Hiv and oral health pdf
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- Oral health and health-related quality of life in HIV patients
- Oral Healthcare for the HIV-Infected Patient
- HIV/AIDS and Oral Health
- Oral Health Services
It is the most devastating illness of our time with respect to loss of human life and its associated social and economic costs. It is often the first clinical sign of the disease and usually the most common complaint of those suffering from the illness. Approximately 40 varying oral manifestations of the disease have been reported since the start of the AIDS epidemic.
Oral health and health-related quality of life in HIV patients
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Oral health policies for children living with HIV should be emphasised, and further studies should evaluate the mechanism underlying the relationship between oral and overall health.
In a general population of children, oral health status is an important contributor to the overall health status 1. Poor oral health is associated with a lower quality of life 2 and increases in the incidence of some infectious diseases 3. Dental caries is a common but preventable childhood disease 5 associated with tooth loss 6 and an increased risk of chronic diseases e. Dental caries are also associated with various manifestations of paediatric malnutrition, including low body weight and height 8 , 9 and iron deficiency These associations may be due to changes in dietary intake e.
Compared to uninfected children, children living with HIV CLWH face increased oral health risks, including the risk of oral lesions 11 , 12 and elevated rates of periodontal disease incidence and progression 13 , These discrepancies may be consequent to early childhood dental caries, which themselves may have arisen due to inadequate feeding practices intended to address a failure to thrive or the use of some antiretroviral drugs that contain sugar 14 , 15 , Moreover, antiretroviral drugs may delay dental development directly In other words, the detection and treatment of oral health problems in CLWH are particularly important in terms of maximising the quality and longevity of life Currently, the association between the oral and overall health statuses, and particularly between the dental health and immune status, of CLWH remains unclear.
Findings from a previous study revealed a significant association between the frequency of HIV-related oral lesions and the immune status However, few studies have addressed the associations of other oral health indicators, including dental health, salivary status and oral health-related quality of life, with the immune status.
Such associations, if present, might suggest that oral health affects the overall health status. Oral health is a significant problem affecting children in Cambodia. Therefore, the main objective of this study was to examine the relationship between the DMFT score and immune status e.
Initially, data were collected from children. After excluding nine subjects with incomplete or outlier data, subjects were included in the analysis. The mean duration on ART was 4. The children had mean overall health-related quality of life and oral health-related quality of life scores of Moreover, a significantly higher percentage of male children reported experiencing diarrhoea, compared to female children These observations suggest that a higher salivary pH level, an essential factor in the prevention of dental caries, is associated with a better immune status, while a worse dental health status is closely associated with a decreased immune status.
The former observation is consistent with the findings of a previous study Notably, reduced immunity or immunodeficiency may lead to a decrease in salivary flow, which may impede the recovery of the salivary pH level after eating Similar findings have been observed in patients with other diseases of immunodeficiency, such as end-stage renal disease A very similar result was reported among children with advanced-stage disease who participated in another study of CLWH aged 0.
Similar to our observations, those study findings suggest that a lower level of immunity is closely associated with a worse dental health status. This may be attributable to the presence of xerostomia, which is often diagnosed due to a lack of salivary flow in people living with HIV who present with advanced immune suppression 25 , As mentioned above, reduced salivary flow hinders the recovery of the salivary pH level and thus renders the oral cavity favourable to dental caries.
In terms of dental development, permanent teeth generally erupt earlier in female children, and thus male children face a later onset of the risk of caries. Furthermore, female children usually undergo menarche at approximately 10—13 years of age, and the resulting hormonal imbalances reduce their level of immunity According to that study, chronic postnatal malnutrition throughout childhood might have a mechanistic effect at the molecular level that would prevent age-appropriate physical and salivary gland development, resulting in the ineffective removal of dental plaque Such a molecular mechanism might also explain our observation that a high debris index score was associated with a lower HAZ.
In general, perinatally HIV-infected children have worse nutritional status than uninfected children, and our study population was no exception. Therefore, CLWH could be considered at risk of delayed salivary gland development and, consequently, at risk of a worse oral health status. Oral care should be promoted and provided to these children to compensate for the disadvantages of an impaired oral health status.
Our findings suggest that oral and overall health are closely related in CLWH. Possibly, an underlying mechanism exists by which HIV-induced advanced immune suppression yields an oral environment favourable for the reproduction of cariogenic bacteria However, the findings of other studies have suggested the opposite, namely that oral health influences overall health 3 , This is particularly true with respect to periodontal disease-causing bacteria, which are known to trigger the onset of acquired immune deficiency syndrome AIDS 34 , Further research is needed to clarify the influence of oral health status on immune status in HIV-infected populations.
Moreover, intervention studies are needed to demonstrate whether an improved oral health status can prevent the onset of AIDS or improve the overall health status. This study has some limitations. The cross-sectional design did not enable us to prove causality. We also did not examine changes in oral microbial colonisation and the effect of HIV on cariogenic bacteria in the participating children. Therefore, additional studies are needed to determine which factors affect the risk of dental caries in this population.
Furthermore, the use of a single-centre setting may have caused an inherent sampling bias. Therefore, our findings may be significant and applicable to the general population of CLWH in Cambodia. In conclusion, this study demonstrated associations of a better oral health status with better immune and nutritional status in CLWH in Cambodia. Our findings underscore the importance of promoting oral health policies for CLWH.
Further research is needed to clarify the mechanism between the oral and overall health status in this population. This study setting was selected because most CLWH in Phnom Penh and the surrounding regions undergo treatment at this hospital. Furthermore, this hospital includes all diagnostic and therapeutic paediatric departments, including antiretroviral therapy ART and dental clinic.
The majority of children treated at this hospital were provided antiretroviral drugs such as zidovudine, lamivudine and nevirapine, which were available in the form of syrups or tablets. The sucrose contained in these syrups is often considered to have cariogenic potential The overall framework of the study included interviews of both CLWH and their caregivers. CLWH aged 8—15 years were included in the analyses. The inclusion criteria were the receipt of care and treatment at the study site hospital and a duration under ART of at least 3 months.
We excluded children who were unable to respond to the interview items because of mental or physical illness. Next, a random number table was used to select candidates for study participation. The selected children were interviewed until the necessary sample size was achieved.
Randomisation was performed by research assistants other than the main researchers. Statistical significance and power were set at 0. We conducted face-to-face interviews of CLWH using a structured questionnaire.
Prior to the interview process, six research assistants participated in a 1-day training session intended to increase their understanding of the questionnaires. Subsequently, the research assistants administered the interviews to 10 participants not included in the main study as a pre-test.
We developed the interview questionnaire based on previous studies 37 , 38 , A higher score indicates a higher overall health-related quality of life. The oral health-related quality of life was assessed using the Child Perceptions Scale i. A higher score indicates a lower oral health-related quality of life. Regarding the dental status, we determined the DMFT score of each child by observing the teeth directly and calculating the number of teeth that were decayed, missing or filled.
The dentition status of each child was recorded on a WHO oral health assessment form A higher DMFT score indicates a worse dental status. A debris index score was then calculated based on the extent of staining on the dental surfaces, with a higher score indicating a worse plaque status.
All dental status and dental plaque data were collected by a dentist who participated in the research team. To increase reproducibility and assure calibration, one dentist examined the dentition status of all children according to the WHO guidelines Furthermore, the stained teeth were photographed to enable later verification of the scoring accuracy.
We measured the body weight kg and height cm of each child using electronic scales Omron, Kyoto, Japan and a manual stadiometer, which were calibrated to 0. First, the data were stratified by sex. Next, we conducted a multiple linear regression analysis of the associations between oral health indicators and overall health indicators in the participating children.
The oral health indicators included the DMFT score, debris index, salivary flow, salivary pH and oral health-related quality of life score. The age and sex of the child and duration of ART therapy were included as covariates. Variables that exhibited multi-collinearity were excluded from the analyses. Statistical software SPSS version All experimental procedures were performed in accordance with the relevant guidelines and regulations. All participation was voluntary, and the confidentiality of the subjects was maintained.
Rowan-Legg, A. Oral health care for children - a call for action. Child Health. Selwitz, R. Dental caries. Fejerskov O.
Oral Healthcare for the HIV-Infected Patient
The human immunodeficiency virus HIV is a retrovirus transmitted horizontally via direct contact with infected bodily fluids, including blood, semen, and vaginal fluids, or transmitted vertically from infected mother to infant during childbirth. HIV is a chronic infection that, if left untreated, will eventually result in failure of the immune system, characterized by specific clinical symptoms such as rapid weight loss, recurring fever, diarrhea lasting more than a week, and persistent enlargement of lymph nodes; risk for opportunistic infections such as candidiasis, tuberculosis, pneumonia, herpes simplex, and Mycobacterium avium complex; and death. The first published report of what would come to be known as HIV was released on June 5, According to CDC, at the end of , 1. The U. When a diagnosis is made too late in the disease's progression, substantial damage may have already occurred to the immune system. Moreover, a patient's lack of knowledge of infection and lack of symptoms for years after infection can lead to continued transmission.
The global burden of oral diseases and risks to oral health. Carga mundial de enfermedades bucodentales y riesgos para la salud bucodental. This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes.
HIV/AIDS and Oral Health
Rua Silva Jardim, 94, Vila Mathias. Santos, SP, Brasil. The objective was to understand how PLWHA deal with their oral health, in order to promote humanized and integral care.
Oral Health Services
Design : Quasi-Experimental study. Results : At baseline, There was a significant decrease in the prevalence of oral health related attributes among the cases but not the controls.
Metrics details. Information about demographic, socioeconomic status, depression, and other comorbidities were collected. All patients with depression had a medical diagnosis. Comorbidities were defined as medical diagnoses of arterial hypertension, type-2 diabetes, tuberculosis, syphilis, cardiopathy, chronic renal failure, lymphoma, HCV infection, HBV infection and fatty liver disease. Independent t-tests were used to compare differences between mean levels of HRQoL, age, and DMFT and its components according to groups of sex, comorbidities and depression.
Many of these problems with the teeth, gums, or mouth can be prevented or quickly treated. If you are HIV-positive, tell your dental health care provider so they can.