HIV Screening in the Dental Setting

 

 
 

The role of the oral health team in addressing the HIV continuum of care


By Helene Bednarsh, RDH, MPH, director, HIV Dental Program, Boston Public Health Commission; and Anthony J. Santella, DrPH, MCHES, associate professor, Hofstra University

 

The evolving association between oral health and systemic health reinforces the importance of oral health and interprofessional collaboration. Oral health provides a window to overall health as stated by former Surgeon General C. Everett Koop in year 2000 report “Oral Health in America,” which stated, “You are not healthy without good oral health.” Moreover, in 2011, the National Academies of Science, Engineering and Medicine, formerly the Institute of Medicine, called for an emphasis on disease prevention and oral health promotion as well as reducing oral health disparities in their 2011 report, “Advancing Oral Health in America.”

 

Although not discussed very often, the oral health team can help curb the HIV pandemic. The Centers for Disease Control and Prevention reports an estimated 37,600 new HIV infections in 2014 with approximately 12 percent of people living with HIV, or PLWH, unaware of their HIV status. The HIV Care Continuum outlines the steps a PLWH experiences from initial diagnosis to achieving viral suppression. The oral health team, including dentists and hygienists, can help move PLWH through each stage of the continuum, whether it be by providing HIV screening in the dental setting, connecting and retaining people living with HIV to medical care, providing those on anti-retroviral therapy, or ART, adherence support, and helping PLWH navigate and manage health systems with the goal of achieving viral suppression. This is especially promising as now we have strong evidence that undetectable = untransmittable (U=U). This means that the risk of HIV transmission from a PLWH who is on ART and has achieved an undetectable viral load in their blood for at least six months is non-existent.

 

Former Surgeon General Regina Benjamin said it best: “While good oral health is important to the well-being of all population groups, it is especially critical for PLWH. Inadequate oral health care can undermine HIV treatment and diminish quality of life, yet many individuals living with HIV are not receiving the necessary oral health care that would optimize their treatment.” Let’s remember during National Public Health Week that the oral health team is critical to our future success in creating the healthiest nation.