Dear Dr. Reznik,

I have these two wisdom teeth on each side of my mouth that are impacted and will probably one day have to be removed. I've been Poz since 7/98, and I notice that I get slight patches of thrush on my cheeks in the area where the wisdom teeth are, and it comes and goes. Could the wisdom teeth be causing this by themselves, or is the thrush aided by HIV? Do you see this as something I should take care of right away?

Thanks for all your work here,

Jim

Dear Jim:

I would definitely suggest that you have this looked at sooner rather than later for a few reasons:

1. To see whether or not you are experiencing thrush or linea alba, which is nothing more than cheek biting.

2. If you are experiencing thrush, you would need to have your viral load checked as well as CD4 count and other pertinent labs.

Can impacted wisdom teeth lead to infection? The answer to this question would be yes. You can experience a condition known as pericornitis which is an infection and inflammation of impacted teeth. Would this necessarily lead to thrush? The answer would be no, unless you were on broad spectrum antibiotics or your viral load or CD4 count were consistent with this diagnosis.

Hope this helps!

DR