The Importance of Dental Care

Oral health is very important. It is a crucial aspect of maintaining general health. Unfortunately, this is a topic that does not get as much attention as it should in HIV health care. According to a study conducted by the U.S. Department of Health and Human Services, 80% of people with HIV disease will present with at least one oral manifestation at some time during the course of their infection.

Reasons why oral health is important to individuals living with HIV:

• Problems in the mouth not only may be the first symptom of HIV infection but also can signify clinical progression.

• Proper dental care can reduce the presence of bacteria, which reduces strain on the immune system.
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• Open sores and exposed tissue is a potential entrance for infections into the body.

• Regular dental visits allow for early identification of conditions and infections. This allows for early treatment of these issues before they develop into serious problems.

Common Oral Manifestations

There are several oral manifestations associated with HIV. An important part of proper dental health care for individuals living with HIV is to be able to differentiate one manifestation from another, as well as practicing proper dental hygiene as a preventative measure to promote a healthy mouth.

Oral Candidiasis

This condition occurs frequently and is most often called "thrush." The affected area can be all over the mouth and possibly in the throat. The problem appears as white patches that can be wiped away, leaving a red surface. Some of the symptoms related with oral candidiasis are pain, loss of taste, distortion of taste, burning and discomfort.

Kaposi's Sarcoma

Kaposi's Sarcoma is the most common tumor associated with HIV and may initially appear as an intraoral tumor. The affected area is commonly on the roof of the mouth, but may also appear throughout the entire oral cavity. The symptoms of Kaposi's Sarcoma are red or purple patches or swellings, which may appear as raised or flat and may become painful.

Hairy Leukoplakia

This is a common condition which appears usually without any symptoms. This is a white lesion that most often presents on the sides of the tongue; however, it may appear in other parts of the mouth. If symptoms present, the oral manifestation is described as white, streaky, "hairy" patches that cannot be scraped off.

Gingivitis and Periodontitis

This is a commonly occurring problem, often described as the most painful of oral manifestations. Gingivitis and periodontitis affect the gums and teeth. Symptoms include inflammation of the gums, swelling, bleeding, bad breath and breaks in the seal between the gums and teeth.

Xerostomia

This problem is also called dry mouth. This is one of the most common complaints among individuals living with HIV. This problem should be addressed immediately to ensure the prevention of dental decay and periodontal problems. The affected areas can be the entire mouth and throat. The symptoms of dry mouth include the observation of reduced saliva production, leading to ongoing dryness of the mouth and throat area.

The above oral manifestations and descriptions are not a comprehensive listing of all potential problems. There are several other oral manifestations which may occur; however, the above have been listed as the most common. If you would like more information on specific oral manifestations, www.HIVdent.org and www.projectinform.org are two resources that can help in your research.

Promoting Good Oral Health

After understanding potential oral manifestations it is essential to learn the general guidelines promoted by the American Dental Association as a preventative measure associated with good oral health.

1. Brushing your teeth

Good brushing should take a minimum of two minutes and should involve brushing in a circular motion, working your way from one side of the mouth to the another, keeping in mind to pay attention to certain neglected areas such as the very back teeth and your tongue. Dentists recommend using soft bristle brushes and toothpaste that contain fluoride.
2. Floss regularly

It is recommended that individuals floss on a regular basis after meals and before brushing their teeth. The proper way to floss is to push the floss gently between your teeth to the gum to loosen debris your toothbrush cannot reach. When you begin flossing, you may experience light bleeding which will fade once your gums get used to the flossing process.
3. Mouthwash

Using a mouthwash that contains fluoride at least twice a day is a good preventative measure that kills bacteria responsible for the plaque that causes cavities and gum disease.
4. Dental visits

Regular dental visits about every six months are crucial to early identification of potential problems that could develop into more serious problems.

Finding a Dentist That is Right for You

Dental care is an important aspect of general health care. However, one must not overlook the issues of finding a dentist that is right for you. Finding a dentist can often be a difficult process, and it is important to find someone you feel comfortable with, one to whom you are willing to disclose your HIV status. This is important because there are conditions and problems such as those discussed in this article that the dentist will need to pay attention to during your regular checkups. Hopefully after reading this article, you will have a better understanding of the importance of dental care to your overall health.

If you don't already have a dentist, take this opportunity to do some research. There are several outlets for research to find a dentist that fits your needs. First, if you feel comfortable doing so, you may want to ask your doctor for a referral to a dentist or for a listing of area dentists with experience working with individuals living with HIV. Also, there are several listings in the resource database at AIDS Survival Project. Just give a peer counselor a call at (404) 874-7926 ext. 11 and ask for help locating a dentist in your area. Lastly, if you still need help locating a dentist, visit www.HIVdent.org, which provides information on HIV dental care as well as referrals to HIV dental programs in your community.