Prevalence of tooth wear and associated risk factors among people living with HIV/AIDS in Rwanda: a cross-sectional...

Tooth wear has been reported to be on the increase worldwide. More importantly, tooth wear was found to be considerably high and severer among People Living with HIV/AIDS (PLWHA) compared to HIV negative counterparts. Moreover, there is scarcity of information on tooth wear and associated risk factors. Specifically, no single study has been done in Rwanda to provide baseline data on this topic.

The aim of this study was to determine the prevalence of tooth wear and associated risk factors among PLWHA in Rwanda.

A cross-sectional study was conducted among two hundred and thirty-seven (237) PLWHA aged 18 years and above attending HIV clinics in Kigali (Muhima hospital) and outside Kigali (Nyamata and Kabgayi hospitals) in Rwanda. Oral examination was done by calibrated examiners and tooth wear was assessed using Tooth wear index (TWI). Descriptive statistics, Chi square, and multiple binary logistic regression analysis were used for data analysis using Stata version 15 software.

Overall, our study found a high prevalence of tooth wear 200 (92.83%) among PLWHA in Rwanda. More than half of the study participants (56.12%, 133) had dentinal wear up to 1/3 of the crown, 54 (22.78%) had enamel wear to dentine in a single spot, and 33(13.92%) had dentinal wear that extended to more than 1/3 of the crown. Our results showed that 142 (60%) of the participants had tooth wear in 4 to 6 sextants, 160 (67.51%) had tooth wear in both anterior and posterior teeth, and 219 (81.02%) had tooth wear in both upper and lower jaws. The predictors of tooth wear were older age of 55+ (OR: 20.872; 95% CI:1.704-255.733), longer duration on HIV medication (OR: 6.594; 95%CI:1.053-40.719); and horizontal brushing technique. Although not statistically significant, males were 3.547 times more likely to have tooth wear than females. In addition, PLWHA who grind teeth were 2 times more likely to have tooth wear than those who do not grind teeth.

According to our study results, tooth wear is a highly prevalent and a notably severe condition among PLWHA in Rwanda. Longer duration on HIV medication, older age, horizontal brushing technique were associated with tooth wear. Therefore, there is a need to raise awareness on tooth wear and its risk factors in this population and health workers (dental professionals, nurses/ physicians in HIV services). Hence the need to integrate oral health services to HIV services towards provision of oral health care to this high-risk group of PLWHA.