Barriers to dental care and dental caries status in people living with HIV
DOI:
https://doi.org/10.14456/taj.2024.1Keywords:
HIV, barriers to dental care, DMFTAbstract
This cross-sectional study aimed to identify barriers to dental care, assess dental caries status, and determine associated factors in people living with HIV at a public hospital in southern Thailand. Data were collected using a self-administered questionnaire and a dental examination to assess dental caries, extractions, and fillings. Of the 151 participants, 77 were females (51.0%), with an average age of 44.0 years. A significant proportion (67.5%) of the HIV-positive participants had not received dental care in the preceding 12 months. Barriers identified included long waits at the dental office (45.7%), the need for a new appointment (17.8%), dental fear (17.2%), and dentist declinations or referrals (13.9%). The mean decayed, missing, and filled teeth (DMFT) index was 7.8. The statistically significant difference in factors associated with dental caries status (p<0.05) included being female, being over 35 years of age, having a CD4 count of less than 500 cells/mm3, brushing teeth before bed, using mouthwash, and possessing a certain level of oral care knowledge. Dental caries and lack of dental care were prominent issues for people living with HIV. The issues arising from dental service provision should be addressed to enhance access to dental care and mitigate problems stemming from discrimination by dental personnel. Additionally, imparting knowledge on oral care to individuals living with HIV is crucial and should be implemented across all service units.
References
Department of Disease Control. Estimated HIV infections Thailand [Internet]. Nonthaburi; 2022 [Cited 2023 Oct 9]. Available from: https://hivhub.ddc.moph.go.th/epidemic.php
Srithanaviboonchai K, Stockton M, Pudpong N, Chariyalertsak S, Prakongsai P, Chariyalertsak C, et al. Building the evidence base for stigma and discrimination-reduction programming in Thailand: development of tools to measure healthcare stigma and discrimination. BMC Public Health [Internet]. 2017 [updated 2017 March 11; cited 2023 Oct 17];17:245. Available from: https://doi.org/10.1186/s12889-017-4172-4
Department of Disease Control. HIV stigma and discrimination survey guidelines and procedures manual “health care provider”. Nonthaburi: National AIDS Management Center; 2015.
Krabi Provincial Health Office. HIV-related stigmatization and discrimination on people living with HIV and Thai health service providers. Krabi: Krabi Provincial Health Office; 2019. (in Thai)
Rungsiyanont S, Lam-Ubol A, Vacharotayangul P, Sappayatosok K. Thai dental practitioners' knowledge and attitudes regarding patients with HIV. J Dent Educ. 2013;77(9):1202-8.
Nazir M, Blinkhorn FA, Reilly D, Sedgewick K. The provision of dental treatment for HIV positive patients in Manchester. International Journal of Health Promotion and Education. 2005;43(1):11-6.
Rungsiyanont S, Vacharotayangul P, Lam-Ubol A, Ananworanich J, Phanuphak P, Phanuphak N. Perceived dental needs and attitudes toward dental treatments in HIV-infected Thais. AIDS Care. 2012;24(12):1584-90.
Nittayananta W, Talungchit S, Jaruratanasirikul S, Silpapojakul K, Chayakul P, Nilmanat A, et al. Effects of long-term use of HAART on oral health status of HIV-infected subjects. J Oral Pathol Med. 2010;39(5):397-406.
Tappuni AR. The global changing pattern of the oral manifestations of HIV. Oral Dis. 2020;26(1):22-7.
Ottria L, Lauritano D, Oberti L, Candotto V, Cura F, Tagliabue A, et al. Prevalence of HIV-related oral manifestations and their association with HAART and CD4+ T cell count: a review. J Biol Regul Homeost Agents. 2018;32(2 Suppl. 1):51-9.
Vohra P, Nimonkar S, Belkhode V, Potdar S, Bhanot R, Izna, et al. CD4 cells count as a prognostic marker in HIV patients with comparative analysis of various studies in Asia Pacific region. J Family Med Prim Care. 2020;31;9(5):2431-6.
Navazesh M, Mulligan R, Barron Y, Redford M, Greenspan D, Alves M, et al. A 4-year longitudinal evaluation of xerostomia and salivary gland hypofunction in the women's interagency HIV study participants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(6):693-8.
Bureau of Dental Health. The 8th national survey of dental health, Thailand (2017). Bangkok: Department of Health; 2018. (in Thai)
Broadbent JM, Thomson WM. For debate: problems with the DMF index pertinent to dental caries data analysis. Community Dent Oral Epidemiol. 2005;33(6):400-9.
Bloom BS. Taxonomy of education objective handbook. New York: David Mckay Company Inc; 1975.
Petersen PG, Baez RJ. Oral health survey: basic methods, 5th ed. Geneva: World Health Organization; 2013.
Parish C, Siegel K, Pereyra M, Liguori T, Metsch L. Barriers and facilitators to dental care among HIV-infected adults. Spec Care Dentist. 2015;35(6):294-302.
Giuliani M, Lajolo C, Rezza G, Arici C, Babudieri S, Grima P, et al. Dental care and HIV-infected individuals: are they equally treated? Community Dent Oral Epidemiol. 2005;33(6):447-53.
Aleixo RQ, Scherma AP, Guimaraes G, Cortelli JR, Cortelli SC. DMFT index and oral mucosal lesions associated with HIV infection: cross-sectional study in Porto Velho, Amazonian Region - Brazil. Braz J Infect Dis. 2010;14(5):449-56.
Saravani S, Nosrat ZT, Kadeh H, Mir S. Dental health status of HIV-positive patients and related variables in Southeast Iran. Int J High Risk Behav Addict [Internet]. 2016 [cited 2023 Oct 18];5(2):e29149. Available from: https://doi.org/10.5812/ijhrba.29149.
Shaghaghian S, Homayooni M, Amin M, Rezazadeh F. Oral health status of patients infected with human immunodeficiency virus and related factors, Iran: a cross-sectional study. BMC Oral Health [Internet]. 2021 [cited 2023 Oct 18];21(1):657. Available from: https://doi.org/10.1186/s12903-021-02002-3.
Phelan JA, Mulligan R, Ivelson E, Brunelle J, Alves ME, Navazesh M, et al. Dental caries in HIV-seropositive women. J Dent Res. 2004;83(11):869-73.
Nayak SK, Das BK, Das SN, Mohapatra N, Nayak S, Bhuyan L. Oral manifestations of human immunodeficiency virus/acquired immunodeficiency syndrome and their correlation to cluster of differentiation lymphocyte count in population of North-East India in highly active antiretroviral therapy era. Contemp Clin Dent. 2016;7(4):539-43.
Kalanzi D, Mayanja HK, Nakanjako D, Mwesigwa CL, Ssenyonga R, Amaechi BT. Prevalence and factors associated with dental caries in patients attending an HIV care clinic in Uganda: a cross sectional study. BMC Oral Health [Internet]. 2019 [cited 2023 Oct 18];19:159. Available from: https://doi.org/10.1186/s12903-019-0847-9.
Aminabadi NA, Balaei E, Pouralibaba F. The effect of 0.2% sodium fluoride mouthwash in prevention of dental caries according to the DMFT index. J Dent Res Dent Clin Dent Prospects. 2007;1(2):71-6.
Youssef L, Hallit S, Sacre H, Salameh P, Cherfan M, Akel M, et al. Knowledge, attitudes and practices towards people living with HIV/AIDS in Lebanon. PLoS One [Internet]. 2021 [cited 2023 Oct 18];16(3):e0249025. Available from: https://doi.org/doi: 10.1371/journal.pone.0249025.
Soufi LR, Davoodi P, Abdolsamadi HR, Jazaeri M, Malekzadeh H. Dental caries prevalence in human immunodeficiency virus infected patients receiving highly active anti-retroviral therapy in Kermanshah, Iran. Cell J. 2014;16(1):73-8.
Thanapaisal S. Oral health status and associated factors of HIV-infected patients with different duration of High Active-Antiretroviral Therapy (HAART) in Samutprakarn hospital. Region 11 Medical Journal. 2018;32(3):1155-64. (in Thai)
Murererehe J, Malele-Kolisa Y, Niragire F, Yengopal V. Prevalence of dental caries and associated risk factors among people living with HIV/AIDS and HIV uninfected adults at an HIV clinic in Kigali, Rwanda. PLoS One [Internet]. 2023 [cited 2024 Mar 13];18(4):e0276245. Available from: https://doi: 10.1371/journal.pone.0276245.
