Dental Health for People with AIDS

A cartoon of a tooth with the ribbon for HIV awareness

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Dental visits are so routine and such a normal part of living that it is easy to think of them as universal for everybody – unless you are compromised by money, lack of health insurance, a limited supply of providers or a severely compromised immune system.

In an effort to eliminate these factors in the Charleston area, the new Ryan White Dental Clinic at Roper St. Francis Healthcare seeks not only to serve people who are underinsured but also to care for HIV/AIDS patients who could potentially die from a regular dental checkup.

“People living with HIV/AIDS can have severely compromised immune systems,” said Dr. Tawana Philpott Brown, the clinic’s program director. “The mouth is a gateway for infections that can escalate to other opportunistic infections which can harm other organs if not treated.”

Opening in December 2021, the clinic now operates as the only sexual health one-stop-shop primarily serving the tri-county area of Berkeley, Charleston and Dorchester counties for people living with HIV.

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“We were seeing firsthand that patients in our clinic were not receiving regular dental care due to various barriers such as lack of insurance, limited income, transportation, limited providers and stigma,” said Dr. Philpott Brown. “And by partnering with MUSC College of Dental Medicine on-site, we are able to mitigate some of the barriers our patients face to receiving regular dental care.”

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In its first six months of operation, the clinic’s staff recorded more than 440 patient visits.

Fillings and extractions are the biggest dental clinic need. Other clinical and support services provided by the clinic include:

  • Doctors’ visits, labs and on-site pharmacy;
  • Medical case management services;
  • Mental health and substance use services;
  • Eye care;
  • Transportation services;
  • Housing assistance;
  • Free rapid HIV testing.

“If a patient needs further treatment, such as a root canal, partial dentures or crowns, they are referred downtown to the MUSC College of Dental Medicine,” Dr. Philpott Brown said. “And due to some of the side effects caused by HIV medications, such as dry mouth, which predisposed them to dental decay, periodontal disease and fungal infections, having dental services on-site allows us to continue to expand our one-stop-shop concept and enhance the overall patient care experience that we can provide here.”

While the dental clinic seemed to just happen overnight, it was actually years in the making. Spearheaded by former director Dr. Kimberly Butler Willis, it opened as a work-in-progress, with Dr. Philpott Brown being named as a full-time director only this past summer.

“Ryan White already had an established relationship with the MUSC College of Dental Medicine as they were seeing our patients at their downtown clinic,” Dr. Philpott Brown said. “And now we have a dental assistant, registered dental hygienist, a dentist and students who rotate each week – normally two third-year students and two fourth-year students.”

Based on reports from the South Carolina Department of Health and Environmental Control, more than 4,500 Lowcountry residents were living with HIV/AIDS in December 2020. Their care, treatment and prevention services are a top priority for the state’s HIV Program, part of an SCDHEC initiative known as Ending the HIV Epidemic plan.

The plan aims to end the HIV stigma, as well as discrimination, with a commitment to normalizing HIV testing and creating an enabling environment for HIV treatment and care services. The new dental clinic, which currently serves as the RSFH system’s first fully operational dental facility, is a big step toward achieving that goal.

“Being part of the Diversity, Inclusion and Health Equity Department, we are currently exploring ways in which we can expand dental services to our other community health department partners, such as Access Health, Greer Transitions Clinic and the Lowcountry and Waring Senior Centers,” Dr. Philpott Brown said.  “And the people here at the new dental clinic are committed to the total wellness of our patients and the overall mission of RSFH of healing all people with compassion, faith and excellence.”

By L. C. Leach III

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