HUMAN immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). This virus is passed from one person to another through blood-to-blood contact, such as blood transfusions, as well as the use of HIV-infected needles and sexual contact.

Additionally, an infected pregnant woman can pass HIV to her baby during pregnancy or delivery, as well as through breastfeeding.

AIDS occurs when the HIV infection has weakened one’s immune system to the point that it has difficulty fighting off certain illnesses and infections. “Opportunistic” infections also occur, taking the opportunity a weakened immune system gives to cause illness.

HOW DO I KNOW IF I HAVE HIV/AIDS?

Dental problems such as sore bleeding gums, herpes sores in the mouth, and fungal and candida (yeast) infections may be among the first signs of AIDS. However, you should not assume you are infected if you have any of these symptoms, as these occur in the general population as well.

The only way to determine whether you are infected is to be tested for HIV infection. Consult with your physician or other health-care professional.

A positive HIV test result does not mean that you have AIDS. AIDS is a medical diagnosis made by a doctor based on specific criteria. You also cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years.

ORAL EFFECTS

The oral effects of HIV and AIDS occur because of your weakened immune system and the medicines you must take. These effects are also found in other people with weakened immune systems. They include:

1. Dry mouth (xerostomia);

2. Enlarged lymph nodes (lymphadenopathy);

3. Thrush (oral candidiasis);

4. Hairy leukoplakia associated with a viral infection (Epstein-Barr virus);

5. Oral bacterial infections such as periodontal (gum) disease;

6. Swollen salivary glands;

7. Herpes simplex virus sores;

8. Human papilloma virus warts;

9. Canker sores (aphthous ulcers); and

10. Kaposi’s sarcoma (no longer frequently seen).

If you have HIV, changes in your mouth may reflect changes in your immune status. Some oral conditions are seen when your immune system first starts to get worse. Others are seen at later stages.

Your dentist can show you how to do an oral exam and teach you to look for certain oral changes. If you see these changes, you should alert your dentist or physician.

Daily brushing with toothpaste, flossing, use of fluoride mouthwashes, and regular dental visits are important for people infected with HIV. When your immune system is still strong, visit your dentist every six months. However, if your disease gets worse, you should see your dentist more often.

Dry mouth is a common side effect of medicines that may be taken for HIV/AIDS. Dry mouth can make you more prone to tooth decay, gingivitis, thrush (oral yeast infection), and gum disease.

This is because there is less saliva, and the quality of the saliva has changed. Besides water, saliva includes electrolytes, mucus, antibacterial compounds, enzyme, and other proteins. The amounts of these substances change in people with dry mouth.

A decrease in saliva reduces its ability to wash away sugars, food, bacteria, and the acids that bacteria produce. These acids cause teeth to decay. Your dentist can prescribe a fluoride rinse or gel or a saliva substitute to counteract the increased risk of tooth decay and thrush.

CHILDREN WITH HIV/AIDS

Thrush, a fungus infection, is a common oral problem in children with HIV. It can be treated with medicated rinses.

Many medicines 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 medicines, be sure 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 with chewing, problems with 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. This includes your immune status.

Tell your dentist about all the medicines you take. This should include over-the-counter vitamins and herbal supplements.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710. Like their Facebook page, Dental Place Cosmetix Spa, for an opportunity to take advantage of weekly specials.