Dental Clinic Is Leader In Hiv Care

PORTLAND - Like many diagnosed with HIV in the mid-1980s, Jack Cox had difficulty finding a dentist.

"You couldn't get service anywhere," he said. "It was as simple as that."

That's why Cox, 59, became one of the thousands of people with HIV who come from as far as Montana to a North Portland dental clinic that has long combined HIV expertise and a welcoming attitude.

Located in a squat concrete building near Legacy Emanuel Hospital, the Russell Street Dental Clinic, known as Project Dental Health, has served nearly 2,000 HIV patients since David Rosenstein founded it in 1975.

It continues to play an important role in HIV dental care because it is in the forefront of serving HIV patients whose needs have changed as they live longer than once expected.

"Only a few clinics in the nation have focused on HIV clients the way they have," said Mark Loveless, director of the Oregon Health Divisions HIV/STD/TB program. "They provide most of the dental care to persons with HIV in Portland."

Rosenstein began serving HIV patients in the early 1980s, when many dentists were reluctant to provide care. Although that has begun to change, Rosenstein thinks not enough dentists have experience in treating the unique and difficult dental problems that come with HIV, the virus that causes AIDS.

HIV patients often suffer from frequent lesions and cancers, recurrent herpes and perpetual canker sores. With a compromised immune system, minor infections can turn deadly, Rosenstein said.

"I've had a patient die of a canker sore," he said.

Clients describe the clinic as an oasis of expertise and compassion that combines the science and psychology of treating HIV patients. They say that's largely due to Rosenstein, who heads the Public Dentistry Program at Oregon Health Sciences University and holds degrees in dentistry, public health and medical sociology.

"David is different from most dentists," Cox said. "We're friends; we laugh together. He cares about me, and that's good because he's the smartest man I know."

Rosenstein, who was raised on welfare in the Boston projects, said watching his disabled mother not receive the care she needed spurred him to study public health. He went on to become a tireless HIV advocate.

For some HIV patients, finding dental care still can be difficult, even though the Americans With Disabilities Act of 1990 makes it illegal to deny care based on HIV status.