Dental caries prevalence and dental health behaviour in HIV infected children.
OBJECTIVES: To determine dental caries prevalence in a group of HIV positive children and their reported dental health behaviour. DESIGN: Standardized epidemiological dental examination and structured interview. SETTING: Paediatric HIV outpatient department in a South London hospital. STUDY POPULATION: HIV-positive children attending the above outpatient clinic over a 6-month period (30 subjects) and parents (20 informants). METHODS: Epidemiological examination of children was undertaken by one trained and calibrated examiner to determine caries prevalence using dmft/DMFT. Parents were interviewed to obtain information on their children's dental health behaviour: toothbrushing, diet, fluoride; oral medication and dental attendance were explored. RESULTS: Sixty-three per cent (n = 19) of children had dental caries experience, much of it untreated. Mean dmft/DMFT was 4.4. Sixty per cent (n = 18) of all children presented with active or untreated caries and the care index for those at/under age 5 years was low (10%). Unfavourable dental health behaviour included: consumption of nonmilk extrinsic sugars at night, use of sugar-based medications, low fluoride intake, late commencement of toothbrushing and poor dental attendance. Dental health was not considered a priority for many of these children. Parents did not necessarily disclose their child's HIV status on dental attendance. CONCLUSION: Caries prevalence was high, much of the disease untreated, and unfavourable dental health behaviour, including the use of sugar-based medicines was common. HIV infected children should be considered a high caries risk and receive appropriate dental care, in terms of both treatment and preventive services, following confirmation of seropositivity.