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OBJECTIVES: This study investigated dentists refusal to treat patients who have HIV. METHODS: A survey was mailed to a random sample of all licensed dentists in Canada, with 3 follow-up attempts (n = 6444). Data were weighted to allow for probability of selection and nonresponse and analyzed with Pearson's chi 2 and multiple logistic regression. RESULTS: The response rate was 66%. Of the respondents, 32% had knowingly treated HIV-infected patients in the last year; 16% would refuse to treat HIV-infected patients. Respondents reported willingness to treat HIV-infected patients (81%), injection drug users (86%), hepatitis B virus-infected patients (87%), homosexual and bisexual persons (94%), individuals with sexually transmitted disease(s) (94%), and recipients of blood and blood products (97%). The best predictors of refusal to treat patients with HIV were lack of ethical responsibility (odds ratio = 9.0) and items related to fear of cross-infection or lack of knowledge of HIV. CONCLUSIONS: One in 6 dentists reported refusal to treat HIV-infected patients, which was associated primarily with respondents' lack of belief in an ethical responsibility to treat patients with HIV and fears related to cross-infection. These results have implications for undergraduate, postgraduate, and continuing education.

HIV-related oral candidiasis was investigated in 71 HIV-seropositive patients who received interviews, oral examinations and hematologic investigation. Diagnosis of candidiasis was based on clinical signs and examination of PAS-stained smears. The frequency of candidiasis was 24/71 (34%). The clinical presentations were pseudomembranous 8 (11%), erythematous 14 (20%), angular cheilitis 3 (4%). Twenty-six patients (37%) had candidiasis or were receiving antifungal treatment for recurrent pseudomembranous type. Twelve of 13 (92%) patients with AIDS and 14/58 (24%) without AIDS were affected. Bivariate analyses showed significant associations with AIDS, the use of zidovudine, low T4-count, xerostomia; marital status (sometime married), restricted performance status and age of greater than 35 yr. Multivariate logistic regression analysis showed that the presence of xerostomia was an independent and statistically significant predictor of HIV-related oral candidiasis. T4-count and restricted performance status were the second and third most important predictors.

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