Smoking, Alcohol Use, Dental Anxiety in High-Risk/HIV+ Dental Patients

Objectives: To identify, in a sample of high risk/HIV-infected dental patients, 1) the prevalence of smoking and risk of alcohol abuse, 2) the relationship between smoking, risk of alcohol abuse, and dental anxiety (DA), and 3) the association of smoking and alcohol abuse risk with demographic and health care-seeking variables.
Methods: English-speaking adult patients (n=100) at the Harlem United Community AIDS Center dental clinic (HU) were surveyed with a structured questionnaire (response rate=79%). DA was measured with the Short-Dental Anxiety Inventory (S-DAI), and alcohol use was assessed through the Alcohol Use Disorders Identification Test (AUDIT-C). Participants were categorized as smokers (daily, occasional, and past smokers) or nonsmokers, and as at high or low risk for alcohol abuse based on the AUDIT-C score.
Results: Among participants 33% smoked at least occasionally; 34% of participants had positive risk scores on the AUDIT-C screen. The S-DAI scores (mean S-DAI, 21.3±9.3) ranged from 9 to 45. DA was not associated with smoking (r=0.127, p=0.232) but was significantly statistically associated with alcohol use (r=0.29 p<.007), controlling for age, gender, educational level, time since last dental visit, and time since last medical visit. Cross-tabular analysis further demonstrated that smoking status was associated with race/ethnicity(p=.040); while risk for alcohol abuse was associated with educational level (p=.024).
Conclusions: Smoking and alcohol abuse are of great importance for both general and oral health, especially in vulnerable HIV-positive populations, and are associated with increased risk for oral cancer and other oral conditions. This pilot study documents prevalence of risk for alcohol abuse and use of tobacco among study participants. It further documents an association between dental anxiety and risk of alcohol abuse. Study results demonstrate a need for greater understanding of the processes leading to tobacco use, alcohol abuse, and dental anxiety among high-risk/HIV-positive dental patients.