Fall 2007

Table 1. Demographic Information of HIV-infected children versus non-infected peers
All Subjects (N=40)­ Control Subjects (N=10)­ HIV-infected (N= 30)­

Sex
Male Female	18, 45% 22, 55%	4, 40% 6, 60%	14, 47% 16, 53%
Race/ethnicity
White Black non-Hispanic	3, 7.5% 37, 92.5%	0, 0% 10, 100%	3, 10% 27, 90%
Mean Age (years), SD	11.0, 5.1	8.91, 5.85	11.6, 4.76
Mean Age (months) SD	131.4, 61.4	106.9, 70.17	139.60, 57.12

RESULTS
Demographics
The response rate for the eligible HIV-infected patients and controls combined was 83% (40 of 48). There were 30 HIV-infected participants (14 males and 16 females) and 10 control subjects (4 males and 6 females). The HIV-infected patients included 3 white participants (10%) and 27 Black non-Hispanic participants (90%). All 10 of the control subjects were Black non- Hispanic (100%) (Table 1). All participants were Medicaid participants. Of the 38 participants who had a recorded poverty level value, the mean value was 142.4 ± 61.8 %.

Questionnaire
Questionnaires revealed that there were no statistically significant differences between the HIV-infected children and the control group in regards to having a regular dentist (p = 0.4507), brushing frequency, mean number of daily brush times (p = 0.9463), use of fluoride toothpaste (p = 1.000), or the presence of sealants (p = 0.2686). HIV-infected subjects tended to have a greater

frequency of dental care (p=0.064) and less soda and juice intake (p=0.068) (Table 2).

Salivary flow rate
and plaque accumulation
Children above 2 years of age were included in the saliva collection portion of the study. The mean salivary flow rate for HIV-infected patients was 0.138 ± 0.14 g/min while the mean salivary flow rate for the control was 0.0943 ± 0.11 g/min. The mean plaque index for those with HIV was found to be 0.996 ± 0.74 versus the control participants which had a mean plaque index of 0.579 ± 0.62. Within the HIV-infected population, those with viral loads below 10,000 copies/mL had a mean salivary flow rate of 0.16 g/min versus those with a viral load of greater than 10,000 copies/ mL who had a mean salivary flow rate of 0.10 g/min (p = 0.18). Interestingly, those described as having more severe HIV-infection (having reached a CD4 % of below 20% at least once) had a mean salivary flow rate of 0.16 g/min. Those with a lowest CD4 % of greater than or equal to 20 % had a mean salivary flow rate of 0.12 g/min.

Table 2. Dental background All

Child has a regular dentist	28, 70 %	6, 60 %	22, 73.3 %
Frequency of visits to dentist Every six months Once a year Every 2 years Less often than every 2 years Whenever needed (no regularschedule)	21, 52.5 % 7, 17.5% 0, 0.0% 4, 10% 8, 20%	3, 30 % 3, 30 % 0, 0.0% 3, 30 % 1, 10%	18, 60 % 4, 13.3% 0, 0.0% 1, 3.3% 7, 23.3%
Mean Number of brush times per day SD	1.805, 0.850	1.80, 0.919	1.81, 0.84
Use of fluoride toothpaste	37, 92.5%	9, 90%	28, 93.3%
Soda and juice intake 0 per day 1 per day 2-3 per day 3+ per day	4, 10% 8, 20% 13, 32.5% 15, 37.5%	0, 0.0% 0, 0.0% 6, 60% 4, 40%	4, 13.3% 8, 26.7% 7, 23.3% 11, 36.7%
Presence of sealants	15, 37.5%	2, 20%	13, 43.3%

Eruption

Children aged 14 years and below were included in the eruption study. There were a total of 26 participants (19 HIV infected, 7 control). The HIV-infected cohort contained 11 children with delayed eruption, 2 children with accelerated eruption and 6 with appropriate eruption.

The control group included 2 children with delayed eruption, 1 child with accelerated eruption, and 4 children with appropriate eruption. Statistical analysis did not reveal significant differences between the two groups (p = 0.5626). No males were found to have accelerated eruption, but 50% of the males and 50% of the females were found to have delayed dental eruption (Table 3).

Table 3. Count and percent eruption pattern of teeth in patients versus the control

	All Male Subjects (N = 8)	All Female Subjects (N = 18)	HIV-infected Subjects (N = 7)	Control Subjects (N = 7)
Delayed Eruption	4, 50%	9, 50%	11, 58%	2, 29%
Accelerated Eruption	0, 0%	3, 17%	2, 11%	1, 14%
Appropriate Eruption	4, 50%	6, 33%	6, 32%	4, 57%

Poverty level did not significantly affect eruption status. Those with normal or accelerated eruption status had a mean poverty percentage of 133.3 % while those with delayed dental eruption had a mean poverty percentage of 120.3 % (p = 0.30). The mean z-score for height was compared to each eruption category. The mean z-score for those individuals with normal or accelerated eruption was 0.06 while those with delayed eruption had a mean z-score of -0.42 (p = 0.13). Those with appropriate eruption had the lowest mean CD4 count and the highest viral load while those in the accelerated category had the highest CD4 count and the lowest viral load (Table 4).

Out of the 8 patients with normal or accelerated eruption, 2 patients had a lowest CD4 percent of less than 20%. Out of the 11 patients with delayed dental eruption, 5 had a lowest CD4 percent of less than 20%. These differences do not reveal a significant trend of disease severity and delayed dental eruption (p = 0.36). When examining viral load as a predictor of dental eruption status, there were 4 patients with viral loads above 10,000 copies/ mL. Although not statistically significant (p = 0.44), 21 % of those with delayed dental eruption had viral loads above 10,000 copies/mL and 12.6 % of those with Normal or accelerated eruption had viral loads above 10,000 copies/mL.

Table 4. Eruption status by z-score and severity of HIV-infection

	Mean height z-score (N = 20)	Mean CD4 count (N = 19)	Mean viral load (N = 18)
Delayed Eruption	-0.6582	1054.6	10,958.7
Accelerated Eruption	-0.3133	1700.5	1,633.5
Appropriate Eruption	-0.7283	810.0	138,716.0

To continue the article click here.

Psi Omega Fraternity
1040 Savannah Highway
Charleston, SC 29407

Telephone: (843) 556-0573
Fax: (843) 556-6311
E-mail: psiomega@bellsouth.net