Despite the fact that the first MMWR report included descriptions of oral problems and early reports indicated oral findings as markers for HIV infection, little has been reported regarding either the impact of oral problems on health status or intervention to prevent oral problems from occurring. Oral problems associated with AIDS present risks to health status and can result in an inability to eat properly. Further, the disfigurement and loss of control over one's body takes an emotional toll in addition to creating health problems. This project would first determine if HIV-related oral problems can be reduced using a new dental care protocol for HIV positive individuals. An analysis would then determine if functional status and quality of life have been affected by preventing oral problems and if there has been an impact on health care expenditures. Subjects selected will be HIV positive, will have at least 20 natural teeth, are between 25 and 45 years of age, and have severely compromised immune systems (cD4 counts between 100 and 500). These criteria were established so that changes could be expected to occur in a relatively short time period, without losing subjects to mortality. Five hundred subjects will be randomly assigned into either a control or the special intervention group. The special intervention group will receive bimonthly professional prophylaxis, twice daily chlorhexidine rinses, and routine dental care. The control group will receive care on an ideal recall regimen. The patients will be examined at entry, and at six and twelve months. The primary outcomes will be four scales from the RAND 36-item Health Survey. Secondary outcomes will include tooth attachment loss, gingival index, CD4 counts, weight loss, and other functional status and quality of life scales. In addition, the incremental visit costs of care will be compared.
| Brown, Jonathan Betz; Rosenstein, David; Mullooly, John et al. (2002) Impact of intensified dental care on outcomes in human immunodeficiency virus infection. AIDS Patient Care STDS 16:479-86 |
