"Toothaches, dentists and HIV"


(Report of a dentist; anonymos; 16. april 1999)

Don't worry, this chapter is not about losing your teeth through being HIV-positive!

However, HIV-positive individuals don't take the control of teeth and gums as seriously as other people. In general: Nobody likes to go to see the dentist! This part is about the interactions and fears between dentists and HIV-positive patients.

On the patients side it's not about being hesitant to go to the dentist but also how hard it is to find a dentist who is knowledgeable in the field of HIV and who is not turning down patients at the doorstep. Knowledgeable also meaning that he/she is not recommending senseless therapies.

On the side of the dentist - frequently as a result of insufficient information - creating an atmosphere of understanding an HIV-positive patient. Many dentists are to be criticized for lack of training in HIV-related dental diseases resulting in wrong diagnoses and therapies. It is common sense nowadays, that the routine plaque removal on the gums is associated with microbleeding and can be a potential source of infection. Therefore, many dentists behave like that:

In order to avoid any risk in treating such patients, I'd rather not treat them at all!

Another important point for turn-ing down HIV-positive patients lies in the uncertainty of the other patients' reaction. The public is in panic due to the information in the media and many patients would walk away from any kind of doctor's office, where HIV-patients are being treated. Common rumors say:

"You contract AIDS just from being in the same room with a patient or from shaking his hand."

Therefore, financial interests govern the decision of several dentists not to treat HIV-patients at all in order not to lose their routine clients.

On the side of the patients there is a double risk: Is he honest and informs the doctor, he runs the risk of being declined. Is he not telling his HIV-serostatus, he is potentially exposing the treating physician or his personnel to a certain risk. But it is so much easier - not to tell - and receive treatment. As a result of all this, some dentists take advantage of the patient's uncertainty. This implies to perform costly treatments that show a result shortterm but do not have any influence on the prognosis of the dental status in the long-line. A temporary fixation is usually helping the dentist, because the patient has to come back and needs new inlays or fillings. Not all dentists behave like this and the goal of this statement is not to scare people. As a result, HIV-positive individuals should frankly communicate their HIV-serostatus and not hide it because of the concern of being denied. On the other hand, dentists should not take advantage of seropositive patients.

"...when I became diagnosed ..."