Prevalence of tooth wear and associated risk factors among People Living with HIV/AIDS in Rwanda: a cross-sectional study

Background Tooth wear has been reported to be on an increasing prevalence repeatedly. More importantly, tooth wear was found to be considerably higher and severer among People Living with HIV/AIDS (PLWHA) compared to HIV negative counterparts. There is scarce of information on tooth wear and associated factors in general. Specifically, no single study done in Rwanda to provide baseline data on this topic. Aim The aim of this study was to determine the prevalence of tooth wear and associated risk factors among PLWHA in Rwanda Methods A cross-sectional study was conducted among 237 PLWHA aged 18 years and above attending HIV clinics outside Kigali city (Nyamata and kagayi hospitals) and within Kigali city (Muhima hospital) in Rwanda. Oral examination was done by calibrated examiners and tooth wear was assesses 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. Results Overall, the results revealed a higher prevalence of tooth wear among PLWHA 220 (92.83%) in Rwanda. Among them, more than a half 133 (56.12%) had dentinal wear up to 1/3 of the crown, a considerable number 33(13.92%) had excess tooth wear that extends to more than 1/3 of the crown. Only 54 (22.78%) had enamel wear to dentine in a single spot. Regarding the location and categories of teeth affected, a big number 142 (60%) of participants had tooth wear in 4 to 6 sextants. More participants had tooth wear in both anterior and posterior teeth 160 (67.51%) and majority of PLWHA had tooth wear in both upper and lower jaws 219 (81.02%). 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 more like 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. Conclusion According to study results, tooth wear is a highly prevalent and a notably severe condition generalized to all teeth in the oral cavity among PLWHA in Rwanda. Longer duration on HIV medication, older age, horizontal brushing techniques were strongly associated with tooth wear. Therefore, there is a need of efforts from multidisciplinary health workers (dental professionals, nurses/ physicians in HIV services to raise awareness on tooth wear and its risk among this high risk group of people. In addition, tooth wear in PLWHA are left untreated. Hence the need to integrate oral health services to HIV cervices to provide oral health care to this high risk group of PLWHA. Clinical trial number not applicable.