Receiving Dental Care: A Qualitative Assessment by HIV+ Adults

Objective:

Despite the increased need for dental care and available dental resources, HIV-infected adults have suboptimal rates of dental care use. This qualitative study aimed to discover internal and external barriers that prevent oral health care seeking behaviors among this population by exploring subject’s experiences and expectations concerning dental care. 

Method:

A convenience sample of HIV-infected adult subjects was recruited from three outpatient HIV-medical clinics in Cleveland, Ohio. We performed one-on-one semi-structured face-to face audio-recorded interviews consisting of 9 open-ended questions about medical/dental care experiences. Of these, 2 questions assessed the least comfortable (past) experience and most comfortable imagined (future) experience in a dental care setting. Themes and sub-themes from respondents were identified by one dental student (NAC) using grounded theory. Data saturation was reached at 42 subjects.

Result:

Assessing the least comfortable (actual) and most comfortable (ideal) dental experience of 46 subjects, we identified four major themes: 1) communication between dentist and patient, 2) professionalism of dentists and dental staff, 3) fear of dentists and dental procedures, and 4) the atmosphere of the dental office. Amongst each major theme were sub-themes which included:  26% of respondents desired a more relaxing atmosphere within the dental office, 24% wanted dentists to communicate with care and compassion, and 24% wanted prompt service. Additionally, 22% wanted staff to be more pleasant, 17% wanted dentists to explain procedures/expectations, and 15% of subjects felt the dentist did not listen to them. Finally, 15% of subjects had dental fears. 

Conclusion:

Our results indicate that more effective communication by dentists is desired by HIV-infected adults. More favorable attitudes by patients towards dentists, the staff and the dental setting may translate into improved dental care compliance and improved oral health outcomes in this population.