Jane, a mother of two young children, is HIV positive
and wants to protect her confidentiality. Living in a small town, she wants
to shelter herself and her children from the reaction and rejection of others.
Jane's mouth has been hurting for weeks, but she's
afraid to make a dental appointment. She's afraid that if she tells her oral
care provider about her HIV diagnosis she'll be turned down or worse, that other
people will find out.
While good oral health care begins with brushing and flossing
our teeth and having a nutritious diet, a big part of keeping our mouths healthy
is to have regular dental checkups.
For most Canadians, a trip to the dental office is almost as routine as brushing
our teeth. But some, including people living with HIV/AIDS, may not be getting
the oral health care they need. Good dental and oral health care are essential
for people living with HIV/AIDS because they can suffer from a number of oral
health conditions. Protein and vitamin deficiencies can affect different parts
of the body, including the mouth. Mouth ulcers, and throat infections like oral
thrush
are examples of problems that can be painful and may prevent people from chewing
and eating. Yet some, like Jane, do not seek out oral health care services for
fear of discrimination.
What many people in Jane's position don't know is that the perception of people
living with HIV/AIDS has changed among oral health professionals. Oral health
professionals work as a team that includes dentists, dental hygienists, dental
therapists and dental assistants. Dental hygienists play a key role in health
promotion and disease prevention, by promoting daily practices to maintain a
healthy mouth.
Confidentiality-an essential right
In recent years, there has been an increased focus on client and patient rights.
This is particularly important for those living with HIV/AIDS.
The Clients'
Bill of Rights, published by the Canadian
Dental Hygienists' Association includes the right to be treated with respect
and the right to care that meets a person's needs.
The right to confidentiality is essential for people living with HIV/AIDS.
Information that is shared between an oral health care provider and his or her
client must remain between the two of them. Certain rare
exceptions exist, such as instances where disclosure on the part of the
oral health care provider is necessary in an emergency situation.
Disclosure-a difficult and personal choice
Many people wonder if they have to disclose their HIV/AIDS status to their
oral health care provider. The answer is no. When completing a health questionnaire,
people are not required to check the box that says HIV/AIDS.
Disclosure is a difficult choice for many people living with HIV/AIDS. According
to the Canadian HIV/AIDS
Legal Network, "…the act of disclosure can lead to both positive
and negative results. This is why people living with HIV/AIDS are entitled to
control over this crucial decision… to decide if, when and how they will
tell other people about their HIV status." (HIV/AIDS and the Privacy of Health Information.)
While disclosure may be difficult, it's important to consider the benefits
of sharing HIV/AIDS status with oral health care providers. Knowing that a client
is living with HIV/AIDS can help health professionals to diagnose specific oral
conditions and determine the best treatment.
More information for professionals = less stigma
Education is making great strides to remove the fear and stigma
associated with HIV/AIDS. In dental hygiene classrooms across the country,
for example, students are much more informed about HIV/AIDS.
"Because our understanding has improved so much over the years, the fear
associated with treating HIV/AIDS clients has been minimized significantly,"
explains Bonnie Blank, a Dental Hygiene Program Instructor at Camosun College
in B.C.
Many schools have adapted their curriculum to include a focus on "special
needs" or "care for exceptional clients". These courses teach
students about the social and emotional challenges of people living with infectious
or communicable diseases, including HIV/AIDS.
The result is a greater sensitivity and empathy for the personal situations
and choices of those living with HIV/AIDS.
Universal precautions protect everyone
From washing hands and protecting eyes to wearing gloves and sterilizing instruments,
universal
precautions are strictly followed by oral health care professionals across
Canada. They are a set of routine safety standards established for the purpose
of infection control and are taken to protect everyone.
Some people may not know that they are infected with a communicable condition.
Others may choose not to disclose their status. Universal precautions are there
to protect both clients and oral health providers-in every situation.
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