HAB HIV Core Clinical Performance Measures: 

Adult/Adolescent Clients Group 2

Performance Measure: Oral Exam OPR-Related Measure: Yes 

www.hrsa.gov/performancereview/measure

s.htm 

Percent of clients with HIV infection who received an oral exam by a dentist at least once during the 

measurement year 

Numerator: Number of clients who had an oral exam by a dentist during the measurement year, based 

on patient self report or other documentation

Denominator: Number of clients with HIV infection who had a medical visit with a provider with 

prescribing privileges1 at least once in the measurement year 

Patient 

Exclusions: None 

Data Element: 

1. Is the client HIV-infected? (Y/N) 

a. If yes, did the client receive an oral exam by a dentist during the 

measurement year?(Y/N) 

Data Sources: 

• Ryan White Program Data Report, Section 3, Item 33c may provide data useful in 

establishing a baseline for this performance measure2

•Electronic Medical Record/Electronic Health Record 

•CAREWare, Lab Tracker or other electronic data base 

•HIVQUAL reports on this measure for grantee under review 

•Medical record data abstraction by grantee of a sample of records 

National Goals, 

Targets, or 

Benchmarks 

for 

Comparison 

IHI Goal: 75%3

National HIVQUAL Data:4 

2003 2004 2005 2006 

Top 10% 66.7% 78.5% 66.7% 77.4% 

Top 25% 46.7% 62.2% 53.6% 56.4% 

Mean* 34.6% 39.7% 37.3% 39.4% 

*from HAB data base 

Outcome 

Measures for 

Consideration: 

Rates of dental disease and oral pathology. 

Basis for Selection and Placement in Group 2: 

Oral health care is an important component of the management of patients with HIV infection. A poorly 

functioning dentition can adversely affect the quality of life, complicate the management of medical 

conditions, and create or exacerbate nutritional and psychosocial problems.5 When the oral cavity is 

compromised by the presence of pain or discomfort, maintaining adherence to complicated antiretroviral 

therapy regimens becomes more difficult.6

 

There is limited evidence on the risks of oral procedures among persons with HIV/AIDS. Evidence for the 

utility of selected oral lesions as markers for seroconversion is limited to a single study of a single oral 

condition—candidiasis.7 In the later stages of HIV disease, greater numbers of oral lesions and aggressive 

August 1, 2008 Page 15 
HAB HIV Core Clinical Performance Measures: 

Adult/Adolescent Clients Group 2

periodontal breakdown are more likely; therefore, oral health care visits should be scheduled more 

frequently.8 

Measure reflects important aspect of care that impacts HIV-related morbidity and focuses on treatment 

decisions that affect a sizable population. Completing an oral health exam at least every 12 months is not 

specified in the PHS guidelines but is accepted as good practice.

US Public Health Guidelines: 

Primary health care providers should make an initial dental referral for every HIV/AIDS patient under their 

care. Oral health care providers should examine all patients on a semiannual basis for dental prophylaxis and 

other appropriate preventive care. As HIV-related medications may affect dental treatment and cause adverse 

effects, the patient’s oral health care provider should review all medications being used by the patient and 

should understand the potential for these medications to affect oral health care.9

 

References/Notes: 

1

A “provider with prescribing privileges” is a health care professional who is certified in their jurisdiction to 

prescribe ARV therapy. 

2

RDR does not provide number of dental exams, preventive, curative treatments and/or surgeries. It only 

provides information on the number of clients and number of visits in the “Oral health care” service category. 

3

IHI Measure reads, “Percent of Patients Receiving an Annual Dental Exam” 

(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsReceivinganAnnu

alDentalExam.htm) 

4

http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf

5

US DHHS Oral Health in America: A Report of the Surgeon General 

http://www2.nidcr.nih.gov/sgr/sgrohweb/welcome.htm 6

http://www.hivguidelines.org/public_html/center/clinicalguidelines/oral_care_guidelines/oral_health_book/oral_health_supp_pages/oral_health_chap1.htm#references

7

http://www.ahrq.gov/clinic/epcsums/denthivsum.htm

8

http://www.hivguidelines.org/public_html/center/clinicalguidelines/adult_hiv_guidelines/supplemental_pages/oral_health_adults/pdf/adults_oral_health.pdf 9

New York State Dept of Health AIDS Institute Oral Health Care for People With HIV Infection 

http://www.hivguidelines.org/Content.aspx?pageID=263

August 1, 2008 Page 16