IADR Abstract Archives
Periodontal Disease Adversely Impacts Tooth Loss in Dentate HIV+ Patients
Objectives: Recent advancements in antiretroviral therapy (ART) medications transformed HIV disease into a chronic manageable condition. Tooth loss reflects the accumulation of oral disease throughout life. Periodontal disease is an important cause of tooth loss. The effects of newer ART therapies on periodontal health and tooth loss have not been fully investigated in HIV+ patients. The objective of this retrospective study was to investigate the relationship between tooth loss and periodontal health among dentate HIV+ patients on newer ART regimens.
Methods: The medical/dental records of approximately 450 HIV-infected individuals receiving care at an HIV Care Facility in San Bernardino, CA were surveyed. A total of 88 records of dentate HIV+ individuals with full-mouth periodontal charting and intra-oral periapical radiographs were identified. The following data was collected: age, gender, poverty level, years since HIV+ diagnosis, CDC categorization of HIV/AIDS, living situation, most recent viral load, most recent CD4 count, other medical conditions including diabetes, cigarette smoking, sexual behavior, ART drug regimens, and most recent full-mouth pocket-depth (PD). Tooth decay and alveolar bone loss (ABL) were radiographically assessed. Average PD and percent ABL were calculated to determine periodontal health status.
Results: Age range 28-87 years, 76% males, 48.72% AIDS diagnosis, 40% on integrase inhibitors, 57.69% ABL ≥15%. Majority of patients (88.63%) had lost 1 or more teeth. Average tooth loss (SD) 7.2 (5.7). Univariate analyses showed no association between tooth loss with years HIV+, AIDS diagnosis, viral load, CD4 count, ART drugs, caries, and cigarette smoking. Patients with ABL ≥15% showed higher number of missing teeth than patients with ABL <15% (p=0.001). Of all the factors investigated, multiple stepwise regression analyses (controlling for demographics) showed that tooth loss positively associated with age (β=0.45, p<0.01) and ABL (β=0.39, p<0.01). By contrast number of years on ART negatively associated with tooth loss (β=-0.28, p<0.05).
Conclusions: Tooth loss remains prevalent among HIV+ patients, and periodontal disease is a significant contributor. ART drugs are unrelated to tooth loss. However, the number of years on ART seem to improve oral health behavior and reduce tooth loss.
Methods: The medical/dental records of approximately 450 HIV-infected individuals receiving care at an HIV Care Facility in San Bernardino, CA were surveyed. A total of 88 records of dentate HIV+ individuals with full-mouth periodontal charting and intra-oral periapical radiographs were identified. The following data was collected: age, gender, poverty level, years since HIV+ diagnosis, CDC categorization of HIV/AIDS, living situation, most recent viral load, most recent CD4 count, other medical conditions including diabetes, cigarette smoking, sexual behavior, ART drug regimens, and most recent full-mouth pocket-depth (PD). Tooth decay and alveolar bone loss (ABL) were radiographically assessed. Average PD and percent ABL were calculated to determine periodontal health status.
Results: Age range 28-87 years, 76% males, 48.72% AIDS diagnosis, 40% on integrase inhibitors, 57.69% ABL ≥15%. Majority of patients (88.63%) had lost 1 or more teeth. Average tooth loss (SD) 7.2 (5.7). Univariate analyses showed no association between tooth loss with years HIV+, AIDS diagnosis, viral load, CD4 count, ART drugs, caries, and cigarette smoking. Patients with ABL ≥15% showed higher number of missing teeth than patients with ABL <15% (p=0.001). Of all the factors investigated, multiple stepwise regression analyses (controlling for demographics) showed that tooth loss positively associated with age (β=0.45, p<0.01) and ABL (β=0.39, p<0.01). By contrast number of years on ART negatively associated with tooth loss (β=-0.28, p<0.05).
Conclusions: Tooth loss remains prevalent among HIV+ patients, and periodontal disease is a significant contributor. ART drugs are unrelated to tooth loss. However, the number of years on ART seem to improve oral health behavior and reduce tooth loss.