AIDS and the Periodontium
(Surrounding tissues of the teeth)
As you know the acquired immune deficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV) and is characterized by the destruction of lymphocytes (T4 cells or immune cells of the body.) This places the patient at risk for many opportunistic infections such as pneumonia, candidiasis, hepatitis, herpes viruses and malignant tumors such as Kaposi'sarcoma and lymphomas. Those patients at high risk are but not limited to:
- IV drug users
- Infected blood transfusion
- Homosexual men
- Heterosexuals in contact with any of the above
The sign and symptoms can vary from:
- Fever
- Involuntary weight loss
- Night sweats-Diarrhea
- Shortness of breath
- Lymphadenopathy of the neck, axilla and/or groin.
NOTE: any of the above sign and symptoms can be present in other medical conditions, please check with your doctor for in depth diagnosis.
In terms of the oral manifestation:
- Oral hairy leukoplakia
- Candidiasis
- Atypical periodontal disease
- Ulcers
- Viral infection
- Kaposi'sarcoma
Oral hairy leukoplakia: This conditions present as a white "hairy" appearance on the lateral borders of the tongue, however it can be present elsewhere. The lesion will not rub off.
Candidiasis: This is a fungus of the normal oral flora. It is painless and can be easily scraped off. Usually red, or red and white, lesions on the palate or other parts.
Atypical periodontal disease: A rapid progression of bone loss where there was none for several years. Possibly a well demarcated red thin band following the outline of the gums (at the junction of the gums and the teeth). A deep aching pain of the gums is often a complaint. Finally, this will respond poorly to most conventional treatment.
Oral Ulcers: There is a higher incidence of mouth ulcers and will take longer than a 7-10 day healing period.
Viral infections: Syphilis, gonorrhea and other sexually transmitted diseases are more frequent, but are rarely present in the mouth, unless there an oral-genital contact.
Kaposi'sarcoma: A rare tumor and most often present in older men of Mediterranean origin. In HIV infected patients this tumor is more aggressive. It is painless with a reddish purple color and mostly found on the palate.