AIDS still figures among the ten major and most important world health problems, despite all progress in the studies focusing on the virus and transmission prevention. Therefore, it is imperative that dental professionals have all possible knowledge towards HIV+ patients’ care, mainly when it comes to cross contamination and pathogen dissemination. Having that in mind, the aim of the current investigation was to evaluate the level of dental care professionals’ knowledge and practice in relation to HIV/AIDS individuals in the State of Rio de Janeiro, Brazil.
At the beginning of this study, it was possible to reach about 5,000 dentists through their e-mails registered at the state dental council of Rio de Janeiro. However, only 242 of those professionals accepted to participate in the study, representing a low response rate (4.8%). Nonetheless, it is still a comparable sample size to other studies [13, 18, 19]. In the study of Maia et al. [13], 170 dentists from Northeast Brazil were included; in Senna et al. [18], 140 dentists answered a questionnaire in another state capital. In the current investigation, most participants were women (66.9%). A predominance of female participants (64.3%) was also reported in other studies [18, 19].
More than 75% of participants know that HIV/ AIDS individuals can be diagnosed with oral manifestations. Moreover, most participants said that Kaposi’s sarcoma (89.5% of women and 90% of men) and oral candidiasis (85.2% of women and 82.5% of men) are oral signs of HIV/ AIDS. Those diseases seem to be the most known by dentists as related to HIV/ AIDS, as it was demonstrated by other studies [12, 20, 21]. In Oliveira et al. [20], 92.5% and 90.3% of participants said that Kaposi’s sarcoma and oral candidiasis, respectively, are oral manifestations of HIV/ AIDS. Similarly, Oberoi et al. [21] presented a percentage of “yes” of 95% for oral candidiasis, 86% for Kaposi’s sarcoma, 88% for necrotizing ulcerative gingivitis, 85% for hairy leukoplakia, 81% for Herpes zoster and major aphthous and 75% for salivary gland infection. In Sadeghi and Hakimi [12] work, several lesions were pointed out as associated to HIV/ AIDS. Interestingly, despite oral herpes simplex being an oral pathognomonic marker of HIV, current results showed a low rate of positive answers relating these lesions to HIV+.
Regarding accident with sharp objects, above 85% of the participants answered that HIV is transmitted via needle stick injury, which is in accordance with previous reports with dental students [10, 12, 17, 22, 23]. Nevertheless, this notion is not universal, as demonstrated by Aggarwal and Panat [24]. In the study of Rostamzadeh et al. [19] only 84% of the dentists affirmed that HIV/ AIDS prophylaxis is recommended after a needlestick injury.
Additionally, current data demonstrated that nearly 100% of individuals were worried of acquiring HIV after sharp object accident and would be taking a test afterwards. Those findings are a reflection of a great awareness on the existing risk in the injury with contaminated sharp objects [21, 25]. However, in another study [20], only 48% of participants said that they would be tested for HIV after a sharp object accident. Despite that low rate of concern with accidents, in Maia et al. [13] dentists presented major concerns in terms of work conditions in the care of HIV/ AIDS individuals. In that study, it was demonstrated that dentists who had continuous education towards HIV/ AIDS individuals’ care might feel more confident to provide better care. Interestingly, a Canadian study showed that people living with HIV/ AIDS would prefer to be treated by dentists who are knowledgeable on the condition and with previous experience in treating carriers [26]. In fact, participants of that study believed that an increase in the knowledge and in the clinical experience may create an improved relationship between the patient and the professional.
In the current study, it was shown that disposable masks are used by almost every participant. The use of cap was significantly different between men and women. This could be explained by the fact that women are more worried with their hair contamination when there is a contaminated spray produced during handpiece use. In terms of using protection goggles, the current data is much higher to the ones reported by Oliveira et al. [20], in which 8% of women and 21% of men used it with all patients. Overall, current findings showed that the use of individual protection equipment were more frequent when compared to another study [19].
In general, current participants consider AIDS, nowadays, as not the most important health problem in the world. It is in accordance with other studies, in which 68% [12] and 65% [24] of participants had similar answers. It is a fact that worldwide efforts on implementation of HAART have guaranteed longevity and quality of life to the ones living with HIV/ AIDS. Therefore, currently, it is not the most important health problem in the world. Nonetheless, it still is among the 10 major health problems in the world [5].
Not only is preventive approach a must in daily dental clinics, but it is also essential that dentists may be able to provide incipient diagnoses through the evaluation of oral cavity manifestations of HIV/AIDS. Ultimately, a good oral health will contribute for a good quality of life.