Bruxism and Enamel Erosion in Patients Treated With HIV Anti-Retroviral Therapy

Objectives: Severe enamel erosion and bruxism have been observed in patients who are treated with HIV anti-retroviral therapy. The objective of this study was to elucidate the relationship between HIV anti-retroviral therapy and bruxism.
Methods: Assessment of bruxism was conducted both with a survey questionnaire and clinical assessment of tooth wear at Russell Street Dental Clinic in Portland, Oregon. The survey questionnaire comprised of questions on each participant’s gender, age, HIV status, current medications, awareness of tooth grinding or clenching, jaw soreness, tooth or gum soreness, and frequency of headaches. For the clinical evaluation, a dental provider recorded the degree of wear on each tooth using a scale of 0 – 3. An Individual tooth-wear index was used to rank persons with regard to incisal and occlusal wear without being influenced by the number of missing teeth. Data analysis included descriptive analysis, tests of association using IBM SPSS Statistics software V20.
Results: The study sample involved 104 patients (HIV+ve = 67, HIV–ve = 37) with age range of 20-90yrs (mean=49.6yrs, s.d= 12.9). Majority of the patients were males (79%) and many presented with existing psychological disorders (40%). HIV+ve patients reported significantly more psychological disorders than the HIV–ve controls (p < 0.01). Clenching during the day as well as night was significantly higher in HIV+ve patients versus HIV–ve controls (p<0.01). The mean tooth wear index was higher in HIV+ve patients than HIV–ve patients (8.19 vs. 5.77), however, this difference was not statistically significant.
Conclusions: HIV+ve patients, who are on anti-retroviral therapy, have significantly higher psychological disorders as well as bruxism. The findings from this study will be used to initiate a dialogue with medical providers about the possible side effects antiretroviral therapy and to introduce appropriate preventive measures.