Underserved residents of Kentucky who have HIV or AIDS will continue to have access to comprehensive oral healthcare through the University of Louisville (UofL) School of Dentistry thanks to $2 million in federal funding.
The funding has been awarded to the Kentucky Cabinet for Health and Family Services Department for Public Health HIV/AIDS Services Branch, Ryan White Part B program, and contracted to the UofL School of Dentistry. The Ryan White Part B program provides grants to support the overall healthcare, including oral care, of people with HIV and AIDS.
The UofL’s Community Based Dental Partnership Program (CBDPP) is one of only 12 Ryan White CBDPP federally funded oral health programs in the United States and the only one in Kentucky. The 2-year grant will allow for increased access to oral healthcare services for people living with HIV while providing education and clinical training for dental care providers, especially those practicing in community-based settings.
Dental care is one of the most common unmet needs for people living with HIV and AIDS in Kentucky. These needs include fillings, crowns and bridges, dentures, and more. Additionally, patients with HIV may suffer from oral candidiasis, which includes a burning sensation in the mouth and changes in taste.
“Patients who have issues with their teeth begin to limit the types of food they eat. This can result in malnourishment, which in turn affects the absorption of HIV medications. The end effect is a more compromised immune system,” said Catherine Binkley, DDS, MSPH, PhD, associate professor in the department of surgical and hospital dentistry at UofL and program director for the Ryan White CBDPP.
Herpes simplex, linear gingival erythema, and painful recurring ulcers are possible as well. Furthermore, HIV is associated with episodes of illness, fevers, diarrhea, and super-infections, all of which can result in oral effects involving both hard and soft tissues.
Plus, HIV-infected children may see developmental effects in tooth enamel and soft tissue linked to medications or the disease itself. Overall, patients see significant effects on their quality of life.
“Social interactions also can be negatively impacted by poor oral health. Patients with fractured or missing teeth all too often limit educational and career seeking opportunities, as well as withdraw from friends and group scenarios,” said Binkley. “Restoring teeth for patients in all these situations impacts their lives in major ways. We want to help our patients put their lives back together and become part of society by providing a new smile.”
The dental school first received funding from the Kentucky HIV/AIDS Branch Ryan White Part B program for a 6-month pilot in January 2014. The funding was provided to expand the reach of oral health services and create a statewide network for improving access to comprehensive oral healthcare and improved oral health outcomes for individuals living with HIV and AIDS enrolled in the Kentucky Ryan White Part B program.
Based on the pilot program’s success, the UofL School of Dentistry’s CBDPP received a $1.2 million 2-year state contract for 2014 to 2016 and has now received $2 million for 2016 to 2018 to continue. Last year, UofL dental healthcare providers performed more than 6,000 procedures for nearly 600 HIV and AIDS patients.
Furthermore, the federal House Appropriations Committee recommends $13.1 million for fiscal year 2017 for the Ryan White Part F program, which specifically covers the unreimbursed costs of providing dental care to people with HIV and AIDS. Although the program has provided oral healthcare to these patients, the committee is concerned that it has not kept pace with the number of people in need.
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