Problems In The Mouth Offer First Clues to HIV Infection

November 26, 2008

USC School of Dentistry Takes the Lead in Raising Awareness of the Importance of Oral Health as Part of World Aids Day

(Los Angeles, CA) 40 million people worldwide are living with HIV/ AIDS throughout the world. From the onset of the HIV/AIDS epidemic, oral health problems were identified as key indicators of the disease.  The University of Southern California School of Dentistry leads the effort to raise awareness in the importance of oral health as part of World Aids Day on December 1.

According to the 2008 Report on the Global Aids Epidemic, there are 1.1 million adults and adolescents living with HIV/AIDS in the U.S., with 232,700 unaware of their infections. Antiretroviral treatment has reduced both the mortality and the morbidity of HIV infection. “Medications  are allowing people with HIV/AIDS to  live longer, more productive lives, but they also create another set of oral health issues — saliva, the body’s natural cleansing process, is disrupted, prompting the development of oral lesions in many of these patients,” says Dr. Mahvash Navazesh,  professor with the USC School of Dentistry.”

90 percent of people living with HIV have one or more HIV-associated oral lesions over the course of the disease.  “These lesions are often a harbinger for the disease’s progression to full-blown Aids”, says Dr. Veronica Green, Assistant Professor of Clinical Dentistry with the USC School of Dentistry. Green adds, “Access to oral health care, both for the person at risk for HIV infection and the person already living with HIV, is critical”.

Fungal Infections
Without the body’s natural defenses, fungi, viruses and bacteria flourish. Typical fungal manifestations include candidiasis also known as thrush, a fungal infection resulting in unsightly creamy white lesions in the mouth.

Viral Infections
Oral warts caused by humanpapilloma virus may be cauliflower like, spiky, raised or flat.

Bacterial Infections
Necrotizing ulcerative periodontitis and necrotizing ulcerative gingivitis are both periodontal diseases and  indicators of severe immune depression. NUP causes severe pain and bleeding of the gums and leads to rapid destruction of the tissues and bones.

For the HIV-positive person who is unaware of his/her condition, lack of access to dental care represents missed opportunities for an early screening, diagnosis and testing for HIV.  Oral symptoms provide dentists with the clues to diagnose the disease before the patient has seen his or her own health care provider or been tested for HIV.

The USC School of Dentistry Special Patients Care Clinic provides HIV/AIDS patients with an environment where they feel safe. Prior to beginning any dental treatment, a thorough review of the patient’s medical history is in order. “For the benefit of the patient, we work closely with their physician in providing treatment. A consultation prior to delivering care is important in determining appropriate care and reduces the chance of infection or other complications,” Greene adds.  Working hand in hand with medical professionals, dentists are taking a more active role in bringing awareness to the importance of oral health care as it pertains to HIV and AIDS.