Post-menopausal women with HIV also had significantly less teeth than those without HIV.
As treatment for HIV has become more widespread and effective, people with HIV are living longer, particularly post-menopausal women with HIV. Women with HIV are already at a greater risk of periodontal disease due to higher rates of inflammatory proinflammatory cytokines found in their bodies and menopause results in bone loss in the spine and hip, but few studies have shown how this affects the alveolar bone, which is the ridge that teeth are anchored into.
A study led by Sunhil Wadhwa, D.D.S., an orthodontist at Columbia University, published last week in BMC Oral Health, aimed to study bone density in the alveolar bone in post-menopausal women with HIV.
From September 2017 to December 2022, 135 women were recruited from the dental clinic at the Comprehensive Health Program at Columbia University Irving Medical Center. Seventy-six of these women were HIV-positive and 59 were HIV-negative. The average age of participants was 55 years old.
A full mouth exam was performed and gingival crevicular fluid (GCF) samples were collected from each participant to determine the levels of receptor activator of nuclear factor kappa beta (RANKL), the major cytokine associated with periodontal disease alveolar bone reabsorption. Researchers also took X-rays and scanned participants using three-dimensional cone beam computed tomography to determine the density of their alveolar bone.
“Women with HIV had significantly higher RANKL expression in Gingival Crevicular Fluid, fewer teeth present, lower trabecular number, and greater trabecular separation when compared to women without HIV,” the authors write.
Participants with HIV had on average less than 18 teeth present. This may be because 19% of women with HIV have unmet dental needs because they fear the dentist, it’s too expensive, or they worry they will be judged for their HIV diagnosis. The World Health Organization recommends adults have at least 21 teeth to maintain a functional and aesthetically pleasing mouth.