When you have HIV, good oral health means more than having a bright smile and clean teeth. Between one-third and one-half of people with HIV experience serious problems in their mouths. These issues can cause pain, embarrassment, and trouble eating—which, in turn, depletes your body of the energy it needs to cope with your virus.
For this reason, your HIV care team should include a dentist as a key component. With the right preventive steps and treatment, you can feel better and keep oral health problems from interfering with your life.
Choose the Right Dentist
Many signs of worsening HIV infection first appear in your mouth. Bacterial and fungal infections that begin there can spread throughout your body, endangering your heart and other organs. Find a dentist who has experience treating people with HIV/AIDS. This way, he or she knows how to spot signs of trouble.
See your dentist regularly for checkups and cleanings. If you develop tooth pain, a sore, or other mouth-related problems between visits, don’t delay. Call your dentist and ask for advice.
Keep records of your dental visits, just as you do your doctor’s appointments. Be sure to bring any recent lab results with you to your appointment. Your dentist may need to know your CD4 count, platelet count, or other results to take care of you properly.
Understand the Risks
Because you have HIV, your risk for cavities, gum disease, and other dental health problems increases. You also may develop mouth conditions directly related to your infection. These include:
Canker sores. Your doctor or dentist may recommend creams, mouthwashes, or oral corticosteroids to treat these red, painful ulcers.
Oral herpes. This viral infection manifests as red sores on the roof of your mouth or on your the lips. Prescription medication can speed healing and prevent outbreaks.
Hairy leukoplakia. Another virus, the Epstein-Barr virus, causes thick, white patches to grow on your tongue or inside your cheek or lower lip. Mild cases don’t need treatment. Medication can help control pain in more severe cases.
Thrush. Also called candidiasis or yeast infection, thrush appears as creamy or bumpy white patches throughout your mouth. Treatment options include antifungal lozenges, mouthwash, or pills.
Warts. These rough bumps can appear pink, white, or gray, and sometimes look like cauliflower. Your doctor can remove warts surgically or by freezing them. However, they often return.
Kaposi's sarcoma. This cancer can appear in many parts of the body, but often affects the mucous membranes in the mouth. Its hallmark signs include brown, red, or purple blotches. If they form, your doctor will know HIV has damaged your immune system enough to qualify you for a diagnosis of AIDS. Antiretroviral therapy (ART) can help prevent Kaposi's sarcoma and also keep it from progressing to advanced stages.
Practice Good Oral Health
To prevent these problems, brush your teeth at least twice a day—preferably after every meal. Floss every day to clean parts of your mouth your toothbrush can’t reach. Inspect your teeth, tongue, and gums regularly, and report any unusual changes to your doctor or dentist.
Taking your HIV medications regularly can keep your immune system strong and reduce your risk for oral health issues. However, sometimes these treatments can also contribute to dry mouth. This causes discomfort and can increase your risk for tooth decay. That’s because saliva helps control bacteria and fungi in your mouth.
If you experience dry mouth, try sipping water or sugarless drinks, chewing sugar-free gum, or sucking on sugarless hard candy. Avoid alcohol, tobacco, and salty foods. Use a humidifier at night. If you continue to experience discomfort, pain, or trouble chewing and swallowing, ask your doctor about treatment with artificial saliva.