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Oral Health and HIV

Education Packet

Oral Health and HIV – This packet is a compilation of recent fact sheets and other resources. You may wish to customize it to meet the needs or interests of particular groups, such as event participants, providers, patients, clients, or the general public. So please feel free to distribute all or part of this packet as either a printout or PDF. 


Fact Sheets, Brochures, and Websites

HIV/AIDS & Oral Health (National Institute of Dental and Craniofacial Research, reviewed July 2018) – This fact sheet provides and overview of oral health problems seen in people with HIV, including information about their causes, symptoms, and treatment. These include aphthous ulcers (canker sores), oral herpes (fever blisters/cold sores), hairy leukoplakia, candidiasis (thrush), and oral warts. A “Healthful Tips” section also provides tips for dealing with dry mouth. Also available in Spanish.

Oral Health Affects Your Whole Body: It’s an Important Part of Your HIV Care (New York State Department of Health and Northeast/Caribbean AETC, June 2020) – This brochure includes information about oral care, cavities and gum disease, infections and mouth sores, preventive care, and good nutrition.

Human Immunodeficiency Virus (American Dental Association, November 2021) – This fact sheet includes basic information about HIV and testing, as well as the following sections specifically related to oral health: infection control, dental care, and dental patient management.

HIV and Your Mouth (The Well Project, October 2021) – This fact sheet includes information about oral conditions that are common among people with HIV; oral health, street drugs, and tobacco; sources of dental care for people with HIV in the U.S.; and how people with HIV can take care of their oral health.

HIV-Related Mouth Sores: Symptoms and Treatments (WebMD, June 2020) – This fact sheet includes basic information about conditions that are either characterized by, or may result in, sores in or near the mouth in people with HIV.  These include canker sores, oral hairy leukoplakia, thrush, oral herpes, human papillomavirus (HPV) warts, syphilis, and gonorrhea.

HIVDent (regularly updated with new resources) – This website compiles and links to resources specifically about oral health and HIV – including oral manifestations, dental treatment, and infection control – as well as more general news and information about HIV. It also links to a video series about COVID-19 and dentistry. 

Oral Health Care (TargetHIV, updated as needed with new resources) – This web page compiles and links to a variety of resources on oral health care in people with HIV. These include guidelines and manuals, webinars and trainings, tools and job aids, reports and best practices, and websites.

Oral Health Professionals (TargetHIV, updated as needed with new resources) – This web page links to a range of resources for dentists, dental hygienists, and dental assistants, including curricula, tools, and best practices “to enhance the skills of staff in delivery of dental care to people with HIV.”

Strategic Plan

National HIV/AIDS Strategy (2022-2025) (White House, December 2021) – This document outlines the framework and direction for the Administration’s policies, research, programs, and planning through 2025 in an effort to end the U.S. HIV epidemic by 2030. Page 30 of the Strategy describes missed opportunities for HIV diagnosis, including the potential for dental facilities to provide point-of-care HIV screening and testing. Page 62 describes the importance of establishing integrated, comprehensive health care delivery models, which should include oral health care.

 

Curricula and Toolkits

National HIV Curriculum: Oral Manifestations (AETC, University of Washington, and other partners, updated 2020) – This is the second lesson in the Curriculum’s Basic HIV Primary Care Overview module. It includes two activities: Implementing Oral Health Care into HIV Primary Care Settings Curriculum and an Intraoral Examination video, as well as information about oral health and periodontal disease and six of the most important oral manifestations of HIV disease.

Integration of Oral Health and Primary Care Technical Assistance Toolkit (Health Resources and Services Administration HIV/AIDS Bureau – HRSA HAB, July 2019) – This resource identifies and reviews seven components of oral health and primary care integration: 1) ask – assess the risk of oral health disease; 2) examine – conduct an oral health examination to identify active disease; 3) educate – provide tailored education to improve oral health care literacy; 4) intervene – undertake primary care interventions to reduce risk and treat disease; 5) refer – refer to oral health care providers for more extensive care when needed; 6) support – offer patient navigation services to improve treatment adherence; and 7) share – exchange information between primary and oral health care settings.

Tools for Creating Innovative Oral Health Care Programs: Tools from the Integrating HIV Innovative Practices Program (HRSA HAB) – This toolkit focuses on ways to expand/replicate innovative models of oral health care for people with HIV. It includes a fact sheet, pocket guide, intervention guide, training manual, curriculum, and several webinars.

Guide to Oral Health Care for People with HIV (HRSA HAB, March 2014) – This webinar curriculum for primary care providers focused on recognizing and managing oral health and disease in people with HIV.

Occupational Exposure for Oral Healthcare Workers: Resources Supporting Policy and Procedures Pertaining to a Bloodborne Pathogen Exposure for Dental Settings (New York State Department of Health, reviewed October 2021) – This toolkit includes guidance on: post?exposure prophylaxis (PEP) following occupational exposures in the oral health setting; employer responsibilities in PEP management to prevent HIV infection following an occupational exposure; developing an exposure control plan for a small private office; information for exposed workers and source patients; and samples of exposure record and source patient record documentation.

 

Ryan White HIV/AIDS Program (RWHAP)

Ryan White HIV/AIDS Program (RWHAP) Part F: Dental Programs (HRSA, reviewed February 2022) – This web page describes the two dental programs funded under RWHAP Part F: the Community-Based Dental Partnership Program (CBDPP) and the Dental Reimbursement Program (DRP). These programs fund oral health care for people with HIV, as well as education and training for oral health providers

Ryan White HIV/AIDS Program Part F Dental Services Report: Instruction Manual 2022 (HRSA, December 2021) – This manual includes an overview of RWHAP dental programs, data collection forms and requirements, how to register for and access the Dental Services Report Web system, navigating the Dental Services Report website, Dental Services Report workflow, Dental Services Report instructions, and how to manage a user profile. Frequently asked questions and glossary sections are also included.

Ryan White HIV/AIDS Program Oral Health Data Report: 2017 (HRSA, November 2019) – This report provides data about RWHAP clients who received oral health services and providers who offered such services, with breakdowns for selected characteristics, including the provider type, and clients’ age, race/ethnicity, gender, transmission risk category, income, health care coverage, and housing status.

 

Other Selected Resources from AIDS Education and Training Centers (AETCs) and HRSA

HIV and Oral Health: Short Talks (AETC National Coordinating Resource Center – NCRC, March 2022) – These training slides provide tips to help patients prepare for their dental visits and to address fear in dental patients.

HIV Discrimination, Privacy, and Confidentiality: Impact on the Delivery of Oral Healthcare (New England AETC, January 2022) – In this webinar, speakers discuss the impact of anti-discrimination laws, including those prohibiting discrimination against persons with disabilities, on the delivery of oral healthcare.

The Importance of Oral Health in HIV Care: How Non-Clinical Providers can Promote Good Oral Health with Clients (Northeast/Caribbean AETC, October 2021) – These training slides highlight the overall importance of oral health and provide information on how to assist patients in recognizing their oral health needs, as well as how to incorporate basic oral health assessment into everyday practice.

Oral Health, HIV, and COVID-19 (Pacific AETC, August 2021) – This course explains the links between oral health and COVID-19, addresses patient and staff concerns about COVID-19 safety measures, reviews COVID-19 vaccines and implications for people with HIV, and helps providers prepare for post-COVID-19 HIV oral health care.

HIV and Oral Health Update (New England AETC, July 2021) – This webinar covers oral manifestations, treatment considerations, current trends in HIV, and the role of the healthcare team in HIV prevention and care.

Oral Manifestations of Sexually Transmitted Infections in People with HIV (South Central AETC, June 2021) – This webinar reviews the categories of oral sexually transmitted infections (STIs), identifies oral manifestations of STIs, and discusses the differences in oral STIs among people with HIV.

HIV and Oral Health: Treating Patients with HIV In the Era of COVID-19 (Southeast AETC, February 2021) – This updated dental brochure provides guidance for oral health providers caring for people with HIV during the COVID-19 pandemic. It includes dental practice protocols, oral health recommendations, and additional resources.

Short Bites: HIV Oral Health and COVID-19 (AETC NCRC, December 2020) – This article examines the connection between oral health and the severity of COVID-19, as well as the importance of maintaining oral health, including dental visits, for people with HIV.

Oral and Oropharyngeal HPV Infection in People with HIV (Northeast/Caribbean AETC, November 2020) – These training slides on oral HPV infections in people with HIV cover HPV pathogenesis, prevalence, risk factors, benign and malignant disorders, vaccines, and other topics.

Taking the Fear out of Dental Visits: Oral Health, COVID-19 and HIV (New England AETC and Pacific AETC, October 2020) – This workshop recording provides an interprofessional update on HIV oral health issues and the role of medical and dental providers, case managers, and others in assuring access to safe oral healthcare during the COVID-19 pandemic. The session includes background information about HIV and oral health; safe dental visit procedures for emergency, urgent, and routine care; discussions on successful tele-dentistry practice; and best practices for dental team members in providing care during pandemics.

Infection Control in Dentistry, Sterility Assurance (New England AETC, June 2020) – This webinar focuses on infection control and sterility assurance in dental settings.

Infection Control in Dentistry, Post-Pandemic Planning (New England AETC, June 2020) – This webinar provides an update on infection prevention and control in dentistry, as well as interim guidance and planning for post-pandemic dental practice.

COVID-19 & Dental Health Care: Patient and Provider Challenges (Northeast/Caribbean AETC, June 2020) – These training slides include information on patient and provider anxiety and offer practical guidance for dental visits during the pandemic.

Oral Health (HRSA, February 2018) – Although this web page is not HIV-specific, it includes extensive information that is applicable to people with HIV, including the following topics: risk assessment; oral health evaluation; preventive intervention; communication and education; and interprofessional collaborative practice.

 

Selected Additional Resources

How Depression Is Linked to Oral Health (CareQuest Institute for Oral Health, May 2022) – This fact sheet includes findings on the impact of depression on oral health, including oral hygiene, dental visits, oral health problems, and pain and pain medication use.

The Influence of Antiretroviral Therapy on HIV-Related Oral Manifestations (Journal of the National Medical Association, August 2021) – This paper provides an overview of oral manifestations seen among people with HIV, the impact of antiretroviral therapy on  the prevalence of oral manifestations, and the provision of dental care to people with HIV.

HIV Screening in the Dental Setting in New York State (PLoS ONE, April 2020) - This article describes a study examining the feasibility of implementing HIV screening in the dental setting, identifies patient characteristics associated with acceptance of HIV rapid testing, and discusses best practices of HIV screening in the dental setting.

Dental Complications After Treating Patients with AIDS (Journal of the American Dental Association, March 1994) – Although old, this paper provides a valuable overview of the types and rates of oral complications associated with invasive oral procedures in people with HIV.