Periodontal Implications of HIV Not Always Understood by Dentists

Dentists and dental hygienists were found to lack expertise when it came to how HIV infections could affect a patient’s teeth, according to a study published in Frontiers in Public Health.¹ In contrast, periodontists and oral medicine practitioners had a more comprehensive knowledge in the subject area.

HIV currently affects approximately 38.4 million people across the world, with fatalities due to the disease expected to rise. Among its other effects, HIV can cause oral lesions and periodontal disease, even in those whose disease is being treated. Periodontitis and gingivitis are 2 of the most prevalent presentations in HIV, and changes in salivary microbial composition² can come as a result of children being infected with HIV. Although not a primary form of spread, the possibility of cross-contamination while at a dentist’s office is not impossible. This study aimed to evaluate how much dentists and dental hygienists know about HIV and its implications on periodontal diseases.

HIV Awareness Ribbon | Image credit: barbaliss - stock.adobe.com

This cross-sectional survey primarily recruited senior-level dentistry and dental hygiene students who were enrolled in institutes across Saudi Arabia. Dental practitioners and dental hygiene practitioners were also recruited from private and government hospitals. Participants were excluded if they did not provide consent or were younger than 18 years.

The questionnaire was distributed on an online platform with all participants encouraged to participate through emails and WhatsApp. The questionnaire was formulated by 2 periodontists and modified after being distributed to a small number of participants. The responses to the questions included strongly agree, agree, not sure, disagree, and strongly disagree. The questionnaire focused on periodontal manifestations in patients with HIV, periodontal management, management of HIV, and educational statements about HIV and periodontal diseases.

There were 486 participants included in the study who had a mean (SD) age of 24.26 (7.53) years. The mean comprehension score for all participants was 10.31 (9.34). The highest scores were found in patients aged 31 to 40 years (20.67 [8.31]) followed by those 40 years and older (19.38 [9.39]); lower scores were found in participants aged 20 to 30 years (9.53 [8.96]) and those younger than 20 years (8.92 [8.57]). Male participants had significantly lower scores (8.74 [7.57]) compared with female participants (15.06 [12.2]).

General dentists had higher comprehension scores (15.56 [8.12]) compared with dental students (11.13 [10.44]). Dental hygiene students also had a lower mean score (5.52 [3.56]) compared with dental hygienists (7.67 [9.72]). Periodontists had a much greater comprehension of HIV compared with other dental specialists (9.77 [8.25]).

There were limitations to this study. The number of surveyed items could have caused survey fatigue. The specialist subgroups also had a small number of participants, which could limit the comparison.

The author concluded that dental professionals are less knowledgeable on the relationship between HIV and periodontal effects compared with periodontists and oral medicine practitioners. Future developments should improve HIV education for dentists in this region.

References

1. Ahmed MM. Dentists and dental hygienists’ comprehension of HIV infection associated periodontal implications and management. Front Public Health. Published online April 4, 2024. doi:10.3389/fpubh.2024.1370112
2. Shaw ML. Immunosuppression to blame for oral microbiota change in children with HIV. AJMC. August 5, 2020. Accessed April 23, 2024. https://www.ajmc.com/view/immunosuppression-to-blame-for-oral-microbiota-change-in-children-with-hiv