Oral Health and Dental Management

Abstract

Prevalence of orodental findings in HIV-infected Romanian children

Catherine Flaitz, Blake Wullbrandt, John Sexton, Timothy Bourdon, John Hicks

Background: Romania, the pediatric AIDS capital of the world, has tremendous unmet dental care
needs for children and adolescents with HIV infection. The purpose of this study was to assess the
prevalence of orodental conditions in symptomatic HIV positive children from Constanta, Romania.
Methods: The children underwent dental examinations and treatment at Constanta Municipal Hospital
by a volunteer team of dental healthcare professionals from the United States. Oral lesions and dental
caries were recorded during an 8-day period prior to initiating comprehensive dental care.
Results: The study population consisted of 173 children (88 males; 85 females) with a mean age of 8.8
years (range 6 to 12 years). The primary HIV risk factor was contaminated needle reuse and/or blood
products (88%). The most common oral and perioral lesions included: candidiasis (29%), ulcers (15%),
salivary gland diseases (9%), necrotizing ulcerative gingivitis/ periodontitis (5%), linear gingival erythema
(4%), labial Molluscum contagiosum (3%), oral warts (2%), hairy leukoplakia (2%), and herpes
zoster (1%). One or more oral/perioral lesions occurred in 55% of the children. Severe dental caries
was noted in the majority of children (dfs/dft 16.9/3.7 and DMFS/DMFT 8.1/3.1). Over-retention of primary
teeth (25%) and delayed eruption (42%) were common. Postoperative complications included
delayed clotting (common) and thrombocytopenia-induced bleeding disorders (4%).
Conclusions: The oral healthcare needs of Romanian HIV infected children are considerable, with the
majority living with persistent, symptomatic oral diseases.