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 (blood transfusion, using needles previously used by HIV-infected people), and sexual contact.

HIV weakens your immune system, making you vulnerable to a wide variety of diseases. Oral diseases are especially common.

In fact, more than a third of those who are HIV-positive suffer from oral health problems that are a direct result of their condition. Here are five oral manifestations of HIV to which you should pay attention.

1. Oral warts

Oral warts can develop anywhere inside your mouth. These warts aren’t painful, but look like raised or smooth bumps that can develop as one or many blemishes. They’re caused by human papillomavirus (HPV), and are much more common among those who are HIV-positive than in the general population.

Dentists can remove warts by freezing them or cutting them away with lasers, but they may recur.

2. Hairy leukoplakia

Hairy leukoplakia causes white, hairy patches to develop on the surface of your tongue. Unfortunately, you won’t be able to remove these patches with your toothbrush. They can be painful and may affect the way your food tastes, as well.

This condition comes from the Epstein-Barr virus, the same virus that causes mono. It usually affects people with weakened immune systems, so developing hairy leukoplakia may be the first sign you are HIV-positive and need treatment.

3. Oral thrush

Oral thrush produces white sores on your tongue and the inside of your mouth. At first glance, it looks similar to hairy leukoplakia, but oral thrush can be wiped away. Keep in mind this may cause bleeding.

Oral thrush is caused by a fungus called Candida that is actually present in small amounts in everyone’s mouths. Healthy immune systems keep the population of Candida under control, but in people with HIV, the condition can grow beyond one’s control. It can be cured with anti-fungal medications, but may recur later on.

4. Canker sores

Canker sores are very common, and appear on the insides of your cheeks, lips or even your tongue. These round or oval sores are usually white in the centre and red around the edges. They can be uncomfortable when irritated by food or strong liquids, and may take as long as 15 days to fully heal.

There is no official cure for canker sores, but your dentist can prescribe medication to ease your symptoms while the sore heals on its own. If you suffer from frequent canker sores, you should talk to your doctor about adjusting your HIV treatment plan.

5. Gum disease

Gum disease is caused by poor oral hygiene that allows bacteria to build up along the gumline. These bacteria irritate your gums and cause them to become red, swollen, and quite painful if left untreated. People who are HIV-positive develop gum disease more easily than those with healthy immune systems, and the inflammation can become a chronic problem.

Gum disease ultimately goes away with good oral hygiene. If good oral hygiene isn’t enough, your dentist may also prescribe an antimicrobial rinse.

HIV affects your whole body, and your mouth is no exception. Oral manifestations of HIV are very common, so if you are HIV-positive, stay alert for changes inside your mouth, and see your dentist right away if you notice any outstanding problems.