Not many people may realize that between 30-80% of HIV-infected adults have what are referred to as “HIV-related oral abnormalities” (according to the ADA). One of the most common conditions is xerostomia, more commonly known as “dry mouth.” Additional oral health problems linked with weakened immune systems of HIV-positive patients can also include:
- Mouth ulcers
- Hairy Leukoplakia (hair-like growth on the side of the tongue, cheeks, or lower lip)
- Candidiasis (fungal/yeast infection, also referred to as thrush)
- Oral warts, inside the lips and other areas of the mouth (appearing gray, white or pink)
- Blisters
- Gingivitis
- Periodontitis (bone loss around the teeth)
- Canker sores
The cause of these conditions originates from what are called “opportunistic infections” (OIs). OIs are more likely in patients diagnosed with HIV because of their weakened immune systems. This heightens their susceptibility to a variety of germs (bacteria, fungi, viruses, and parasites).
And, because salivary flow and antibodies are decreased in HIV-positive patients, it can also increase the likelihood of developing cavities (dental caries).
Because of the myriad of oral manifestations associated with HIV, it’s important that someone living with HIV have routine dental visits. This enables a dental professional to monitor and track any changes or progressions of oral diseases and conditions, as well as preventing future or further oral health issues.
What Precautions Need to be Taken with Patients Who Are HIV Positive in Dentistry?
Since HIV is primarily transmitted through exposure to blood and bodily fluids, the American Dental Association (ADA) stipulates that standard precautions should be taken with all patients (whether or not they have been diagnosed with HIV). At Penn, we strictly adhere to these safety initiatives which include:
- Personal protective equipment (PPE) for all dental personnel
- Gloves
- Face masks
- Protective eyewear (depending on the dental procedure)
- Removal of protective equipment upon departure of work areas
- No reuse of any PPE
It’s important to note that the average risk of HIV transmission is extremely low—only 0.3%.
Can a Dentist Refuse to Treat a Patient with HIV?
They shouldn’t. According to the ADA:
“All dental practices should be able to provide routine dental care for adult or pediatric HIV-positive patients. Nearly all patients with HIV are able to tolerate routine dental care and procedures, including oral surgery.”
As we mentioned earlier, we provide comprehensive dental care here at Penn for people living with HIV.
Penn Dental Medicine: Advancing HIV Research
Not only do we welcome HIV-positive community members, but we also hold a commitment to the advancement of HIV research. In fact, Penn Dental Medicine Assistant Professor of Oral Medicine at PDM, Dr. Temitope Omolehinwa is helping to lead an investigation aiming to provide insight into oral health, systematic health, and treatment of people living with HIV.
The $3.75 million-dollar funded study (over five years) for which Omolehinwa is involved, will focus on compiling a prolific database of valuable research. This resource will provide Omolehinwa and other dental leaders with evidence-based research and practices to provide improved care for people living with HIV.
Specifically, the study will explore connections between medications HIV dental patients are taking (antiretroviral therapy drugs as an example) with what occurs in their oral cavity, and what conditions affect their whole body.
Participants of this study will be monitored and tracked over a period of years, seen every six months to help gather information and further research.
Getting the Care You Deserve
If you or someone you love is living with HIV, our student doctors and faculty advisors welcome you to book an appointment with us.
We would also like to offer you a valuable, FREE resource to provide further information on our oral medicine procedures: “Oral Medicine at Penn Dental Medicine: Oral Conditions and Treatments.” Simply click here to receive this downloadable whitepaper about various conditions addressed by oral medicine and why Penn Dental Medicine is uniquely equipped as an oral medicine provider.
Please call our PDM office at 215-898-8965 for any questions you may have.