Oral Effects
The oral effects of HIV and AIDS occur because your immune system is weakened and less able to fight off infection. These effects also are found in other people with weakened immune systems. Some of the more common oral conditions in people with HIV include:
- Dry mouth (xerostomia)
- Enlarged lymph nodes (lymphadenopathy)
- Thrush (oral candidiasis)
- Hairy leukoplakia associated with a viral infection (Epstein-Barr virus)
- Kaposi's sarcoma
- Oral bacterial infections such as Periodontal (gum) disease
- Swollen salivary glands
- Herpes simplex virus lesions
- Human papilloma virus lesions
- Canker sores (aphthous ulcers)
- If you have HIV, changes in your mouth may reflect changes in your immune status. Many oral conditions are associated with specific levels of immune system strength. Some are seen when your immune system first starts to deteriorate and others are seen at later stages. Your dentist can show you how to do an oral exam so you can become familiar with the tissues in your mouth. Your dentist can teach you to look for certain oral changes that you should alert your dentist or physician about.
Daily brushing and flossing, fluoride mouthwashes or mouth rinses and regular dental visits are important for people infected with HIV. If your immune system is still strong, you should visit your dentist every six months. However, if your disease gets worse, you should see your dentist more frequently.
Dry mouth (xerostomia) is a common side effect of medications that you may take for HIV/AIDS. Dry mouth can make you more prone to decay, gingivitis, thrush and periodontal (gum) disease because your saliva is less able to wash away sugars, food, bacteria and the acids that bacteria produce. Your dentist can prescribe a fluoride rinse or gel or a saliva substitute to counteract the increased risk of tooth decay.
Children With HIV/AIDS
Thrush is a common oral problem in children with HIV. It can be treated with topical medication rinses. Many medications given to children with HIV or AIDS are thick liquids that contain high amounts of sugar to make them taste good. If your child takes such medications, it's important to rinse his or her mouth out with water afterward to avoid tooth decay. Tooth decay is a serious problem for a child with HIV. It can lead to pain, infection, difficulty chewing, difficulty gaining weight and malnourishment.
At the Dentist
Always tell your dentist about your medical condition. Your dentist should be a part of your treatment team and know as much about your condition as possible, including your immune status and the medications you are taking.
In general, people with HIV or AIDS do not need antibiotics before major dental treatment. Your dentist may use antibiotics if your neutrophil count is low (a condition called neutropenia). He or she may also prescribe an antibiotic mouthwash before and after treatment, and may treat your gums with such a mouthwash before surgery.
AIDS also can reduce your counts of platelets (which help the blood to clot) and red blood cells. A low platelet count, called thrombocytopenia, does not affect routine dental treatment if the count is still above 50,000. If your platelet count drops below this, you should be treated by a dentist well informed about treating medically compromised patients, rather than by a general dentist.
Anemia (low red blood cell count) is common in people with HIV, either as a result of infection or as a side effect of antiretroviral therapy. If you are severely anemic, make sure your dentist knows about the condition. Because HIV/AIDS and commonly prescribed medications can affect your blood counts, give copies of your most recent blood tests to your dentist.
