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Bleeding gums, Herpes, and HIV
Dec 1, 2000

I am an HIV+ male with CD4 counts of 500+ and a low viral load who is not on medication.

I have had problems with dry and receding gum line all my life. Periodically, this causes bleeding and pain that must be addressed by a competent dental professional.

I have two questions in regards to this situation:

1. How, if at all, does my my positive status affect my gums. I have heard that in advanced stages of AIDS that gum problems are common, but my problems started long before I had HIV and I am still a long way from being sick. Should a dentist be aware of my status in order to properly diagnose and treat my gum problems?

2. I also have the Herpes virus, and I am concerned that I will transmit it orally to my boyfriend. How can we reduce the risk of him contracting it?

Thanks.

Response from Dr. Reznik

1. How, if at all, does my my positive status affect my gums. I have heard that in advanced stages of AIDS that gum problems are common, but my problems started long before I had HIV and I am still a long way from being sick. Should a dentist be aware of my status in order to properly diagnose and treat my gum problems?

Yes, I believe it important to let your dental health care professionals know your status. This will enable the providers to look for signs and symptoms of HIV infection which may appear in your mouth. There are specific periodontal (gum) problems associated with HIV infection: LGE (Linear Gingival Erythema) and NUP (Necrotizing Ulcerative Periodontitis). We have also seen rapidly advancing periodontal disease in our patient population in Atlanta. The key is for you to actively receive dental care and pay close attention to your home care. As long as you take good preventive measures, you should be able to avoid the periodontal complications seen in association with HIV/AIDS.

2. I also have the Herpes virus, and I am concerned that I will transmit it orally to my boyfriend. How can we reduce the risk of him contracting it?

If you have oral herpes virus infection (ulcerations which appear on keratinized tissues such as the hard/soft palates and gingiva) you should avoid kissing or other oral activities while the ulcers are present. If you are concerned about genital herpes, refrain from exposing your partner to this area when there is active shedding or active disease.

Take care!

DR


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