Dental care gets low priority for many of us. In Austin, Texas we have radio commercials from a dentist who says most of his patients haven't seen a dentist in five to 30 years. (He offers sedation so he can do a lot of work in one visit.) According to Reference 1, dental care tends to be the last thing HIV patients and their doctors worry about. But it's very important. Opportunistic infections often start in the mouth, and have a profound impact on the health of anyone with a compromised immune system. Dentists who specialize in HIV patient care can make a big difference. Here are 10 oral health issues that are especially significant for HIV patients:
1. Candidiasis, a fungal lesion commonly called “thrush”. Treated with anti-fungal medications.
2. Histoplasmosis, a fungal infection that can cause lesions anywhere on the body, including the mouth.
3. Herpes simplex or zoster, lesions from the family of viruses that cause cold sores, chickenpox, genital herpes, and shingles. Treated with anti-viral medications.
4. Human Papilomavirus. This virus causes both oral and genital lesions, as well as cervical cancer. Treated by surgical removal of the lesion.
5. Cytomegalovirus, oral ulcers that signal systemic infection. Treated with anti-viral medication.
6. Hairy leukoplakia, another viral lesion.
7. Periodontal disease, a chronic inflammatory process caused by bacterial or fungal infection. This condition is common even without HIV infection, and can make eating painful. Treatment includes dental hygiene and oral antibiotics.
8. Apthous ulcers (canker sores). These have many causes, and the treatment depends on the diagnosis.
9. Xerostomia (dry mouth). This can be a side effect of HIV medication or a complication of other illnesses.
10. Kaposi's sarcoma, the characteristic illness that first alerted doctors to the presence of AIDS. Some of the lesions are oral.
Mark Cichocki, RN, recommends finding an “HIV friendly” dentist who has experience with a large number of HIV patients and stays up to date on treatment options. Resources for selecting the best dentist for you include: local HIV case management agencies, referrals from friends, your current dentist (especially if you're moving to a new area), and professional associations such as the American Dental Association or the Academy of General Dentistry. The first visit to your HIV friendly dentist should be something simple. You can just get a consultation to talk about HIV issues if you want a totally painless first visit.
Reference:
Mark Cichocki, RN, “Living with HIV: A Patient's Guide”, McFarland Publishers, 2009.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.