A Smart + Strong Site
Subscribe to:
POZ magazine

Back to home » Treatment News » Web Exclusives

Most Popular Stories
Undetectable Viral Load Essentially Eliminates Transmission Risk in Straight Couples
FDA Approves New Single-Tablet HIV Regimen, Triumeq
Life Expectancy for Young People With HIV Is Nearly Normal
A 15-Year Jump in Life Expectancy for People With HIV
Scientists Devise Method of Snipping HIV From Immune Cells
Monkey HIV Vaccine Success Opens Door for Human Trials
HIV Combo Pill Less Toxic Thanks to New Form of Tenofovir
What's That Mean?
(just double-click it!)

If you don't understand one of the words in this article, just double-click it. A window will open with a definition from mondofacto's On-line Medical Dictionary. If the double-click feature doesn't work in your browser, you can enter the word below:

Most Popular Lessons
Aging & HIV
The HIV Life Cycle
Herpes Simplex Virus
Syphilis & Neurosyphilis
Treatments for Opportunistic Infections (OIs)
What is AIDS & HIV?
More News

Have medical or treatment news about HIV? Send press releases, news tips and other announcements to news@aidsmeds.com.

Click here for more news


September 8, 2009

Mouth Full of Problems: A Crisis in HIV Dental Care

by David Evans

Too few people with HIV get the routine oral health care they need to stay healthy. The teetering economy, experts say, might make the situation a whole lot worse.

Not accessing dental care can be deadly. In early 2007, a 12-year-old boy named Deamonte Driver from suburban Washington, DC, died of an infection that had spread from an abscess in his mouth to his brain. His family’s Medicaid had lapsed because of a technicality, so he didn’t get care until his mother took the by then very ill boy into an emergency room. Experts say an $80 tooth extraction, if done early enough, could have saved his life.

Though Driver’s HIV-status was never reported, and there hasn’t been wide press coverage of a similar story involving an openly HIV-positive person, David Reznick, DDS, head of the HIV Dental Alliance in Atlanta, says that all the necessary ingredients to create such a tragedy are already in place—and could be getting worse.

People with HIV are simultaneously more likely than their HIV-negative counterparts to have more frequent and more serious oral health issues, while being less likely to have the funds and insurance to cover necessary procedures. The public support that is available for providing clinical oral health care to people with HIV, Reznick says, is drying up as various states confront catastrophic budget crises. “We’re just not seeing enough [funding] increases to take care of the people we already serve,” Reznick laments, “So it’s an overwhelming need and no resources to pay for it.”

Open Wide

People rarely think—at least until their face is horribly swollen and they’re immobilized with pain—that oral health care can have much of an impact on their overall well-being. According to Reznick, however, a neglected mouth can lead to more than localized tooth pain: Tooth and gum infections can spread to other parts of the body, and mouth pain can cause people to go without necessary nutrition—and even cause them to forgo their HIV medications.

“If you’re in an extraordinary amount of pain, you’re not going to be able to take your medications,” he explains. “If you don’t have any teeth to chew with, how are you going to get the nutrition you need to stay healthy?”

Reznick also has concerns about chronic inflammation from untreated periodontal disease. A growing number of studies are illuminating the role of inflammation in a variety of non-AIDS-related health problems such as cardiovascular disease. The link between gum and heart disease has been proposed in HIV-negative people, and some evidence suggests it to be true.

For all of these reasons, preventive dental care can have a tremendous influence on a person’s overall well-being.

Unfortunately, many people with HIV don’t know or understand the importance of regular preventive dental care. According to the Health Resources and Services Administration (HRSA), people with HIV who are uninsured are three times as likely to have untreated dental needs as people with HIV who have insurance. HRSA also states, “Moreover, oral infections, mouth ulcers and other severe dental conditions associated with HIV infections go untreated more than twice as often as other health problems related to the disease.”

Roadblocks to Care

Reznick says that HIV stigma and cultural habits against seeking dental care are two big reasons that people fail to go to the dentist regularly even when they have coverage or access to a dentist through public or private benefits. But even among people who want to go to a dentist as often as is recommended—at least once every six months for a thorough cleaning and checkup—lack of insurance or comprehensive public benefits can mean going without. Given the severe budget woes of most states right now, publicly funded dental care is not expanding sufficiently to meet the growing epidemic. In fact, in many areas it is shrinking.

In most cities and towns, the only options for people without dental insurance are oral care programs covered by the Ryan White CARE Act or Medicaid. Ryan White, however, has been essentially flat-funded for several years, and Medicaid dental coverage, already stingy in many states, is beginning to disappear. “Without the Ryan White dollars, there’s minimal access,” Reznick says. “With states that had adult benefits through Medicaid who have lost them, it’s caused a gigantic crunch.”

“We’re struggling to keep up with the need,” Reznick explains, “because people are living longer, and more people are getting tested and entering into the system of care. So we’re literally booked through until November, and I have eight dental chairs and over three full-time dentists and three hygienists, and we’re having a very difficult time meeting the need.”

Reznick hopes that policymakers and people living with HIV understand the consequences of too-little access to good oral health care. Aside from the pain and illness it will almost certainly cause, Reznick contends, it will also end up costing more money in the long run. He is hoping for increases, rather than additional cuts, to services. When people don’t get preventive care, Reznick says, “they end up in the emergency department, and that’s going to cost the public a whole lot more than if they would have kept the benefits in place.”

Search: oral health, dental, teeth, mouth, gum, periodontal disease, David Reznick, HIV Dental Alliance, Grady, Deamonte Driver, inflammation

Scroll down to comment on this story.


(will display; 2-50 characters)


(will NOT display)


(will display; optional)

Comment (500 characters left):

(Note: The AIDSmeds team reviews all comments before they are posted. Please do not include ":" "@" "<" ">" in your comment. The opinions expressed by people providing comments are theirs alone. They do not necessarily reflect the opinions of Smart + Strong, which is not responsible for the accuracy of any of the information supplied by people providing comments.)

Comments require captcha.
Please enter this number for verification:

| Posting Rules

Show comments (33 total)

[Go to top]

Quick Links
About HIV and AIDS
The Cure
Lab Tests
Clinical Trials
HIV Meds
Starting Treatment
Switching Treatment
Drug Resistance
Side Effects
Hepatitis & HIV
Women & Children
Fact Sheets
Treatment News
Community Forums
Conference Coverage
Health Services Directory
POZ Magazine
AIDSmeds on Twitter

Conference Coverage

XX International AIDS Conference
(AIDS 2014)
Melbourne, Australia
July 20 - 25, 2014

21st Conference on Retroviruses and Opportunistic Infections
(CROI 2014)
Boston, MA
March 3 - 7, 2014

7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention
(IAS 2013)
Kuala Lumpur, Malaysia
June 30 - July 3, 2013

more conference coverage

[ about AIDSmeds | AIDSmeds advisory board | our staff | advertising policy | advertise/contact us]
© 2016 Smart + Strong. All Rights Reserved. Terms of use and Your privacy.
Smart + Strong® is a registered trademark of CDM Publishing, LLC.