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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, Infographics, Brochures, and Websites

HIV/AIDS & Oral Health (National Institute of Dental and Craniofacial Research) – 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.

HRSA’s Ryan White HIV/AIDS Program Oral Health Data Infographic (HRSA HAB) – This infographic illustrates client-level data for RWHAP oral health services, dental programs, and AETC programs.

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) – 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) – 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) – 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) – 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.”

Oral Health for People With HIV (HRSA) - This web page provides information to help people with HIV take good care of their oral health.


Strategic Plan

National HIV/AIDS Strategy (2022-2025) (White House) – 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) – 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) – 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) – 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) – 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.

Organization for Safety, Asepsis and Prevention (OSAP) Education & Training - Education and training resources on dental infection prevention, occupational health, and patient safety.


Ryan White HIV/AIDS Program (RWHAP)

Ryan White HIV/AIDS Program (RWHAP) Part F: Dental Programs (HRSA) – 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 Oral Health Data Report: 2020 (HRSA, February 2023) – The report presents national data from January 2015 through December 2020 on RWHAP oral health programs. The publication provides a deeper look at service utilization, demographic, and socioeconomic factors among clients served across RWHAP oral health programs and the characteristics of RWHAP-funded organizations that deliver oral health services. The report also includes information about trainings delivered to oral health providers to treat people with HIV and providers trained.

Ryan White HIV/AIDS Program Part F Dental Services Report: Instruction Manual 2022 (HRSA) – 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.


New England AETC Oral Health and HIV Recorded Webinars

The Role of the Oral Healthcare Team in Ending the HIV Epidemic (New England AETC, August 2022) – This webinar reviews how interprofessional collaboration of medical/dental teams can help achieve the best possible health outcomes for patients with HIV.

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.

HIV & Oral Health Webinar Series Part 1: Trauma Informed Dental Care (New England AETC, December 2022) – The presenter in this webinar provides: 1) an overview of the approach used by a Part F Community-Based Dental Partnership to integrate/implement trauma-informed care into their program; and 2) examples of strategies participants can apply to create a more trauma-informed practice to improve the delivery of dental care.

HIV & Oral Health Webinar Series Part 2: Emerging Viral Diseases: Implications for People with HIV (New England AETC, January 2023) – The presenter in this webinar discusses: 1) the importance of vaccination for disease prevention and/or elimination of severe disease and death; 2) methods to mitigate the spread of emerging viral infections in the dental setting; and 3) how providers can access the latest data about the impact of emerging viral diseases in their community.

HIV & Oral Health Webinar Series Part 3: Providing Safe and Optimal Oral Health Care to PWH: What Everyone Should Know and Do (New England AETC, February 2023) - The presenter in this webinar: 1) discuss safety concerns when providing dental care to PWH; 2) review the common oral mucosal manifestations of HIV; and 3) review the important role of saliva play in maintaining good oral health and how to best manage hyposalivation.

HIV & Oral Health Webinar Series Part 4: Substance Use Disorders and Oral Health (New England AETC, March 2023) - The presenters in this webinar: 1) review the current trends in substance use disorders and HIV infection rates nationally and in the Boston area; 2) describe the oral presentations and dental implications of opioid, cannabis, methamphetamine, and cocaine use; 3) review oral health trends among patients living with HIV; 4) discuss how to mitigate the oral health risks of medication-assisted treatment; and 5) identify opportunities for interprofessional collaboration to support and promote the oral health of vulnerable patients.

HIV & Oral Health Webinar Series Part 5: Sexually Transmitted Infections and Oral Health for People with HIV (New England AETC, April 2023) - The presenter in this webinar: 1) describe the oral presentations of common sexually transmitted infections (STIs); 2) outline the process of STI transmission through oral tissue; 3) explain the impact of STIs on the risk of oral HIV transmission; and 4) define the role of oral health & hygiene in preventing oral transmission of HIV and others STIs.

HIV & Oral Health Webinar Series Part 6: HIV, Oral Health, and Health Equity for Older People (New England AETC, May 2023) - The presenters in this webinar: 1) define ageism and its root causes, and discuss how ageist beliefs translate into inequitable healthcare practices; 2) identify at least 3 examples oh how ageism is expressed in the delivery of care to older people with HIV and those with oral health needs; and 3) identify strategies that providers can employ to decrease ageism and improve equitable healthcare for older people.

HIV & Oral Health Webinar Series Part 7: HPV, Sex, and Cancer (New England AETC, June 2023) - The presenter in this webinar reviews: 1) the role played by HPV in cancer; 2) the epidemiology of head and neck HPV infection, and its risk factors including HIV-related factors; and 3) the guidelines on HPV vaccination and early evidence for its effectiveness in the "real world".


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

HIV Care Conversations: Engaging Non-Clinical Team Members in Oral Health Care for People with HIV (AETC National Coordinating Resource Center, June 2023) - In this podcast, Helene Bednarsh, BS, RDH, MPH, Dental Director, New England AETC, discusses ways to elevate awareness about the unique role case managers, peer navigators, and other non-clinical team members can play in addressing barriers to care for people with HIV. 

HIV Care Conversations:Trauma-Informed Dental Care (AETC National Coordinating Resource Center, April 2023) – In this podcast, Dr. Jill York shares experiences from her dental program’s participation in the New Jersey HIV Trauma-Informed Care Project and discusses the impact trauma-informed care training has had on clients and staff.  

HIV Care Conversations: Increasing Communication Between Dental and Medical Professionals (AETC National Coordinating Resource Center, February 2023) - This podcast discusses the importance of bi-directional communication between medical and dental professionals to improve healthcare acquisition, delivery, and outcomes.

18th Annual Conference on HIV/AIDS & Aging (New England AETC, September 2022) – This webinar covers many issues related to HIV and aging, including long-term survival, primary prevention, PEP, PrEP, transgender health, oral health, mental health, and substance use.

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.

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.

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.

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.

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.

Other Recent Articles and Papers with Important Updates Relevant to Oral Health and HIV (various journals)

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.