Isabel Rambob

Isabel Rambob

University of Maryland School of Dentistry

Title: HIV, TB & smoking


Isabel Rambob received her Doctor of Dental Surgery degree from the State University of Feira de Santana, Brazil in 1997. She completed a one-year program in Advanced Education in Comprehensive Dentistry at New York University College of Dentistry in 2007. She then pursued and completed a one-year Residency Program in Advanced Education in General Dentistry at Howard University College of Dentistry in 2008. She was a dental provider at HIV+ clinic and a clinical instructor at Special Needs clinic at University of Maryland School of Dentistry from 2009-2012. She was the dental director at National Minority AIDS Education and Training Center from 2009-2010. She was a HIV/AIDS & oral health preceptor at Howard University College of Medicine from 2009-2010. She was the dental director at Health Care for the Homeless, Maryland from 2010-2011. Currently, she is an assistant Professor at University of Maryland School of Dentistry at the Department of General Dentistry. She is also a guest lecturer at New York University College of Dentistry, Howard University College of Dentistry and VA Medical Center, Baltimore. \\\\\\\\\\\\\\\\r\\\\\\\\\\\\\\\\n\\\\\\\\\\\\\\\\r\\\\\\\\\\\\\\\\n


Since the beginning of the 21st century, we are facing the convergence of several epidemics. These include tobacco smoking, tuberculosis (TB) and HIV infection. These epidemics interact by way of increasing disease susceptibility and worsening outcomes. To control these interacting epidemics, it is crucial to better understand each infection and how it influences the others. The association between tobacco smoke and TB was suggested many years ago. Evidence of the impact of tobacco smoking on TB infection has been confounded by its almost universal association with poverty, overcrowding and alcohol usage. Similar pathological mechanisms induced by malnutrition, alcohol abuse and smoking may indeed all predispose an individual to TB. Although both tobacco smoking and HIV infection may be associated through their common associations with poverty and high-risk behavior, tobacco smoking appears to be an independent and important risk factor for contracting HIV. Smoking further raises the extremely high risk of contracting TB in HIV+ individuals. The overall goal of this presentation is to focus on HIV disease, TB and smoking in their impact on the oral health. Tobacco use in HIV+ smokers is responsible for increased periodontal disease and tooth loss. Also HIV+ smokers have an increased incidence of cancer of the larynx, pharynx and esophagus. Smokers have an increased risk of oral candidiasis and oral leukoplakia, as well as decreasing healing of oral lesions. There is a marked risk of oral cancer in tobacco users and more than 80% is squamous cell carcinoma. Therefore dental professionals should play an important role in preventing these epidemics. \\\\\\\\\\\\\\\\r\\\\\\\\\\\\\\\\n