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dental bleeding at the cellular level
May 2, 2012

I am a 61 year old white male; HIV+ and asymptomatic for 24 years. I wear a partial dental appliance in the maxillary region of my mouth. From time to time, my dentist will adjust the appliance to compensate for shifting, etc. I have worn this for several years. The appliance has recently irritated the soft gingiva on the underside of the mouth near the gum line with a pre-molar. This has happened in the past...simple adjustments can help. There is no visible bleeding. My concern is with bleeding at the cellular level that may not be visible to the eye, but could pose a risk to my partner if I am performing oral sex on him. My physician has not been consulted on this particular matter as yet (we have talked about the lack of virus in saliva, enzyme action in the mouth, etc., but I have not addressed my fear of this kind of unseen bleeding in my mouth). Should I abstain from unprotected oral sex when the dental appliance has irritated a part of my mouth?

Response from Dr. McGowan

Thanks for your question.

There is no answer for you based on hard evidence. We do know when people have irritated or bleeding gums or gingivitis there can be an increased risk of having HIV in the oral secretions. So irritation of the gums would likley cause this. There has been at least one report of oral transmission of HIV associated with gingivitis. This is because these irritations release cells that can carry the HIV genetic material. Even though the saliva may not have free virus in it, these inflammatory cells will. A dental dam or latex condom can be used in lieu of abstinance.

Best, Joe

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