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UM clinic offers compassionate dental care to HIV/AIDS patients

When his private dentist passed away, Henry Yeakel quickly searched for a new dental home. While some might have thumbed through a phone book to find the closest provider, Yeakel didn't have that luxury. He needed a dentist who could cater to his unique dental needs.

"My teeth were brittle and breaking and falling apart," said Yeakel, who was diagnosed with AIDS in 1997. "I guess all the medication I was on probably destroyed my teeth."


It used to take Yeakel more than 30 minutes to complete his daily regimen of medication, which consisted of 32 pills twice a day.

Yeakel's search for a new dentist led him to the Plus clinic at the University of Maryland School of Dentistry. The school has run the Plus clinic for nearly 25 years, providing dental care for low-income people living with HIV/AIDS.


HIV/AIDS patients, with weakened immune systems, can suffer from a variety of dental ailments such as oral warts, oral yeast infections (called thrush) and gum disease. The clinic was founded when HIV/AIDS patients had difficulty finding dental care due to concerns about transmission of the disease.

Yeakel, equipped with a set of false teeth and down to one pill a day, is thankful that mistreatment in the dental office isn't an issue for him.

"It's nice to know that if you have this disease, there are places you can go where people care and are willing to respect you and help," said Yeakel.

Students at the Plus clinic undergo training to recognize the oral conditions of HIV/AIDS patients, provide them with a caring environment and practice proper infection control techniques.

Dr. Valli Meeks, clinic director and associate professor, helped start the Plus clinic in 1989.

With the financial burden on some patients with AIDS, Meeks said, dental care can be low on the priority list.

"We are trying to stop people from coming in when they are in pain or when it's an emergency. We get them in sooner," she said.

The Plus clinic is funded through the Ryan White Care Act, a federal program for low-income AIDS patients.


Students at the clinic are also trained in administering the oral AIDS test to other dental patients. The dental school began routine AIDS testing for urgent care and follow-up patients in May. Since then, 484 people have been tested.

"The importance of us trying to incorporate HIV testing along with dental services is needed," said Don Kirk, Community Coordinator of the JAQUES Initiative, the University of Maryland School of Medicine's outpatient clinic for HIV/AIDS patients. "They're already here working on someone's mouth. When the students do come across an individual who is positive, it helps decrease the stigma because they have already had hands-on training."

With recurrent testing, Valli hopes to eliminate the stigma associated with HIV/AIDS.

Student Kimberly Moyer has tested five patients. All have come back negative.

"They are a little apprehensive to do the test at first," she said. "My first session, I was nervous because that's big news to give somebody if they get a reactive test, but with experience it gets easier."

Not all patients are open to the idea of an HIV/AIDS test.


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"Fifty percent say no, 50 percent say yes," Kirk said. "It's based on the condition of the patient."

Kirk said urgent care patients might be in too much pain to agree to a test.

Student Allison Fleming said patients who do get the test "are appreciative when they get the results."

HIV/AIDS patients receiving routine dental care are just as appreciative.

Carlton Smith, president and founder of Baltimore Black Pride, has visited the Plus clinic for at least 10 years. Smith has been on the clinic's advisory board for seven years and advocates on behalf of HIV/AIDS patients.

"One of the biggest concerns this year was not to have dental funds cut but increased and making sure we had no waiting list for people who are living with HIV to come to the clinic," said Smith.


"Not having dental health causes you to have other health-related issues," he added.