Couple brushing their teeth in the mirror.

The Connection Between HIV/AIDS and Oral Health

September 15, 2020

We know that proper dental care should be a part of anyone’s healthcare routine, not only for maintaining a bright and beautiful smile but helping to support our overall health as well.

This is especially true for anyone living with HIV or AIDS, as this virus and disease weaken a person’s immune system and increase the risk for infections in the mouth. Not only are people with HIV/AIDS more susceptible to common problems like cavities, canker sores, and gum disease, but they’re more likely to suffer from less prevalent conditions as well.

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What is HIV/AIDS?

HIV, or Human Immunodeficiency Virus, is a virus that attacks vital cells in the immune system known as T cells which are needed for the body to ward off infection and disease. Over time the HIV virus can potentially destroy so many T cells that the immune system has become too weak to put up a fight. This is when the virus has developed into what we know as AIDS (Acquired Immunodeficiency Syndrome).

Fortunately, HIV treatment has come an incredibly long way since the virus was first clinically observed in 1981. While no cure currently exists, early detection and treatment with antiretroviral drugs can help most patients lead long and healthy lives.

Oral Signs of HIV

Your mouth can be a great barometer of your overall health, as oral symptoms often point to systemic issues in the body, including HIV.

In fact, it’s not uncommon for the mouth to be the first place where signs of HIV become apparent. While none of these symptoms on their own are necessarily an indicator of HIV, it’s important to discuss these issues with your dentist should they appear:

  • Canker sores on the tongue or inside of the lips and cheeks;
  • Herpes sores on the roof of the mouth or outside of the lips;
  • Abnormal bleeding of the gums;
  • Red band gingivitis that can progress to periodontitis if left untreated;
  • Candidiasis (also known as thrush), with creamy-looking patches anywhere in the mouth;
  • Hairy leukoplakia, with white patches typically on the side of the tongue that have a hairy appearance. This is perhaps one of the strongest indicators, as it's caused by the Epstein-Barr virus which is most commonly seen in people with HIV;

Other Potential Complications of HIV/AIDS

Along with the common signs of HIV, the virus can also pose additional oral complications that are less likely in non-HIV-positive patients.

While the antiretroviral medications used in HIV treatment have shown to help reduce many of these risks, HIV-related oral conditions are still seen in a large percentage of patients. These are frequently due to side effects resulting from treatment and infections that are commonly seen in those with HIV.

Chronic Dry Mouth

Many antiretroviral drugs reduce the body’s production of saliva which can lead to chronic dry mouth.

Along with helping us digest our food, saliva protects our teeth’s enamel and controls the level of bacteria and fungi in the mouth. If you suffer from chronic dry mouth, this may lead to cavities and gum disease at a more rapid pace, ultimately contributing to tooth loss. Your dentist might be able to prescribe you an artificial saliva.

Oral Warts

Millions of Americans contract the human papillomavirus (HPV) each and every year. In fact, it’s so common that the Centers for Disease Control predicts that nearly every unvaccinated person will get HPV at some point in their life.

In most cases, HPV doesn’t cause any health problems and goes away on its own within a couple years. But for those who also have HIV, HPV can heighten the risk of oral warts.

Oropharyngeal Cancer

Those with both HIV and HPV also have an increased likelihood of developing cancer of the oropharynx, which includes the back of the throat, the tonsils, and the base of the tongue. Tobacco and alcohol consumption increase this risk even further.

Kaposi's Sarcoma

Though rare, Kaposi’s sarcoma is a cancer that’s associated with the herpes virus and primarily affects those with HIV in its later stages. It usually appears as tumors on the skin or inside the mouth, though it can develop in other parts of the body as well.

While those with HIV or AIDS may be more susceptible to oral disease, the good news is that all dental practices can provide high-quality routine care to both adult and pediatric patients.

Most HIV-related dental conditions can be treated if addressed early at your preventative visits. Your dentist can monitor any disease progression, work with you on an individualized treatment plan, and help you maintain a healthy smile for years to come.

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