CDA Essentials 2019 • Volume 6 • Issue 7

37 Issue 7 | 2019 | I ssues and P eople dentists will feel confident treating people living with HIV. “Or else, they just get referred around,” he says. Challenges and Surprises Recently, a person living with HIV visited the private practice where Dr. Aytoglu works and saw another dentist. The staff who attended to the patient sterilized the instrument twice after providing care. “It was an opportunity to have a constructive conversation,” says Dr. Aytoglu. “We talked about the fact that universal precautions are designed so that we can treat all patients the same. And we talked about how an undetectable viral load means that patients can’t transmit the virus. Being treated differently impacts people in a lot of negative ways.” Stigma lingers around HIV, even now that the virus can be controlled with medication, and many HIV activists say that living with social stigma can be harder than living with the virus itself. The biggest challenge that Dr. Aytoglu faces at the Positive Living BC clinic is helping patients access financial resources for care. The clinic gets funding from the BC government, the provincial dental association and private donations, but its needs tend to outstrip its resources nonetheless. “We work with people who are underserved. There are often a lot of services that they could benefit from,” says Dr. Aytoglu. “At the clinic, we work hard to get treatments approved or to secure coverage.” One of the surprises for Dr. Aytoglu working at the Positive Living BC clinic is how healthy his patients are. He’d expected to see constant oral pathologies and lesions that wouldn’t heal, but instead, with the new drugs, many of his clients have undetectable viral loads. “A person will come in right after diagnosis and they will be sad and worried,” says Aytoglu. “A few months later, they’ll be undetectable and feeling just fine. There is an incredible resilience among the people I’ve met here.” Community Connections Dr. Aytoglu decided to work in health care because he wanted to do work that gave back to the community. In 2004, his family emigrated from the Middle East to Mississauga, Ontario; the experience of being new to Canada without adequate financial resources made life hard for his parents. After Dr. Aytoglu came out at 16, he was essentially on his own. “I felt very alone with my struggles, and it was a very difficult time in my life,” he says. “I didn’t know who to go to for support, emotional or practical.” He focused on school and saw academic achievement as “light at the end of the tunnel.” After earning an undergraduate degree at McMaster University, he applied to dental school and was accepted at three universities. When the job at Positive Living BC came up, Dr. Aytoglu knew it was something that he wanted to do. “I wish there had been someone there for me when I was battling my demons,” he says. “I felt like this was an opportunity for me to be there for others in difficult times.” As well, someone important in Dr. Aytoglu’s life when he was younger, “who made a real mark,” was HIV positive, so he felt a connection to the community. Dr. Aytoglu says that his job at the clinic has changed him. “It isn’t just fixing teeth. I get to know the people that we serve and I get to see the real impact of dentistry on their lives. They are healthier, happier, more socially confident. All of us at the clinic, even when we have a hard day, we know we are doing this work for a noble purpose.” a Dr. Nick Aytoglu, Positive Living Community Dental Clinic manager, is one of four dentists that provides care for between 10–20 patients a day. Photos: Eduardo Cáceres, B.C. Centre for Excellence in HIV/AIDS