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Ask the Experts about Oral Health and HIV

 

Thrush?
Dec 29, 1999

I know that you have had many, many questions about thrush, but I need to ask another one please. How easy is it for a regular doc or dentist to diagnose thrsh? can they look at your mouth and even if they do not see any whit stuff but see red, sore, bleeding gums, can they tell if it is thrush? I am getting white stuff in my mouth overnight. When I wake in teh morning I look in my mouth and see it on my gums and on the cheeks on the inside. After I brush and rinse with Listerene (sp), it goes away. But I have had sores on my gums. They will be white by the tooth and very, very red an sore around that. Does this sound like trush? I have tested negative for HIV many times now, but continue to have such problems. My dentest said that he can't really tell, since he can only see the redness and not the white stuff. Thank you for your help.

Response from Dr. Reznik

How easy is it for a regular doc or dentist to diagnose thrush? This is actually a very good question. Both physicians and dentists are very good when to comes to diagnosing pseudomembranous candidiasis or what people commonly refer to as thrush, but when to comes to diagnosing erythematous candidiasis or the red form of thrush, I would have to go on record as saying that this is the most commonly mis-diagnosed or under-diagnosed lesion associated with HIV disease.

Now specifically to your situation: From what you have described, it would be difficult to assume that you have thrush. First of all, pseudomembranous candidiasis (white thrush), would not normally rinse away. Also it would not be common to see thrush in your mouth upon waking, and then not see it again until the next day. Also, it does not sound as if you have the red form of thrush or erythematous candidiasis. Pictures of both forms of thrush can be found in the HIVdent Internet project at the following URL: http://www.hivdent.org/slides/index.htm From what you have described here, it sounds as if you are building up a great deal of dental plaque which would disappear after brushing and rinsing. It would also make sense that you would have sore "gums" if you were building up a good deal of dental plaque.

My advice would be to visit a general dentist or periodontist (gum specialist) to access whether or not you have gum disease.

Feel better soon!

DR

A note: I tend not to recommend Listerine products as they usually have a very high alcohol content which can irritate the soft tissues in the mouth, especially in people who have dry mouth.



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