Prevalence of oral impacts on daily performances among adolescents living with HIV at a tertiary paediatric hospital in Johannesburg, South Africa

Abstract

To determine the prevalence of oral impacts on daily performance among HIV positive adolescents attending a wellness program at a Tertiary Hospital Johannesburg. A cross-sectional study design was conducted where a clinical examination was performed to determine the intra oral mucosal lesions, decayed, missing, filled teeth (DMFT) and Significant Caries Index (SiC). The Child-Oral-Impact on Daily-Performance (Child-OIDP) questionnaire was interviewer-administered to the adolescents at the tertiary paediatric hospital. There were n=208 adolescents with mean age 15.3 years (SD: 2.19; range 9.6-19.9 years). Fifty-five percent of the adolescents were female and 32% of had unemployed parents. About 39% rated their oral health as poor. More than 70% reported not accessing dental services six months prior. The most reported oral conditions were toothache (28.4%), unwanted colour of teeth (24.5%) and bleeding gums (24.0%). The dental caries prevalence was 87%, the DMFT was 3.9 (SD: 3.2; range 0-16) and the SiC was 7.6 (range 4-16). The participants had very minimal restorations (11.7%). The most common mucosal condition identified was linear gingival erythema (27.4%). The prevalence of at least one oral impact was 82% whilst the three mostly impacted activities were difficulty cleaning teeth (53.4%) eating food (51.2%) and enjoying being with people (48.9%). The distribution of the overall impact scores was skewed .The scores ranged from 0-56 with a median of 6 and a mean score of 9.3 (SD = 10.5). The individual mean score range was, 0 to 9, the highest being ‘smiling or laughing’ at 2.8. A poor self-rated oral (p = 0.00) and not being satisfied with appearance of teeth and mouth (p = 0.05) was related to the overall impact score. There was a high prevalence of oral impacts, dental caries and the symptoms related to dental caries. The most impacted activity was cleaning teeth and eating. These activities are related to the symptoms reported. It is imperative that dental caries and the symptoms are managed well to reduce the impacts on the adolescents’ daily oral activities.