POZ Community Forums
Main Forums => Living With HIV => Topic started by: odyssey on September 19, 2009, 08:15:48 pm
-
I'm scheduled to go to the dentist in a little over a week for my cleaning that I get every six months. Last time I went I had just been diagnosed so I was still not ready to discuss my HIV status. But now I'm thinking that it might be a good idea to disclose my status to the dentist, not for their sake, but so they can keep a better eye on the health of my teeth an mouth, an maybe be aware of things that might come up in me that otherwise wouldn't if I wasn't poz. Does anyone have any thoughts on this they would care to share with me, or advice, etc? Thanks in advance!
-
You have the right idea. I just went thru this same situation. What I did was call and ask to speak to the dentist before my appt. We talked, he appreciated being told, and the appt came off as normal. He is the first person I had to tell, other than sex partners and medical people, so it was kind of a big deal for me and it went fine.
The laws may be different by state but i was advised that, in NY, i had to tell him and that he could not refuse me as a patient. But neither was an issue in the end. The precautions they take for hep require more serious efforts than HIV, so they will have no need to change they way they treat you.
-
i hope it gose well for you :)
-
I even take copies of my most recent HIV lab numbers to my dentist. He actually requests them, or likes them every year at least once. I assume knowing how strong or weak your immune system actually is assists them in treating you effectively.
-
Odyssey, a few things. Did you see the story "Mouth Full of Problems: A Crisis in HIV Dental Care" a few days ago on poz.com?
http://www.poz.com/articles/hiv_dental_oral_401_17224.shtml (http://www.poz.com/articles/hiv_dental_oral_401_17224.shtml)
Also, there was a good thread about "disclosure" last week in this forum:
http://forums.poz.com/index.php?topic=28832.msg354753#msg354753 (http://forums.poz.com/index.php?topic=28832.msg354753#msg354753)
Now a funny dentist story for you. Like Ruralguy I called my dentist before the appointment and he too was appreciative of being told. No issues. When I went in for the visit last week the hygienist after we got through the niceties "how are you", "How was your summer" "any issues with your mouth"...etc....I asked her if she has spoken with the doctor and she immediately jumped in and said yes and wanted to know how I was doing.
After a minute or two of chatting she went to work and continued talking about stuff. She asked me if I went anywhere good this summer. I told her I had gone to Greece. She was excited and said "oh that is awesome.....didn't you absolutely love it?". It was "OK" I told her. She kept on pressing and wanted to know why it wasn't the most fabulous vacation ever. I said "well...if I hadn't gone there you would not have had to have the chat with the doctor about me before my appointment". She paused for a second then figured out what I was saying and said "Ohhhhh.....I get it....go anywhere else good?
Anywho....no problems at all with the appointment. Both the hygienist and dentist said they were glad to know and they would look out for certain things in the future. I don't think they did anything different as far as how they treated me. When I first told him the dentist said they always use universal precautions.
One suggestion.....I am glad I told them in advance and didn't just spring it on them as the appointment started.
Steve
-
I was thinking of telling my dentist/hygienist myself for quite a while, but for a couple of years each time I end up saying nothing.. Now, I don't really know how to say it?? Should I just say I was recently diagnosed or come clean I've been hiding it for quite some time??? any thoughts...
-
Well I told the dentist I saw, in as much as there was a medical questionnaire to fill out first that asked if you had any blood borne viruses and I put down HIV and Hep C.
I'm not sure I would have had the guts to just come out with it, but then this not that long after I was diagnosed, things are somewhat different now for me.
The experience I had with the dentist wasn't so good though :( She gave me the last appointment slot of the day and even asked if I injected heroin before she would let me lay down in the chair! When I said no she then asked how I caught HIV!
Even after that experience I still think it's a good idea to tell. The dentist can check for HIV-related mouth and gum problems, and make sure that any drugs they use don't interact with your HIV meds.
-
Seems like we just had this thread a month or two ago.
HIV+ should tell all their doctors.
As for the hygenist, I told her and when she came in, she was wearing goggle instead of classes. And she thanked me with no attitude. I had an extremely high viral load at the time. I felt better for having said something.
You know its not really my problem at all, if a few doctors or health professionals have some unfortunate reaction to such information. Most health professionals are professional.
-
I was thinking of telling my dentist/hygienist myself for quite a while, but for a couple of years each time I end up saying nothing.. Now, I don't really know how to say it?? Should I just say I was recently diagnosed or come clean I've been hiding it for quite some time??? any thoughts...
If this all bothers you so much perhaps it would be easier just to start from scratch with a new dentist? I think that's the primary issue always with a dentist, in that for many newly diagnosed they're seeing a dentist that they've seen for years. Personally I never encountered this issue when I was diagnosed because I began anew, and my new dentist was actually my HIV specialist's personal dentist. Guess I was lucky with my referral and timing.
-
I was thinking of telling my dentist/hygienist myself for quite a while, but for a couple of years each time I end up saying nothing.. Now, I don't really know how to say it?? Should I just say I was recently diagnosed or come clean I've been hiding it for quite some time??? any thoughts...
Well, you could always sidestep by simply saying something like, "I wanted to let you know that I am HIV+" No real need to say how long you've known. If you are asked how long you've "had it", I'm guessing you could say that you aren't sure -- unless of course you do know exactly when you became infected. Or you could be honest and tell him/her that you've been nervous about bringing it up, but now realize that it is in your best interest for him/her to be aware so that they can be on the lookout for any oral issues.
Mike
-
i told my dentist last time,the job he did was quick,and i ended up with a swollen gum for a week,i didnt call him back to talk about the pain,i just decicded not to tell i felt he just did a crapy job to get it over with. I WILL NOT TELL AGAIN.
-
I realize that I neglected to answer Odyssey's original question in my last posting here.....
I would definitely tell your dentist. I had a dentist appt a week after I was diagnosed. I just told him that I needed to speak to him in private before the exam and cleaning (he has always done my cleanings himself -- pre and post HIV). I told him I was positve and wanted to be sure that he knew this so that he could look for oral issues. He asked about my t-cells and how I was doing. Since then, the only thing he does differently with me is to wear protective eyewear. I get the same level of care that I have received since I started seeing him in 2000, when I moved to Virginia. He was the one who found OHL on my tongue and monitored it's progress and then (slow) disappearance.
This is NOT about the dentist -- or any other health care provider -- it is about YOU. Insuring that you get the best care possible. Hiding a major medical condition prevents you from getting the best possible care, because they may not know to be on the lookout for something, or may think something is "minor" when, in fact, it may not be minor for you.
Hugs,
Mike
-
Thanks for all the feedback! Now just comes the hard(er) part of doing the actual disclosure. Hopefully they'll be good about it, as have all my treating professionals thus far. Guess I'll just have to wait and see.
-
Thanks for all the feedback! Now just comes the hard(er) part of doing the actual disclosure. Hopefully they'll be good about it, as have all my treating professionals thus far. Guess I'll just have to wait and see.
Good luck!! I realize that the longer you delay revealing it - the hardest it is to break the news. With new doctors I'm seeing every now and then - I just say it upfront and so far never had a bad reaction. The problem is with the longer term physicians that know me for years (dentist and even my general health provider..!!!).
It feels like I might "disappoint" them or be asked uncomfortable questions ("how long"? "how contracted?", "you have unprotected sex with MEN???", etc..), but I guess the advantage of revealing outweighs the uncomfort of it, and if indeed their reaction will be less than perfect - I could always switch to a diff doc/dentist. Next time I'll tell. Promise. I hope..
-
The experience I had with the dentist wasn't so good though :( She gave me the last appointment slot of the day...
I absolutely refuse to go to a dentist who ignorantly insists that hiv positive patients have the last appointment of the day. They'll tell you it's so they can sterilize the equipment afterwards - and that's the biggest crock of shit ever. If they aren't sterilizing between each and every patient to the same high standard, then they can kiss my ass goodbye. Why? Because I've already fought off hep C once and I certainly don't want it again. Or hep B for that matter. Both are much more likely to be transmitted in a dental setting than hiv could ever hope to be.
Ann
-
Thanks for all the feedback! Now just comes the hard(er) part of doing the actual disclosure. Hopefully they'll be good about it, as have all my treating professionals thus far. Guess I'll just have to wait and see.
My dentist has been treating me for twenty years. He also treats some of my family, who do not know of my HIV. I told him straight off, for his benefit. He was unfazed and assured me that he treats all of his patients the same. The only difference I've noticed since then is that he seems to check my gums and under my tongue more thoroughly now. I think you should expect similar treatment from your dentist.
-
I don't tell my dentist about my HIV status and I don't think I ever will.
He should be using universal precautions (they call them "universal" for a reason) and if he chooses to don protective eyewear for only those patients who tell him they are HIV+ (or HCV+ or ???), that's his (unwise) choice.
I fail to see how telling my dentist about my HIV status would be beneficial to my health. Regardless of my HIV status, my dentist should be noticing and informing me of oral issues (e.g. thrush, oral hairy leukoplakia, gingivitis, gum recession, canker sores, herpes sores, KS lesions). That's why he examines everybody's mouth (HIV+ or HIV-), to look for anything out of the ordinary. Few if any of these things are asymptomatic anyway.
I sincerely doubt that any state has a law requiring HIV+ individuals to disclose their status to a dentist (as somebody thought was the case in his/her state).
I just think that those who are experiencing undue anxiety about disclosing to their dentist should realize that they DON'T HAVE TO and the chances of having any deleterious outcome as a result are small (unless their HIV disease is rather advanced).
-
I am GLAD I do NOT have to use dentists in South East Missouri !
THEY ALL REFUSE TO TREAT HIV POSITIVE PEOPLE !
They get away with it too !
It pisses me off big time this HATEFUL bigoted area gets away with all their crap !
Poplar Bluff is a HORRID place to live with HIV !
Even the Health Department is " rude & crude " about the whole topic !
I HAVE to drive two hours to Saint Louis for treatment for HIV and any dental work !
It is a shame such GOD fearing people can be so ignorant !
be well , brush twice a day ;)
Carl
-
I just think that those who are experiencing undue anxiety about disclosing to their dentist should realize that they DON'T HAVE TO and the chances of having any deleterious outcome as a result are small (unless their HIV disease is rather advanced).
You are correct -- you don't have to tell him (well, probably not, I'm not sure of laws in all states). But if you think that doing so won't help your dentist take better care of you, then you are extremely naive.
Tell me, if you had cancer diagnosed by a specialist, would you bother telling your primary care physician?? I mean he/she should be able to pick up on any "side effects" that your specialist isn't treating, right??
You have an absolute right (in my mind anyway) to not tell any health care provider you chose, but your rational needs to be called out for what it is -- a rationalization that is not based in reality - designed to allow your fear to drive your medical decisions.
Now if you have reason to believe that disclosing to a particular provider would cause you to get poor care -- than find a new one. Find one that treats other poz patients, but don't try to convince yourself or others that keeping it a secret has no potential "bad" effects.
Telling a clinician your status is really NEVER about them -- it is about YOU.
Mike
-
(I won't hijack this thread by posting a reply to Bocker3 here. I'll follow up with him via PM. Calling *me* "extremely naive"? B*tch, please!)
-
(I won't hijack this thread by posting a reply to Bocker3 here. I'll follow up with him via PM. Calling *me* "extremely naive"? B*tch, please!)
Take what was said in context: But if you think that doing so won't help your dentist take better care of you, then you are extremely naive.
You're implying that your dentist has absolutely no medical reason to know that you are HIV+. Do a bit of research on HIV and dental issues and you'll find some of these reasons.
-
I am well aware of the context within which Bocker3 accused me of being "extremely naive".
Thanks for the suggestion (though it sounded more like a directive), but I'm well aware of the possibility of oral manifestations of HIV-associated conditions in advanced disease. When you go back to that research to refresh your memory, you'll find that oral issues are rare for those whose immune system is still intact.
I'm aware of my the current stage of my disease and the low risk I currently have of oral complications. I'm also aware of my dentist's background and HIV experience (or lack thereof). These are things you are not aware of, so please save your directives/suggestions for somebody else.
Are there HIV+ people who may benefit from disclosing to their dentist? Yes. Are there HIV+ people who won't benefit and possibly suffer unexpected consequences if they do disclose? Yes. Would it be better for somebody to (a) go the dentist and not disclose versus (b) avoid going to the dentist because they're afraid of "having to" disclose? Yes. Am I able to make my own decisions and state my opinion here? Yes.
-
i told my dentist who promptly rescheduled my appointments to the last of the week , disinfected the room prior to me entering and then again afterwards , treated me in something resembling space suits
i changed my dentist, my doc recommended a dentist who has no problems
-
I'm aware of my the current stage of my disease and the low risk I currently have of oral complications. I'm also aware of my dentist's background and HIV experience (or lack thereof). These are things you are not aware of, so please save your directives/suggestions for somebody else.
Are there HIV+ people who may benefit from disclosing to their dentist? Yes. Are there HIV+ people who won't benefit and possibly suffer unexpected consequences if they do disclose? Yes. Would it be better for somebody to (a) go the dentist and not disclose versus (b) avoid going to the dentist because they're afraid of "having to" disclose? Yes. Am I able to make my own decisions and state my opinion here? Yes.
Whatever. Remember, this is not your thread. Most of our posts are directed to the OP and ensuring that correct information is given. Yes, you were being 'spoken' to directly, but you said "I fail to see how telling my dentist about my HIV status would be beneficial to my health." I suggested doing some research to help you see how it could be. You choose not to, and that's fine. However, perhaps the point that needs to be made to the OP is that there are (or can be) benefits to disclosing to one's health professionals, not that you personally choose not to because it wouldn't benefit you.
-
Well, seeing as this is MY thread. I've done some thinking and looking around and I do agree that like any of my doctors, my care will be best provided for if they know all my information. Somehow I think people tend to forget that dentists are doctors as well. The cancer analogy made lots of sense to me. Thanks! I look forward to getting the best care, in my mouth as well as the rest of my body!
-
According to the POZ magazine cover story that just went up today on HIV criminalization issues some people have even been prosecuted for not disclosing to their dentist (Arkansas). Ludicrous and extreme, of course, but I thought I'd just throw that out here.
http://www.poz.com/articles/HIVtransmission_crime_laws_2376_17279.shtml
-
According to the POZ magazine cover story that just went up today on HIV criminalization issues some people have even been prosecuted for not disclosing to their dentist (Arkansas). Ludicrous and extreme, of course, but I thought I'd just throw that out here.
http://www.poz.com/articles/HIVtransmission_crime_laws_2376_17279.shtml
To be 'fair' then, shouldn't it go both ways; i.e. HIV-positive dentists be required to disclose to patients before treating them?
-
oral issues are rare for those whose immune system is still intact.
Actually, for one example, Kaposi's sarcoma can occur at any CD4 level, not just at a below-normal number. So oral KS can occur with a normal CD4 count.
-
Yes, KS CAN occur at a normal CD4 count, but it is RARE, as I said. ("Rare" means unusual or infrequent, it does not mean impossible.)
And if your went to the dentist, without disclosing your HIV status, and had a KS lesion, the dentist would see the unusual lesion and suggest that you follow up with your doctor.
-
Well, I had my dentist appointment today and I ended up telling the hygienist that I am poz. She was really nice about it and said that they wouldn't treat me any differently, because they use universal precautions with everyone, but that its good to know so they can keep and eye on my mouth as a general part of my greater health. She then proceeded to do a good job cleaning my teeth, chatting me up just like usual, no awkwardness whatsoever. She looked around my mouth for anything unusual, and complimented me on the improvement I've made in my oral hygiene, but other than that, it was the same as any other appointment. She wrote it in my chart, had me sign saying I agreed with the change, as is the standard operating procedure along with the change in meds, and I was on my way. Glad I told, so that I can take care of my health as best as possible!
-
Good for you :)
-
Great news! I think you did exactly the right thing.
Hugs,
Mike
-
It never ceases to amaze me on how hard headed some of you folks can be, about something that should be second nature to you. The last time I checked, my HIV continues to ravage my body and to think that I would deprive one of my primary doctors, my dentist of very relevant information is the most self-defeating thing I can imagine. I have many friends who have lost a large number of teeth, due to various mouth infections, which were not always HIV related. Maybe you forget, that if given a chance, HIV will kill you and at least where my health is concerned, I'm all for stacking my deck however I can.
This has nothing to do with them protecting themselves. It has everything to do with you being in control of your own health care. So go ahead, hide your infection. That will show them.
-
Good for you, odyssey. That's exactly the same response I got from my dentist. The stress and anxiety over whether or not to disclose is often as bad, or worse, than actually disclosing.
-
The stress and anxiety over whether or not to disclose is often as bad, or worse, than actually disclosing.
Worth repeating, because the ACT of disclosing takes far less time than the DECIDING -- we could all use a little less stress in our lives.
Mike
-
I wish I had read this thread a week ago because I had a similar question/concern. I have been with my dentist for 17 years. I actually had an appointment with my HIV doctor the same day but before my dentist appointment. He said there should be no issue with telling my dentist. When I arrived at my dentist office, I told him and he was very encouraging and supportive. Asked if it was recent exposure, about counts and meds. Throughout the visit he had a regular chit chat banter as if everything were normal. After the visit, he said everything was going to be ok and that I was going to live (same story my doctor gave me after my diagnosis). My dentist actually scheduled me for another visit the next day to replace old filling just as we discussed several months ago prior to my diagnosis.
Overall it was a good experience and am happy I disclosed and got that off my chest. I feel good about my health and the doctor and dentist in my charge. Afraid of the day that I no longer have them on my side as my health care provider.
-
My "regular" dentist, who's not aware of my hiv status (as of yet), is always pushing me to get my wisdom teeth out. Last week I went to see a different dentist to get a second opinionon. I told that doctor right upfront bout my hiv and he recommended NOT to get the wisdom teeth out, saying they're not causing me any serious problem, they function properly in my chewing, and because I'm hiv poz - I shouldn't put an unnecessary stress on my body with a surgery that is not needed.
Just an example to show how doctor's knowledge of one's hiv status CAN affect their medical recommendation!
-
My "regular" dentist, who's not aware of my hiv status (as of yet), is always pushing me to get my wisdom teeth out. Last week I went to see a different dentist to get a second opinionon. I told that doctor right upfront bout my hiv and he recommended NOT to get the wisdom teeth out, saying they're not causing me any serious problem, they function properly in my chewing, and because I'm hiv poz - I shouldn't put an unnecessary stress on my body with a surgery that is not needed.
Just an example to show how doctor's knowledge of one's hiv status CAN affect their medical recommendation!
Wow, ATS, sounds like your regular dentist is just out to make a few bucks. I hate it when dentists - or doctors, for that matter - push treatments that are not medically necessary. It's pure greed on their part. I hope you plan on making your "second opinion" dentist your new, regular dentist. I know I would, if it were me.
Ann
-
well I suspected the first dentist might have a hidden interest/agenda there, but actually that's not the case: he doesn't perform that surgery himself but rather refers to an oral surgeon, so I cannot blame him for his recommendation. His arguement was rather from a hygene point of view (wisdom teeth are harder to keep clean, harder to reach to do a filling, and collect more bacteria so might as well remove..)
I guess I would have to tell him I'm poz and see if he still recommends that surgery...
-
I guess I would have to tell him I'm poz and see if he still recommends that surgery...
That's a good point, Dentist #2 has more information than Dentist #1. And how do you determine whose opinion is more valid anyway? Because of his reasoning, knowing of your HIV could reinforce Dentist #1's opinion that you should have the wisdom teeth removed, to preclude future infections.
-
This has been an interesting string. I read it just before I had my teeth cleaning appointment and had made the decision to tell him. But when I got there, I chickened out. The problem is, my Dentist is also my client. I also know him in my circle of friends. I have been VERY choosy who I tell and I am afraid he will tell someone. I know, he is a professional and won't tell. But I just couldn't do it. I guess now I will have to wait till my next appointment.
-
Tell him by telephone perhaps.
-
This has been an interesting string. I read it just before I had my teeth cleaning appointment and had made the decision to tell him. But when I got there, I chickened out. The problem is, my Dentist is also my client. I also know him in my circle of friends. I have been VERY choosy who I tell and I am afraid he will tell someone. I know, he is a professional and won't tell. But I just couldn't do it. I guess now I will have to wait till my next appointment.
Can you switch dentists? Or maybe use him for cleaning but find another one that you disclose to for checkups (an expensive option)? I don't blame you for second guessing yourself. You know there are real risks with your disclosure. And not all of us face the same level of risk, so you shouldn't feel obligated to tell your dentist because someone has decided to.
I do think disclosure is beneficial, so my dentist knows. However, this is the first dentist that I have told and I specifically chose the practice because they focus on gay men (and are mostly gay themselves), under the assumption that they would have come across HIV patients before and understand how to treat us with respect and dignity. It's a private practice. After hearing stories from friends about how they were treated after disclosing to NHS dentists, I don't think I would disclose if I had a NHS dentist. I can't be bothered being made to book the last appointment of the day and having short and shoddy cleanings (which kinda defeats the purpose to disclosing anyway)!
There is no crime in taking your time to measure up the pros and cons of disclosure and choosing the path of least resistance!
My 2 cents.
-
I am a dental hygienist and the law does require if a dental personnel is HIV+ to disclose to each one of their patients before treating them. It is really important to disclose your status to the people who are providing you care. You shouldn't be treated any differently in the way of infection control. All medical issues should be disclosed. If there was a medical emergency in the office ems or whoever is called will want to know your medical history whether you are HIV+ or have high blood pressure. If you are at anytime unresponsive you would not be able to tell your caretaker of any special needs you have or if you are allergic to an antibiotic. When you are in the dental office the dentist is responsible for your well being. It's just the right thing to do for your own safety.
Crystal
-
Crystal, I can't find any reference to this law anywhere. Is this a state law? I find scores of references to local, state, and federal laws about health care providers HIV status disclosure and none of them state mandatory disclosure to patients. I found a lot of stuff about guidelines and recommendations for patient care by a HCP but nothing stating that they had to disclose (in almost all cases). Just curious......
-
Texas Board of Dental Examiners is who governs dental personnel in Texas. This is from the website in the rule bookUnder their rules and regulations Rule #108.25 (c)(d) states:
A dental health care worker(s) who knows he/she is infected with HIV or HBV and who knows he/she
is HbeAg positive shall report his/her health status to an expert review panel, pursuant to provisions of
THSC, §85.204, et seq,1991, as amended.
(d) A dental health care worker who is infected with HIV or HBV and is HbeAg positive shall notify a
prospective patient of the dental health care worker's seropositive status and obtain the patient's
consent before the patient undergoes an exposure-prone procedure performed by the notifying dental
health care worker.
It sucks, but its true
Crystal
-
Luckily, my dentist is in the same clinic as my HIV doc. It is a separate practice. Just this week, I had to have two root-canal teeth extracted, because I didn't get crowns on them and the teeth broke. By the way, don't waste money on root canals unless you get crowns.
Anyway, my dentist and all the personnel seem to not worry at all about it. I was worried for them. I thought they would be wearing haz-mat suits. My dentist just wore his normal eye glasses. His gloves got all bloody and he would push his glasses back up with them. I noticed he had my blood on his mask. He didn't seem concerned--maybe cause my vl is just 14,000. Who knows. He actually goes out of his way to make me feel comfortable. He is constantly shaking my hand when I get there and when I leave. I'm like, "Alright already." I'm getting to where I don't like shaking hands anyway..lol.
I will agree that is good for your dentist to know. He told me I have very soft gums. I've read that can be HIV related. Dentists or all health providers for that matter should assume everyone has HIV. Find you a dentist that is okay with HIV. One that's hot, like mine, is nice too. It is nice when his crotch is touching my arm and he's looking into my eyes..lol.
-
I noticed he had my blood on his mask. He didn't seem concerned
That's most likely because he knows that hiv isn't transmitted outside the body from objects in the environment. Nothing he was doing was putting him at risk for hiv infection.
Ann