HIV/AIDS and oral health: Sri Lankan context

Abstract

Oral manifestations are used as diagnostic, therapeutic and prognostic markers of HIV: Some being characteristic while others are indicative. Oral presentation of HIV patients depends on many factors and varies with geographic location, demographics and culture: a fact not studied for Sri Lanka.

Objective: To evaluate the oral presentation of HIV patients under care in Sri Lanka

Methods: 129 known HIV cases presenting for treatment at ART clinic Colombo selected; consent obtained; interview and clinical examination conducted by a qualified & registered Dentist.

Results: Sample- males-77(60%): females-52(40%), average age- 41.6 years, 80% ever married, 77.5% currently employed and 98.5% having formal education. On average sample was 4.9 years post diagnosis and 78% were on ART- average treatment duration 3.5 years. Majority of the sample presented with satisfactory oral hygiene (>85%). Average Decayed Missing Filled Teeth index (DMFT) was 9.4 teeth: D-3.0, M-5.8, F-0.6 with 13.5% having dental prosthesis. Many 57(44%) showed soft tissue lesions averaging 0.57 lesions per person: HIV Gingivitis and Necrotizing Periodontitis were low at- 3(2%) and 10(8%); 18(14%) Linear Gingival Erythema; 17(13%) Candidiasis; 17(13%) Angular Cheilitis; 5(4%) ulceration; 1(0.8%) Leukoplakia; and 5(4%) geographic tongue. Oral pigmentation was present among 31(24%) while 27(21%) presented with coated tongue. The mean CD4 count was significantly different (p<0.05) among cases with (mean= 398) and without (mean= 452) oral lesions.

Conclusion: Oral soft tissue and hard tissue lesions are common among the sample thus, deserves more respect during patient management.