By Catrise Austin, DDS
Dentistry is a unique profession in which we have the opportunity not only to make people look good with the latest advances in cosmetic dentistry and feel better by restoring our clients’ mouths to optimum oral health, but we also have the opportunity to play a pivotal role in screening for other health-related conditions such as hypertension, oral cancer, and now HIV during routine dental care.
According to the Centers for Disease Control and Prevention (CDC), more than 1.1 million people in the United States are infected with HIV, and 232,700 of them don’t know it. More than 56,000 new HIV infections are estimated to occur annually. These are staggering numbers. Knowledge of one’s HIV status is critical — it enables HIV-positive people to get connected to care immediately, helping them live longer and healthier lives. It also empowers them to change their behavior to protect others. While this disease continues take its toll on our communities, it is up to all of us in the medical profession to do our part to help stem the spread of the disease.
The oral cavity is one of several places where signs of HIV infection are found. Previously, we, as dentists, only had the option of recognizing these signs and referring our patients to their primary care physician for testing, diagnosis, and treatment, never knowing if the patients actually went for testing. Now we have access to HIV tests such as the OraQuick Advance rapid oral fluid HIV test, which has given the dental community an opportunity to incorporate rapid HIV testing in their daily practice.
Knowing these stats and how important it is to diagnose HIV early, I decided to make a difference, take charge, and become a leader in the dental industry by becoming one of the first private dental practitioners in the nation to get certified and trained to offer rapid HIV testing in my dental office.
Since dental school, I’ve always had an interest in the topic of HIV. As a matter of fact, my senior presentation was on “The Hidden Population: HIV in the Mid-life and Elderly Population.” I won several awards on this presentation mainly because it highlighted the surprising fact that NO ONE is exempt from this disease, not even the elderly. The problem remains that many people feel that it just can’t happen to them and either don’t practice prevention or make the effort to get tested to know their status. In order to get more people tested, we have to make HIV testing more accessible and convenient. I believe that by offering rapid oral fluid HIV testing to our patients during routine dental visits at least twice yearly, dentists have a unique opportunity to help combat the spread of HIV, and generate awareness of the importance of being tested and knowing one’s status.
It took about three months to complete the certification and training process, and we began offering rapid oral fluid HIV testing this past July. Surprisingly, patient response has been amazing. We offer HIV testing to all of our patients — married, single, young, and old — at the beginning of their dental appointments. Here’s how it works:
Step 1: The client arrives, and we inform him/her at the front desk of our free HIV testing service. If the patient is interested, we have him/her sign a standard informed consent to perform HIV testing, which we obtained from the Department of Health. We also have the patient provide us with his/her primary care physician’s information in case there is a preliminary positive test result.
Step 2: The patient is escorted to the treatment room. Before starting the scheduled dental procedure, we explain the test, offer pre-test counseling, and then administer the HIV test. Rapid oral fluid HIV testing is very easy; the patient simply swabs the outer gums with the device and then inserts the device into a vial containing a developer solution. We then begin regular patient care. Our office manager is responsible for keeping the time because the test takes 20 minutes to complete.
Step 3: At the end of the visit, the patient is given the preliminary test results. In the clinical studies by the manufacturer, the test proved to be 99.3% accurate for people who were infected with HIV and 99.9% accurate for people who were not infected with HIV-1. The rapid test does not offer a confirmed HIV positive result. Individuals who receive a preliminary positive result must be referred to their primary care physician or partnering clinic for a confirmatory test.
I’m proud to be one of the first private dental practices to offer rapid oral fluid HIV testing to patients. My goal is to encourage more dentists to incorporate HIV testing as a part of their routine patient care. I’ve partnered with the New York State Department of Health to generate awareness and encourage more regular testing among American men and women of all ages, so that those patients who are positive can receive proper treatment and continue to live long, healthy lives.
If you’re interested in offering rapid HIV testing in your dental office, contact your State Department of Health for more information.
The OraQuick ADVANCE® Rapid HIV-1/2 Antibody Test is FDA-approved for use with oral fluid, fingerstick, or venous whole blood and plasma and delivers results with laboratory accuracy in 20 minutes. CDC guidelines call for routine testing in all health-care settings to identify all HIV positive people and connect them to care. This simple test is ideal for screening programs in public health and outreach settings, emergency departments, labor and delivery, laboratories, and physician offices.For more information:http://www.orasure.com/products-infectious/products-infectious-oraquick.asphttp://www.orasure.com/contact/contact-place-order.asp
