September 2007

Objectives: An observational study was carried out in order to describe the experience gained from the establishment of a dedicated dental clinic for HIV-infected people in Athens, Greece. Methods: Data were collected retrospectively from the files of HIV-seropositive individuals attending the dedicated clinic for a period of seven years (1997-2003) and included the following variables: demographic characteristics, transmission route of HIV disease, oral lesions, general health concerns, dental visiting behavior before and after HIV-disclosure and dental procedures, carried out during the study period. Results: The study patients comprised 426 HIV-seropositive individuals; 355 male (83%), 71 female (17%), mean age 40 years (range 17-76). The predominant mode of acquisition of HIV infection was sexual contact (88.5%), followed by intravenous drug abuse (3.8%), blood transfusion (2.5%) and vertical transmission (0.3%). Most of the patients attended the dedicated clinic because of direct/indirect denial of treatment by their dentist (29.1%), fear of attending their dentist (20.6 %), financial constraints (17.5%), or because they were seeking specialized services (2.4%). Nearly half of the patients (46%), after they have been informed about their HIV-seropositivity, either did not attend their dentist, or did not disclose their HIV-status when they did attend. The type of 4,688 dental procedures carried out during the study period, were the same as those performed in any general dental practice, without exhibiting increased risk of post-treatment complications. Finally, a relatively low overall incidence (41%) of oral lesions was observed, due to the effect of the highly active anti-retroviral therapy (HAART). Conclusions: Dedicated dental clinics can play a supplementary, but substantial role in the overall management of people whose HIV-status, or HIV-related clinical problems may prevent them from obtaining treatment from general dental practitioners within Greece. Key words: Attitudes, dedicated clinic, dental services, Greece, HIV, oral lesions.