Lifestyle Factors that Effect Self-Perceived Health in HIV+ Individuals Receiving Comprehensive Dental Care

Objectives: Inadequate dental care can significantly compromise the health and well-being of those with human immunodeficiency virus (HIV). This longitudinal study investigated the impact of comprehensive dental intervention on quality of life using a validated short form-8 (SF-8) in patients with HIV. Mental composite scores (MCS) and physical composite scores (PCS) ranged from 0 (poor) to 100 (excellent).
Methods: 196 subjects were divided into 3 groups: newly diagnosed (≤1 year since HIV diagnosis/no regular dental care n=63), previously diagnosed (>1 year since HIV diagnosis/ no regular dental care n=68) and historical (>1 year since HIV diagnosis/ receiving regular dental care n=65). Dental prophylaxis/ debridement, oral hygiene instruction, and interviews were conducted that included the SF-8, factors affecting oral health, HIV status and demographics at 6 month intervals for 24 mo. Comprehensive dental care was provided.
Results: The majority of subjects were male (75.0%) and African-American (59.8%) with a median age of 43.4 years. At baseline, although 80.6% of participants report taking ART, only 46.2% of these participants were virally suppressed (< 50 copies/mL) at the most recent laboratory visit. Although viral load was not significantly associated with SF-8 scores in the longitudinal data, interestingly, patient-reported ART was strongly associated with mental self-perceived wellness (p=0.0004, Wald chi-square). This association did not depend on oral care provision or date of diagnosis. Compared to patients who were either unemployed or disabled, those patients who were employed scored, on average, 5.4 points higher (p<0.0001, Wald chi-square) on the MCS and 3.27 points higher (p=0.0003, Wald chi-square) on the PCS. Tobacco use was associated with lower PCS (p=0.006, Wald chi-square).
Conclusions: The results from these secondary analyses suggest that lifestyle can greatly influence self-perceived health. It is already well-established that tobacco users are at higher risk of periodontal disease, and those who are employed are more likely to have dental insurance. Thus, it is important that dental medicine focus on risk factors associated with poor quality of life, as these same risk factors are associated with oral disease.