Oral Health

Experts agree that HIV patients must maintain functional oral health in order to receive adequate nutrition. What is functional oral health? Simply, HIV positive people must maintain a healthy mouth and healthy teeth in order to eat properly and get the nutrients they need to stay healthy. Mouth and teeth pain interfere with eating, meaning the HIV positive person will not take in enough calories, vitamins, and nutrients to maintain a healthy diet. Functional oral health simply means maintaining your mouth and teeth so you can eat properly.

The Importance of Good Dental Health

Too many people take their dental health for granted until they get a toothache or “canker sore” that makes eating an adventure in pain. Besides interfering with eating, poor oral hygiene is a breeding ground for fungal, bacterial, and viral infections that can affect the entire body. While this is true for most anyone, people with weakened immune systems such as those living with HIV and AIDS are especially at risk. Mouth ulcers, gum disease, and tooth decay are all conditions that can cause serious illness elsewhere in the body if left untreated. There are several reasons good oral health is important to the HIV infected person.
  • Poor dental health including loose, missing, or painful teeth can severely impact the HIV positive patient’s ability to eat. Being unable to eat, proper nutrition becomes impossible, making HIV progression inevitable.
  • Health issues in the mouth can be one of the first signs of HIV infection and is a predictor of HIV progression probability.
  • A weakened immune system can be further stressed by poor dental health.
  • Mouth ulcers, gum ulcers, and decayed teeth can be portals that allow bacteria and other infectious organisms into the blood stream.
  • Identifying oral health concerns early allows for treatment before those problems progress to other more serious infections.

Barriers to Dental Care

Despite the proven importance of regular dental care for the HIV positive person, there are still considerable barriers to getting that care. A study from 2003 reported the three most common barriers to dental care include cost (30 percent), fear of the dentist (19 percent), and low motivation to go to the dentist (13 percent). Those barriers and a variety of others translate into unmet dental needs. In fact, the same study reported 65 percent of HIV patients had unmet dental needs over the previous three years. Let’s take a closer look at the barriers to dental care for the HIV positive patient.

  • Cost - Like all medical care, dentistry is expensive; so expensive in fact that the cost is a deterrent to getting needed dental care. There is dental insurance but like medical insurance it’s usually provided through an employer. If the person is unable to work full-time because of health concerns that person may not have access to dental insurance. If they are lucky enough to have dental insurance, it's often inadequate to cover the entire cost of the services they need. There are publicly funded dental care options that provide most basic services -- yearly exams and cleanings for instance. Some states have dental assistance programs with funding provided by the Ryan White CARE Act however; these programs have limited funds and often have to turn away new applicants. In rare instances, cities, counties or universities have community dental clinics that offer free or discounted dental care, but again offer only the most basic services.

  • Fear - Fear of the dentist is so common there is a medical term for this very real condition. Dentophobia is defined as a morbid, irrational fear or aversion to going to the dentist. Whatever you call it and however it is defined, fear does get in the way of HIV dental care. Sometimes the fear is rooted in a bad experience at the dentist, to some it’s the sound of the drill and the fear of needles. Others fear the pain associated with dental procedures. For HIV patients, they have the additional fear of disclosing their HIV status and the prejudice that arises from an HIV diagnosis.

    Your dentist can't help you overcome your fear unless you make him aware you have one. It may be a bit embarrassing but the dentist will understand. Your dentist will not judge you, and will be able to offer you options that will help ease your fear, making your trip to the dentist much less trying. Getting to know your dentist a little better will help diminish that fear. Think of it this way: Facing your fear and getting past it is necessary to maintain your dental health and ultimately your overall health. Have the discussion with your dentist. It will be well worth it.

Page 2 - More reasons you need proper dental care...

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