HIV infection, dental treatment demands and needs among patients seeking dental services at the Muhimbili Medical Centre in Dar-es-Salaam, Tanzania

Abstract

The objectives of this cross-sectional study were to determine the frequency of HIV infection among dental patients attending the three dental facilities at Muhimbili Medical Centre (MMC) in Dar-es-Salaam, Tanzania, and to compare the dental treatment demands and needs of the patients found to be HIV-infected with those of their HIV-seronegative counterparts. The facilities were; the dental outpatient department (DOPD) clinic, the dental minor surgery department, and the dental ward. This study which was conducted between March and April, 1996 enrolled a total of 460 patients. The investigations involved detection of anti-HIV IgG antibodies in saliva, examination of oral and peri-oral tissues, and assessment of dental and periodontal status. The overall HIV frequency among the dental patients was 10.9 per cent. The frequencies of HIV infection among patients attending the dental OPD clinic, minor surgery, and those admitted in the dental ward were 9.4 per cent, 26.3 per cent, and 25.0 per cent, respectively. The dental treatment demands and needs of HIV-seropositive patients were not different from that of HIV-seronegative patients. The high frequency of HIV infection calls for institution of infection control measures in the dental clinics. However, such measures need to be tailored for the poor countries, with potentially high frequency of HIV infection and minimal resources, in order to make them relevant.

A Comparison of Chronic Periodontitis in HIV-Seropositive Subjects and the General Population in the Ga-Rankuwa Area, South Africa

“…This conforms with other studies that documented similar clinical manifestations and natural courses of chronic periodontitis in HIV-seropositive and -seronegative subjects [12, 13, 20, 21]. …”

“…The diminution of the CD4+ T-cell count, dysregulation of the cytokine network, and qualitative defects of macrophages, monocytes, polymorphonuclear leukocytes, dendritic cells, and T lymphocytes do not predispose HIV-seropositive subjects to periodontopathic infection [33, 34]. The profound HIV-associated immune suppression also does not appear to predispose to delayed wound healing of the oral tissues [35], to increased incidence of wound infection of periodontal or other oral surgery [36], or to plaque-induced periodontal tissue destruction [12, 13, 20]. …”

“…A great proportion of the loss of periodontal attachment seen in HIV-seropositive subjects with chronic periodontitis is said to be owing to localized gingival marginal recession rather than to the formation of deep periodontal pockets as in HIV-seronegative subjects [7, 9–11]. However, other studies failed to document differences between the natural course of chronic periodontitis in HIV-seropositive subjects compared with the course in HIV-seronegative subjects with chronic periodontitis [12, 13]. …”

Reconstruction of the mandible after ablative surgery for the treatment of aggressive, benign odontogenic tumours in Tanzania: a preliminary study

“…This has been attributed to the presence of high concentrations of autogenous growth factors within the PRP. The use of autologous blood reduces the possibility of cross infection of blood borne diseases like hepatitis B (HBV) or human immunodeficiency virus (HIV), which is important considering the Tanzanian environment because of the high prevalence of HIV infection 12 . The PRP preparation process is easy and does not affect the operation time.…”

Transmission of HIV in the dental clinic and elsewhere

“…In the areas of greatest need (developing countries with a high prevalence of HIV), availability of PEP is limited or nonexistent. Health‐care workers in these areas are at increased risk of exposure to HIV (Matee et al , 1999) and the provision of additional resources to expand access to PEP needs to be a priority.…”