Dental caries on the rise among HIV patients

HEALTH | HIV

With only a few weeks away to the celebration of World Aids Day, HIV patients are still battling a number of health issues that continue to deteriorate their general health.

Dental caries is one of the challenges that have recently come to the spotlight as a problem to critically watch out for among people infected with HIV.

Health workers say, dental caries are closely associated to the continued use of Antiretroviral drugs (ARVs). A condition which is believed to be a result of long-term use of drugs.

Dental caries is a medical term used to define tooth decays or cavities caused by specific bacteria that produce acids which destroy the enamel of the tooth.

According to the World Dental Federation survey, 2.3 billion people worldwide suffer dental caries in their permanent teeth with or without the HIV virus. In Uganda statistics show that about 80% of the population is affected by dental caries.

Dr Maria Goretti Nakyonyi, a dental surgeon working with Jubilee dental clinic explains that HIV and oral health have recently become intertwined adding: "Because HIV tends to compromise the immune system of an infected person, it puts the body system at risk of being affected by any minor illness".

She notes that HIV patients with dental caries tend to present common lesions like; Kaposi's sarcoma which she says is associated with people whose system is incompliant to medication while oral candidiasis which professes in form of an oral thrush is a result of suppressed immunity.

Ongoing research by Dr Dustan Kalanzi, a lecturer at the department of Dentistry School of Health Science at Makerere University shows 99.7% of HIV patients aged between 18 years and above were found to have gum diseases.

Surprisingly, many of the patients who had visited a dentist once in their life time had the highest numbers of dental caries compared to people that had never been to a dentist.

Dr  Kalanzi explained that 80% of HIV patients experience dental caries at least once in their life time due to prolonged use of ARVs.

While 7.3% adult women are affected by HIV compared to 4.5% males, he highlights that still more women were discovered to have dental caries following a current research conducted by Mulago ISS clinic and Makerere Joint Aids Programme.

Another research done by Dr Juliet Nabanja at Mildmay Uganda reveal that dental caries among HIV infected adults range between 42% - 72%. However, she further explains that oral lesions which are usually in form of wounds, sores or ulcers are quit high among children with HIV between 0-17years.

"Children tend to have a dry mouth and eating with difficulty due to the painful ulcers in the mouth. In such a situation, the child experiences weight loss and malnutrition," Dr Nabanja reports.

However, Dr Muhammed Mbabali the Vice president of Uganda Dental Association says the cavities are as a result of changes in the mouth caused by low immunity.

 "HIV lowers a person's immunity immensely that the normal floss in the mouth becomes violent and leads to gum diseases especially periodontitis, which destroys the teeth supporting structure".

He said many of the dental caries are related to ARV medication. Among children, the ARVs are administered in form of syrups, which have sugars whose prolonged use exposes the teeth of the little ones to bacteria.

Dr Mbabali says ARVs interfere with the production of saliva in the mouth, which is essential for cleansing unnecessary bacteria in the mouth thus increasing chances of poor oral hygiene, decay and gum diseases.

He says: "ARV syrups like other syrups on the market have a very high concentration of sugar. If this sugar is left on the teeth of the children, it causes rampant or aggressive teeth decay".

Dr Mbabali noted that the condition is no different from children that suffer common childhood illnesses like cough, colds and infections, who in most cases receive prescriptions of syrups.

However, Cathy Mwesigwa, a dentist holds parents accountable for pitying themselves and their HIV positive children by giving them artificial sugary products thus neglecting oral health of children.

Remedies

Dr Mbabali recommends that every time a child is finished taking a dose, should be given drinking water to rinse out all the sugar and syrup from the mouth.

Additional, parents should do a cotton scrub immediately after a dose to clean off the sugars from the teeth and gum to prevent the accumulation of acids that spoil the teeth.

It is also important for every individual to do a routine dental checkup at least once a year.

Dr Nakyonyi advices that crunchy foods rich in phosphorus such as sweet potatoes, yams are healthy for strengthening the teeth and developing the jaw structure because they encourage chewing.

She further warns against juicing fruits which she says, blending them breaks down the natural sugars that are usually replaced with artificial sugar that is dangerous to the oral cavity.