Interview: 'HIV tests should be offered in every dental practice'

Daniel Zimmermann: Dr Austin, could you tell our readers the reason you decided to offer free HIV tests to your patients?
Dr Catrise Austin: The idea for offering free HIV tests to my patients arose earlier this year once I had learnt that doctors other than medical doctors can offer HIV testing in their practices. I said to myself why not add another service to our existing checklist of lesions or cavities and give patients the opportunity to know their status in a different setting. I saw this as a unique opportunity for me as a dentist to diagnose HIV in its early stages.

Unfortunately, the virus is still highly prevalent. In New York City alone, there are 94,000 confirmed cases and it seems that the number of infections is not improving in 2009/2010.

Why should dental offices test for infectious diseases like HIV/AIDS or Tuberculoses in the first place?
My opinion is that HIV tests should be offered in every dental practice because the oral cavity is one of the first places that shows signs of HIV infection. You can detect signs of herpes and other sexually transmitted diseases in the mouth as well, and so we look for lesions and other signs or symptoms of the disease.

I am currently not aware of other tests that may diagnose diseases other than HIV/AIDS; it would be fantastic if we were able to diagnose everything through the mouth.

How does the test work?
The test is called OraSure Quick and it tests for antibodies in the blood system. It uses an oral swab, which we take under the upper and lower lips and place in a developing solution directly at the beginning of our dental appointments. The results are available within 20 minutes and we can start with normal treatment immediately after we have done the test.

Unfortunately, I often encounter scepticism from some of my colleagues about the comfort level and the way to introduce the test to a patient in a dental setting. I tell them every time that the test is very easy to apply without making the patient feel uncomfortable. I guess that like most new ideas it takes some getting used to, but it will be successful because we are helping to save people’s lives.

So, we hope to get more dentists all over the world interested in offering the test because it is easy for the patients and takes only a little bit of time.

Is the test optional?
The test is completely optional and we offer it to all our patients, from teenagers who are in high school and probably sexually active to those in their 60s and older. We do not discriminate because the virus does not discriminate. Since we began administering the test in August, we have offered it to about 150 patients of which about 60 per cent have taken it. Fortunately, we did not have any positive testing so far.

What happens if a patient tests positive?
We are fully trained and prepared in case a test is positive. If a patient tests positive, we counsel him or her immediately and help him or her call their primary health physician to schedule a confirmatory test. It is important to note that the test that we offer is a screening test only and not a confirmed test. If a patient does not have a physician, we usually refer him or her to one of the clinics in the New York City area with which we have a partnership.

There are thousands of people in the US and more around the world who are unaware that they are HIV/AIDS infected. Do you think that regular checks in dental practices could help to create more awareness of the disease?
That is something I would like to see happening as more dentists begin administering the test. It is time to recognise that we should be concerned with the patient’s holistic health not only his or her oral health.

I am the first dentist in New York to offer the test and I would love to be the trailblazer and help to make the test the standard of care in dental practices around the world. The greatest joy for me is when a patient says that he or she would have never undergone this test if it were not for me.

Thank you very much for the interview.