title: A new approach to ensuring oral health care for people living with HIV/AIDS: the dental case manager.
abstract: BACKGROUND
  The American Dental Association has identified several barriers to adequate dental care for vulnerable populations, including appropriate case management. The objective of this study was to examine the perceptions, attitudes, and beliefs of dental patients living with HIV/AIDS on the role and value of the dental case manager (DCM) and the effect of DCM services on their oral or overall health.
  
  
  METHODS
  We used a qualitative descriptive study design and focus groups. Twenty-five people who had received DCM services on Cape Cod, Massachusetts, attended 1 of 5 focus groups in 2009 and 2010. Digital recordings of the groups were transcribed verbatim. Textual data were categorized using directed qualitative content analysis techniques. We identified major themes and representative quotes.
  
  
  RESULTS
  The following themes emerged from discussions on the DCM's role: being available, knowledgeable about clients and insurance, and empathetic; increasing access; and providing comfort. Most participants credited their oral and overall health improvements to the DCM. All participants believed that the DCM was a valuable addition to the clinic and noted that other at-risk populations, including the elderly and developmentally disabled, likely would benefit from working with a DCM.
  
  
  CONCLUSIONS
  The addition of a DCM facilitated access to dental care among this sample of people living with HIV/AIDS, providing them with an advocate and resulting in self-reported improvements to oral and overall health.
authors.affiliation: Meyers Primary Care Institute, Worcester, MA 01605, USA. celeste.lemay@umassmed.edu
authors.forename: Celeste A
authors.initials: CA
authors.lastname: Lemay
authors.forename: Suzanne B
authors.initials: SB
authors.lastname: Cashman
authors.forename: Anne
authors.initials: A
authors.lastname: McDonald
authors.forename: John R
authors.initials: JR
authors.lastname: Graves
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000592:standards*; D003729:Dental Care; D017742:Dental Care for Chronically Ill / Q000523:psychology / Q000592:standards*; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009909:Oral Health / Q000592:standards*; D017060:Patient Satisfaction; D024382:Professional Role; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods; D011788:Quality of Life; D000078329:Workforce