Since HIV was originally discovered in 1981 there have been remarkable advances in its management. The interaction of therapies to prevent opportunistic infections occurring, together with new medications mean a lot of people living with HIV can now look forward to many years of relatively good health. It is important for people living with HIV/AIDS to have access to good dental care, as the dental team are able to recognize and manage oral diseases associated with HIV. These diseases include necrotizing ulcerative periodontitis, oral hairy leukoplakia, candidiasis and periodontal diseases.
Ensuring Universal Precautions Are Taken
No special precautions are necessary when treating HIV-positive dental patients, but it is important that universal precautions are taken. These are the precautions that need to be taken with every single patient regardless of whether or not they have HIV status. Some patients will be unaware of their HIV status, and HIV is not the only blood-borne germ that dental professionals need to be aware of. Universal precautions should ensure the dental team stays healthy while still providing essential dental care for HIV/AIDS patients. While patients with HIV aren’t required to reveal their status to dental professionals it is recommended, as this will help ensure that dental team can be extra vigilant for the presence of any HIV specific pathology in the mouth.
Oral Diseases May Indicate HIV Is Progressing
The manifestation of oral diseases can often be a key indication that the disease is progressing, as oral lesions occur in approximately 30% to 80% of the population affected by HIV/AIDS, and may show that current treatment isn’t working. Oral lesions can also be an indication that the patient may have HIV and that the patient needs referring to a primary care physician for a proper diagnosis. Even though the introduction of antiretroviral therapy has meant HIV related oral lesions have declined, these lesions are still frequently seen.
Since many signs of HIV infection first manifest themselves in the oral cavity, it’s essential that the dental healthcare provider recognizes the symptoms and offers appropriate therapy, and that they recommend a follow-up with a primary health care provider to determine the underlying cause of the oral lesions. One of the problems with testing for HIV is that many patients who test positive do not return for their results, but nowadays a rapid HIV test can give results within just 20 minutes. People with HIV do need to take extra care of their oral health, and this is something that needs to be emphasized as soon as possible after diagnosis.
Treating Patients with HIV
Patients with HIV status don’t usually require any special provisions when planning dental treatment, but this can change as the disease progresses to AIDS. In this case it may be necessary to conduct laboratory tests to evaluate the progression of the disease before working out an appropriate treatment plan. The dental team also needs to evaluate a patient’s medical history prior to each dental treatment, as the multiple systemic effects of HIV infection could lead to abnormal bleeding tendencies or anemia. People with AIDS can also develop allergies to a number of medications which may affect any antibiotics prescribed by a dentist. In addition people with advanced AIDS may already be taking antibiotics to help prevent opportunistic infection, and it may not be appropriate or necessary to prescribe additional medications.