Prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy in Uganda: a cross sectional study

Abstract

Background Oral diseases are estimated to affect half of people living with HIV in the western world, and are often marked by pain, discomfort, disfigurement and reduced quality of life. Both HIV-specific and antiretroviral therapy-associated oral diseases have been found in this population. However, the prevalence, correlates and treatment needs of dental caries among people on antiretroviral therapy has not been well studied in rural Africa where majority of people living with HIV reside. Moreover, health behaviors and access to dental care vary significantly from high-income countries in the global north. Methods A cross-sectional study was conducted among people living with HIV attending a high-volume HIV clinic with an enrollment of 10,000 patients in a regional referral hospital in Southwestern Uganda. The clinic is located in an urban setting with a large rural catchment area. Oral health data was collected using the modified World Health Organization oral health questionnaire for adults. Dental examinations were conducted to identify and classify dental caries using the decayed, missing, filled, teeth (DMFT) index and compute the treatment need. Logistic regression models were employed to identify correlate of dental caries. Results A total of 194 participants were included in the study. The majority were female (124/194, 63.9%) with a median age of 42 years (IQR 36–49). The prevalence of dental caries experience among study participants was 67%, (130/194, 95% CI 60–75%). The mean DMFT index score was 4 (IQR 2–6) and treatment need was 96% (192/200). A higher CD4 count was associated with the presence of dental caries (OR 0.403, 95% CI 0.175–0.932) although it was not significant in multivariate analysis. Conclusion There is a high prevalence of dental caries among people living with HIV on ART in Uganda. Our data demonstrate a high oral treatment need among this population. We recommend inclusion of preventive and therapeutic oral care into HIV care in this region.

Prevalence, correlates and treatment needs of dental caries in patients attending a diabetic clinic in rural southwestern Uganda: a cross-sectional study

“…Urban residents defined a city, municipality, gazetted town board or a trading center while rural residence [ 17 ]. The questionnaire was administered by a trained research assistant and the dental examination chart was completed by a single well trained dental surgeon with over 20 years’ experience [ 18 ]. After completion of the questionnaire, participants were directed to the dental surgeon for a dental examination, as previously described [ 18 ].…”

Prevalence, correlates and treatment needs of dental caries in patients attending a diabetic clinic in rural southwestern Uganda: a cross-sectional study

“…The questionnaire had ve major sections: socio-demographic factors, diabetes history, oral health status, dental health care (brushing, dental checkup habits, and use of toothpaste), dietary factors (i.e., consumption of fresh fruits, sugary foods), lifestyle factors (tobacco and alcohol use) and dental examination guided the modi ed World Health Organization (WHO) oral health questionnaire for adults [8]. The questionnaire was administered by a trained research assistant and the dental examination chart was completed by a single well trained dental surgeon [9]. After completion of the questionnaire, participants were directed to the dental surgeon for a dental examination, as previously described [9].…”

“…The questionnaire was administered by a trained research assistant and the dental examination chart was completed by a single well trained dental surgeon [9]. After completion of the questionnaire, participants were directed to the dental surgeon for a dental examination, as previously described [9]. Disposable dental mirrors and probes under natural light to examine the participant while seated in a reclined position were used.…”

“…Participants were de ned as to have treatment needs if they had decayed or missing teeth l [9]. Respondents with toothache or dental caries were referred to the dental clinic for management, while those with missing teeth were advised to have dentures if necessary.…”

Use of dental care services among adolescents living with HIV on Antiretroviral Treatment in Kampala, Uganda: a cross-sectional study

“…A study done in Uganda, reported a caries prevalence of 80% in adolescents living with HIV taking ART compared to 67% in the general adult population (17). Another study carried out in Uganda reported that individuals living HIV and taking ART had a need of dental treatment of about 96% and a DMFT (Decayed, Missing, Filled Teeth) score of four (14). People living with HIV (PLHIV) are now living longer due to ART, which means that oral diseases, such as dental caries and other oral manifestations are increasingly important to manage in this population.…”