Cognitive impairment is associated with poorer oral health in people with HIV: evidence from a pilot study.

OBJECTIVE: Despite widespread antiretroviral therapy use, mild and asymptomatic cognitive impairment persists in people with HIV (PWH). Poor oral health is also commonly reported among PWH, yet the prevalence of specific oral diseases in the antiretroviral therapy era remains uncertain. While cognitive impairment has been linked to poor dental outcomes in people without HIV (PWoH), particularly older adults, its impact on oral health in PWH is less understood. This study aimed to compare oral health outcomes in PWH and PWoH; and PWH with and without cognitive impairment. METHOD AND MATERIALS: A cross-sectional pilot study was conducted among 40 participants: 30 PWH and 10 PWoH. Cognitive function was assessed using the Penn Computerized Neurocognitive Battery, and oral health was evaluated through dental caries and periodontitis measures. RESULTS: PWH on average had poorer battery test outcomes (P = .073), with social cognition being the most impaired domain. PWH had significantly worse oral health than PWoH, with higher scores for DMFT (P = .001), DFT (P = .027), and MT (P = .032). Among PWH, those with cognitive impairment exhibited higher DFT scores (median 12.0 vs 7.0) and periodontal inflammation (with respect to bleeding on probing, 51.04% vs 31.67%) compared to those without cognitive impairment. CONCLUSION: Data suggest that PWH demonstrate poorer oral health compared to PWoH. Cognitive impairment in PWH is associated with worse periodontal and caries outcomes. These findings highlight the need for targeted oral health interventions and consideration of cognitive impairment screening in dental care settings for PWH.