HIV infection: dental considerations

For the medical management of human immunodeficiency virus (HIV) infection, see Human immunodeficiency virus infection.

Antiretroviral drugs interact with many commonly prescribed drugs—consult an HIV expert before prescribing any drug in a patient taking antiretroviral drugs. Unusual and rare adverse reactions (eg perioral paraesthesia) can occur with antiretroviral drugs.

With currently available antiretroviral therapy, many patients with HIV are well managed and stable. However, patients with HIV infection, particularly smokers, are at increased risk of oral diseases, such as opportunistic infections, periodontal disease (eg gingivitis, periodontitis), necrotising periodontitis, oral hairy leukoplakia and oral squamous cell carcinoma. HIV-related salivary gland hypofunction can occur, and increases the risk of oral candidiasis. Other oral manifestations of HIV include recurrent aphthous stomatitis, intramucosal haemorrhages and hyperpigmentation of the oral mucosa. Some conditions are particularly related to late-stage HIV, such as Kaposi sarcoma and oral hairy leukoplakia.

Oral diseases and opportunistic infections in patients with HIV infection should be managed in conjunction with an HIV expert. Referral to an oral medicine specialist may also be appropriate.