Prevalence and factors associated with dental caries in patients attending an HIV care clinic in Uganda: a cross sectional study

Abstract

Background Chronic Human Immunodeficiency Virus (HIV) infection is associated with reduced saliva flow rate due to infiltration of HIV and proliferation of CD8 lymphocytes in salivary glands. It is unclear whether HIV infection and antiretroviral therapy (ART) increase caries risk. This study aimed to determine the prevalence and factors associated with dental caries in HIV infected adults attending the Mulago Immune Suppression Syndrome (ISS) clinic in Uganda. Methods A cross-sectional study was conducted among HIV infected persons. Dental examinations were performed by two calibrated dentists using the WHO Radke’s caries classification criteria and reported using the decayed (D), missing (M), filled (F), teeth (DMFT) index. The prevalence and factors associated with dental caries was examined through linear regression analyses. Results Overall, 748 participants (females = 491, 65.6%) with a mean age of 39 ± 9.4 years were included in the final analysis; of whom 83.7% had caries (DMFT> 0), with a significantly ( p < 0.05) higher prevalence among females 86.6% than males 78.2%. The mean DMFT was 5.9 ± 5.5, with statistically significant differences based on gender (males 4.9 ± 4.8 and females 6.3 ± 5.9, p < 0.05) and duration on ART (< 2 years 4.8 ± 4.4, > 2 years but < 5 years 5.7 ± 5.5, > 5 years 6.6 ± 6.0 p < 0.05). The majority (67.2%) of participants reported brushing their teeth twice or more a day, and sugar intake was not associated with dental caries. Conclusion Caries prevalence is high among HIV infected adults under care. Duration of ART was associated with increased risk and severity of caries. Therefore, we recommend integration of dental care in HIV treatment programs.

Caries experience by socio-behavioral characteristics in HIV-1 infected and uninfected Ugandan mothers - a multilevel analysis

“…The prevalence of dental caries was high in this study population and matched previous estimates in the general Ugandan adult population amounting to 67% [33]. Mothers living with HIV-1 presented with a caries prevalence of 81%, being in accordance with previous estimates in comparable groups of Ugandan adults amounting to 83% [20]. HIV-1 infected mothers seemed to be at higher risk of developing dental caries compared to the uninfected controls.…”

“…A study in Uganda reported a caries prevalence of above 80% in HIV positive adults, whereas the corresponding parameters in the general adult population were estimated to 67%. This study also indicated that longer duration of HAART medication associated with increased risk of dental caries [20].…”

“…Although a speci c measure of duration of HAART medication was not available, in this study, HIV-1 infected mothers who were follow-up participants from the PROMISE PEP trial had been on systematic HAART medication for more than 6 years. Studies focusing caries among HIV-1 infected adults on HAART have not yet identi ed any speci c trend [14,20]. However, a recent Ugandan study reported on increased prevalence of dental caries according to longer duration of HAART medication [20].…”

“…Women's Interagency HIV Study (WIHS), including the largest cohort of HIV infected women in the United States, revealed signi cantly higher caries scores (number of decayed, missed lled teeth, DMFT) in women with HIV compared to HIV negative women [18]. Moreover, reports reveal an increase in caries prevalence following HAART medication among people with HIV [19,20] and suggest that the prevalence of dental caries varies according to the type and length of HAART medication taken [14]. A study in Uganda reported a caries prevalence of above 80% in HIV positive adults, whereas the corresponding parameters in the general adult population were estimated to 67%.…”

“…Factors, such as xerostomia, microbial colonization, poor oral hygiene, periodontal disease and carbohydrate diet increase susceptibility to dental caries in HIV infected adults [20]. Kumar et al [11] and Soares et al [21] reported on higher caries experience and higher prevalence of periodontal disease in HIV positive patients of low-compared to high socio-economic status.…”