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That is a great question....

My dentist of five years had NO idea and

all he could tell me was, that my gum recession on my all my teeth

and that he did not understand, why....

From: Dave Marquette <djrunnergo@...>Subject: Dental Care Date: Wednesday, February 4, 2009, 12:00 AM

Is there any special dental care that is given to HIV + people above the normal dental care one receives?I'm noticing some gum recession on my top teeth is this HIV related?Thank You.

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Hi guys,

Check out the web site at http://www.hivdent.org/

- HIVdent by Dr. Reznick of Grady Hospital

(Listed in AIDS InfoNet – Treatment, Specialized Sites at http://www.aidsinfonet.org/fact_sheets/view/930

Bob Munk

Coordinator

AIDS InfoNet

From:

[mailto: ] On Behalf Of 310541w

Sent: Thursday, February 05, 2009 3:59 PM

; Dave Marquette

Subject: Re: Dental Care

That is a great question....

My dentist of five years had NO idea and

all he could tell me was, that my gum recession on

my all my teeth

and that he did not understand, why....

From: Dave Marquette <djrunnergo@...>

Subject: Dental Care

Date: Wednesday, February 4, 2009, 12:00 AM

Is there any special dental care that is given to HIV +

people above the normal dental care one receives?

I'm noticing some gum recession on my top teeth is this HIV related?

Thank You.

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I had a great HIV dentist several years ago, who believed that certain HIV meds were causing dry-mouth induced gum recession and decay in patients. He moved on and was replaced by successive "less-dedicated" dentists, and now I'm seeing a private dentist who asked what kind of insurance I have before he even introduced himself. It's hard to find a dentist who will take Medicaid, and those who do won't give me the same treatment they would if I had decent insurance (they don't get paid as much for procedures - I don't know if the prior approval rules have changed). Anyway, I've lost crowns due to gum recession (which makes flossing properly treacherous), and the latest one needs a root canal to replace - but - he won't do it, only pull the tooth. So I'm shopping all over town to try to find someone who's willing to do the work properly. We even have a White Dental Clinic still - only has a part-time dentist with a waiting list until June 25th. That's my current experience.

Before - standard of care for HIV patients was to at least have a recall visit (cleaning) every 3 months, because we tend to be more susceptible to oral disease. I think it's now every 6. Things are changing fast with this financial climate of funding cutbacks and immune reconstitution. I'm just glad I got fixed up when I had the chance.

BG

Is there any special dental care that is given to HIV + people above the normal dental care one receives?I'm noticing some gum recession on my top teeth is this HIV related?Thank You.

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Many people with HIV have decreased saliva production. A dry mouth is not good, because your saliva works against tartar and plaque buildup which cause tooth decay and gum recession. If you have less saliva you'll probably have more recession. My dentist told me to chew Biotene dry-mouth gum. You can get it at most drug stores, or order it at the Costco Pharmacy for about 45% of what it costs elsewhere if you order 12 packs at a time. You can also use dry-mouth toothpaste or mouthwash (there are various available including Biotene products). All of these stimulate saliva . You want to make sure your mouth is not dry.Even with normal saliva you may also have chronic low-grade inflammation of the gums. There is a special 20mg dose of doxycycline called Periostat, which you take twice a day (ongoing). It will lessen inflamed gums. (Note- this special dose is about 300% more expensive than buying 100mg pills and splitting them 4 ways. Last I checked you cannot get generic doxycycline in 20mg dose. Save lots by asking for generic 100mg and doing it yourself).With inflamed gums and/or quicker build-up of tartar, you may need to get your teeth cleaned more often to prevent recession.> > > From: Dave Marquette djrunnergo@...> Subject: Dental Care> > Date: Wednesday, February 4, 2009, 12:00 AM> > > > > > > > > > > Is there any special dental care that is given to HIV + people above the normal dental care one receives?> > I'm noticing some gum recession on my top teeth is this HIV related?> > Thank You.>

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It's VERY important the HIV+ individuals see a dentist on a regular basis, preferably one that has expertise and training in identifying the over 40 HIV-related oral health issues.

Gum recession is usually caused by bacteria under the gum line and can be exacerbated by dry mouth. Peridex is usually prescribed to help with gum issues, but it can discolor teeth and will discolor crowns when used over a long period of time.

Make sure you're using a SOFT toothbrush. At the Univ. of Penn, we actually recommend Colgate TOTAL since it's as effective as Listerine in killing bacteria but doesn't dry out the mouth.

Of course, smoking, drinking, and drug use will also cause gum problems as well. Recent research is showing that gum disease can lead to heart problems and has also shown to increase the risk for pregnant women to delivery prematurely and have lower birth-weight babies.

There are several White funded dental clinics around the US. 99.9% of all the care is covered under White. Very small exceptions may occur for really complex cases, but I've never heard of a funded clinic denying care because of the inability to pay. Just make sure you keep your scheduled appointments!! Be proactive instead of reactive with your dental care.

Oral Health Outreach Program Coordinator

University of Pennsylvania

School of Dental Medicine**************Great Deals on Dell Laptops. Starting at $499. (http://pr.atwola.com/promoclk/100000075x1217883258x1201191827/aol?redir=http://ad.doubleclick.net/clk;211531132;33070124;e)

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"Is there any special dental care that is given to HIV + people above the normal dental care one receives?I'm noticing some gum recession on my top teeth is this HIV related?"I think the most important thing isn't "special car," but pro-active dental care. I see a periodontist four times a year.The oral cavity is about as clean as a bus station bathroom, and is an important entry point for all kinds of pathogens.People with HIV need to see their dentists regularly, preferably a dentist familiar with HIV issues. Periodontal disease is increasingly common with age, and an important cause of gum recession.Careful attention to flossing, cleaning your tonge, and using a listerine-type mouthwash twice a day can really help to keep gum disease under control.JB

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Can anyone tell me, if I dare tell any dentist or doctor

that I'm HIV positive without them refusing to give me care????

Last year, when I went to have my eyes checked

this nurse ask to see, what medications I was

taking... When she saw my HIV meds listed, she

walked out of the room and never came back...

Finally, the doctor came in and had to ask, what

was wrong with her....

From: Bill Gaul <wgaul1@...>Subject: Re: Dental Care , "Dave Marquette" <djrunnergo@...>Date: Thursday, February 5, 2009, 9:58 PM

I had a great HIV dentist several years ago, who believed that certain HIV meds were causing dry-mouth induced gum recession and decay in patients. He moved on and was replaced by successive "less-dedicated" dentists, and now I'm seeing a private dentist who asked what kind of insurance I have before he even introduced himself. It's hard to find a dentist who will take Medicaid, and those who do won't give me the same treatment they would if I had decent insurance (they don't get paid as much for procedures - I don't know if the prior approval rules have changed). Anyway, I've lost crowns due to gum recession (which makes flossing properly treacherous), and the latest one needs a root canal to replace - but - he won't do it, only pull the tooth. So I'm shopping all over town to try to find someone who's willing to do the work properly. We even have a White Dental Clinic still - only has a

part-time dentist with a waiting list until June 25th. That's my current experience.

Before - standard of care for HIV patients was to at least have a recall visit (cleaning) every 3 months, because we tend to be more susceptible to oral disease. I think it's now every 6. Things are changing fast with this financial climate of funding cutbacks and immune reconstitution. I'm just glad I got fixed up when I had the chance.

BG

Is there any special dental care that is given to HIV + people above the normal dental care one receives?I'm noticing some gum recession on my top teeth is this HIV related?Thank You.

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Callen-Lorde in NYC has excellent dental care, with, what looked to me, like all brand new equipment, with wonderful technicians.On Feb 6, 2009, at 3:08 PM, Cole@... wrote:It's VERY important the HIV+ individuals see a dentist on a regular basis, preferably one that has expertise and training in identifying the over 40 HIV-related oral health issues. Gum recession is usually caused by bacteria under the gum line and can be exacerbated by dry mouth. Peridex is usually prescribed to help with gum issues, but it can discolor teeth and will discolor crowns when used over a long period of time. Make sure you're using a SOFT toothbrush. At the Univ. of Penn, we actually recommend Colgate TOTAL since it's as effective as Listerine in killing bacteria but doesn't dry out the mouth.Of course, smoking, drinking, and drug use will also cause gum problems as well. Recent research is showing that gum disease can lead to heart problems and has also shown to increase the risk for pregnant women to delivery prematurely and have lower birth-weight babies.There are several White funded dental clinics around the US. 99.9% of all the care is covered under White. Very small exceptions may occur for really complex cases, but I've never heard of a funded clinic denying care because of the inability to pay. Just make sure you keep your scheduled appointments!! Be proactive instead of reactive with your dental care.Oral Health Outreach Program CoordinatorUniversity of PennsylvaniaSchool of Dental Medicine**************Great Deals on Dell Laptops. Starting at $499. (http://pr.atwola.com/promoclk/100000075x1217883258x1201191827/aol?redir=http://ad.doubleclick.net/clk;211531132;33070124;e)

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How about an "underfunded clinic" ? - The local White Clinic here (Albany NY), closed for a while, and now has a dentist 1-1/2 days a week. Waiting 6 months to see him is not an option. And we're a regional center for HIV care!

When I'm losing crowns, once every 6 months with a hygenist and using Peridex is obviously not enough. I think a lot of us are outliving the funding models.

BG

Re: Dental Care

It's VERY important the HIV+ individuals see a dentist on a regular basis, preferably one that has expertise and training in identifying the over 40 HIV-related oral health issues. Gum recession is usually caused by bacteria under the gum line and can be exacerbated by dry mouth. Peridex is usually prescribed to help with gum issues, but it can discolor teeth and will discolor crowns when used over a long period of time. Make sure you're using a SOFT toothbrush. At the Univ. of Penn, we actually recommend Colgate TOTAL since it's as effective as Listerine in killing bacteria but doesn't dry out the mouth.Of course, smoking, drinking, and drug use will also cause gum problems as well. Recent research is showing that gum disease can lead to heart problems and has also shown to increase the risk for pregnant women to delivery prematurely and have lower birth-weight babies.There are several White funded dental clinics around the US. 99.9% of all the care is covered under White. Very small exceptions may occur for really complex cases, but I've never heard of a funded clinic denying care because of the inability to pay. Just make sure you keep your scheduled appointments!! Be proactive instead of reactive with your dental care.Oral Health Outreach Program CoordinatorUniversity of PennsylvaniaSchool of Dental Medicine**************

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Well - it's because I have Medicaid, so not directly discrimination. I had a guy at a White Clinic in the 90's who did the same thing. It was just that they didn't make enough on permanent crowns or root canals, but he gave some lame excuse about them not paying for it "in my case" or something like that. I should have sued the guy's pants off for pulling the first two teeth that could have been saved. He's still practicing somewhere. Just was too sick to even think about going after him. I do feel bad for healthcare professionals getting shorted by Medicaid, but neglecting a patient's health isn't the answer to that. I feel worse for people who just don't take care of themselves, because they don't know where to turn at all.

BG

Re: Dental Care

If they deny you care because you're HIV+, then you sue their pants off! Lawyers LOVES those cases. And, make sure you file an official complaint with your State's regulatory board that oversees that profession. A complaint with the State does go a long way in forcing those who are discriminatory to change their ways.

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Well - it's because I have Medicaid, so not directly discrimination. I had a guy at a White Clinic in the 90's who did the same thing. It was just that they didn't make enough on permanent crowns or root canals, but he gave some lame excuse about them not paying for it "in my case" or something like that. I should have sued the guy's pants off for pulling the first two teeth that could have been saved. He's still practicing somewhere. Just was too sick to even think about going after him. I do feel bad for healthcare professionals getting shorted by Medicaid, but neglecting a patient's health isn't the answer to that. I feel worse for people who just don't take care of themselves, because they don't know where to turn at all.

BG

Re: Dental Care

If they deny you care because you're HIV+, then you sue their pants off! Lawyers LOVES those cases. And, make sure you file an official complaint with your State's regulatory board that oversees that profession. A complaint with the State does go a long way in forcing those who are discriminatory to change their ways.

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  • 1 year later...

Thanks to Joanne for the following information:

know you are fairly active on this group

does everyone know about Harper college's dental hygiene clinic

15.00 for kids 21 for adults, x-rays are 10.00 & sealants are 6.00

it just takes a longer time for care since students do the work

I mention it because so many families don't have insurance

the kid would have to sit for 2- 4 hrs

the clinic is open to anyone disabled or not

Ellen Garber Bronfeld

egskb@...

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