1. SPNS IHIP Oral Health Webinar Series: Clinical Aspects of Oral Health Care for PLWHA . Presented by Dr David Reznikof Grady Health System &HIVdent and Helene Bednarsh, RDH, MPH of the Boston Public Health Commission &HIVdent January 22, 2014

2. Agenda Introduction to SPNS Integrating HIV Innovative Practices (IHIP) project Presenters Sarah Cook-Raymond, Managing Director of Impact Marketing + CommunicationsDr. David Reznik Chief of Dental Service and Director of Oral Health Center Infectious Disease Program, Grady Health System President of HIVdent Ms. Helene Bednarsh, RDH, MPH Director of the HIV Dental Program at the Boston Public Health Commission Vice President of HIVdentQ&A 3. IHIP Resources on TARGET Center Websitewww.careacttarget.org/ihip 4. IHIP Oral Health Resources TrainingManualCurriculumPocketGuideWebinar Series Healthy Mouth, Healthy Body (Held Dec. 13) Dental Case Management (Held Jan. 9) Clinical Aspects of Oral Health Care for PLWHA Recording and slides for all Webinars will be uploaded to TARGET Center Web site following the live event: www.careacttarget.org/ihip 5. Other IHIP Resources Buprenorphine Therapy Engaging Hard-to-Reach Populations Training Manual, Curriculum, and Webinars on engaging hard-toreach populationsJail Linkages Training Manual, Curriculum, Monograph, and Webinars on implementing buprenorphine in primary care settingsTraining Manual, Curriculum, Pocket Guide, and Webinars on enhancing linkages to HIV care in jails settingsUPCOMING: Hepatitis C Treatment Expansion In Spring/Summer 2014, look for training materials on increasing access to and completion of Hepatitis C treatment for PLWHA on the TARGET Center Web site. 6. David Reznik DDS Chief of Dental Service Director, Oral Health Center Infectious Disease Program Grady Health System President, HIVdentHelene Bednarsh BS, RDH, MPH Director HIV Dental Program-Boston Public Health Commission Vice President, HIVdent 7. HRSA SPNS Innovations in Oral Health Care Initiative The overarching clinical goal of the SPNS Project is to improve access and adherence to high quality oral health care for people living with HIV/AIDS. 8. Urgent Need for Dental Care Most people with HIV experience oral manifestationsof the disease Preventive care can stall progression of periodontal disease Preventive care/prompt treatment can reduce discomfort and ensure better nutrition and ability to take medications Detection of oral symptoms may serve as trigger for medical care 9. Unmet Need is High Surgeon Generals report significant oral healthdisparities Unmet oral health needs among HIV+ people are higherthan for the general population (Marcus et al, 2000) Unmet needs for oral health care are higher than unmetneeds for medical care (Helsin et al, 2001). 40-50% of HIV+ do not receive oral health care. 10. Innovations in Oral Health Care for People Living With HIV/AIDS Public Health Reports (Vol127 Supplement 2 May /June 2012) www.publichealthreports.org 11. Surgeon General Regina M. Benjamin While good oral health is important to the well-being of all population groups, it is especially critical for PLWHA. Inadequate oral health care can undermine HIV treatment and diminish quality of life, yet many individuals living with HIV are not receiving the necessary oral health care that would optimize their treatment. 12. Oral Manifestations of HIV Disease: The Basics Oral manifestations of HIV infection are a fundamentalcomponent of disease progression. There has been a significant decrease in the overall prevalence of oral lesions from 47 85% pre-cART to 3246% post cART. (Patton et al. 2000; Schmidt-Westhausenet al. 2000;GaitanCepedaet al. 2008, Tam-Maury IM et al. 2011) Factors, which predispose expression of orallesions, include: CD4 counts less than 200 cells/mm3 Viral load greater than 3,000 copies/mL xerostomia (dry mouth) poor oral hygiene smoking 13. Smoking-Related Health Risks Among Persons with HIV in the Strategies for Management of Antiretroviral Therapy Clinical Trial Among participants, 40.5 percent were current smokersand 24.8 percent were former smokers. Compared to never smokers, adjusted Health Risks for current smokers were higher for overall mortality (2.4; P