The Effect of Oral Health on Overall Self-Perceived Health in Individuals with Recent and Long-Term Human Immunodeficiency Virus (HIV) Diagnosis

Objectives: Dental care is among the top unmet needs for people living with HIV (PLWH). The effect of oral health on overall health has been understudied in PLWH. This longitudinal study sought to determine the impact of comprehensive dental intervention on quality of life using a validated short form 8 (SF-8) in newly vs previously diagnosed PLWH. Both mental composite scores (MCS) and physical composite scores (PCS) were determined.
Methods: 194 subjects were divided into 3 groups: newly diagnosed (≤1 year since HIV diagnosis/no regular dental care n=62), previously diagnosed (>1 year since HIV diagnosis/ no regular dental care n=67) 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 mo intervals for 24 mo. Comprehensive dental care was provided.
Results: The majority of subjects were male (76.19%) and African-American (64.28%), and the mean age was 45. Their mean income was less than $851/mo and most had at least a high school education. At baseline, their mean CD4 and HIV viral load were 512.15 cells/ul and 560.68 copies/ ml, respectively. At baseline, differences in MCS scores across the 3 groups approached significance with higher scores in the historical group (Pr>ChiSq=0.059). However, baseline PCS scores were highest in the new group (Pr>ChiSq=0.007). With dental intervention, improvement in MCS were detected in all 3 groups at both 12 and 24 mo with the most significant gains in the new (p=0.0063, SD 7.8) and previously diagnosed (p=0.0075, SD 10.63) groups. Positive changes in PCS score were not statistically significant. Continued increase in MCS and PSC scores were detected in the previously diagnosed and historical groups over 24 mo with mean MSC and PSC of 52.5 and 50.3, respectively in the previously diagnosed group.
Conclusions: Among the 3 groups, those in the previously diagnosed group showed the greatest improvement in overall self-perceived health with Likert scores that approach the national norm. This suggests that the oral intervention was most effective in the previously diagnosed. Overall self-perceived wellness in those with long-term HIV diagnosis improved with comprehensive dental care.