Oral care: for patients with human immunodeficiency virus (HIV)
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Many people with HIV experience ‘dry mouth’. Saliva lubricates the mouth and assists speech, taste and chewing. It also washes teeth, providing minerals for repair. Saliva also helps prevent bacteria, viruses and fungi from causing infections, tooth decay and gum disease.
Medications, such as antidepressants and some antiretroviral medications, can make your mouth dry. Try:
Follow these simple steps to help keep your teeth and gums healthy. Early stages of tooth decay may also be reversed.
Caution: products containing fluoride (such as gels and fluoride rinses) should not be swallowed and must be kept out of reach of children
Healthy gums are pink, firm and don’t bleed when brushed.
Bacteria irritates gums and cause gum infections if plaque is not cleaned from teeth and gums daily. Irritated gums may look red, swollen and bleed. Other signs include receding gums, loose teeth and persistent bad taste or bad breath.
Gently brush teeth and gums in the morning and before bed at night to keep gums healthy. To help prevent gum infection:
If your gums are sore, bleed excessively or have a bad odour, see a dentist urgently.
If you have mouth ulcers, sores, infections or pain in your teeth or gums, seek dental advice.
Thrush (candidiasis) may appear as white spots or a film inside the mouth. Thrush is uncommon in people taking antiretroviral medication for HIV, but if you take asthma or antibiotic medication, or you are not taking medication for HIV, you may experience thrush. To help treat thrush, try:
If your thrush persists, or your mouth splits and bleeds, see your dentist.
Dentures can aggravate thrush. Try soaking your dentures for 30 minutes in diluted Milton’s solution. If the thrush doesn’t improve, or is severe, see your dentist.
Your teeth may be sensitive to hot and cold or sweet food and drinks. Teeth can become sensitive if enamel is lost from the surface of the tooth or if the root surface is exposed.
Sensitivity can be caused by:
Desensitising toothpaste or fluoride gel applied to the necks of the teeth may improve sensitivity. If sensitivity does not improve, or is severe, see your dentist.
Ulcers can occur anywhere in the mouth and may be painful. Viruses, hot foods and some medications may cause ulcers.
People with HIV may need medication to help heal mouth ulcers. If ulcers do not heal within two weeks see your dentist for advice.
Note: Any unusual lumps, swellings, discolourations or persistent mouth ulcers should be reported to your dentist or doctor.
OHL is a white thickening generally found on the side of the tongue. It may be confused with thrush, but unlike thrush it cannot be wiped off. It does not require treatment, but it may indicate a significant viral load and should be discussed with your doctor.
Brown and purple discoloration may occur on the cheeks or gums. This can be caused by HIV medication or it may be Kaposi Sarcoma (KS). If discoloration is caused by medication then nothing needs to be done. If it’s KS, your dentist or doctor may prescribe treatment to make your mouth more comfortable.
Warts may occur on the inside of the cheek or on the lips. The warts may be removed by your dentist if you find them irritating.
Rinse your dentures after meals. Brush dentures daily with a soft brush and mild soap. Don’t use toothpaste – it’s abrasive and may cause wear to your dentures.
Place your dentures in cold water at night and when they are not in your mouth. If your dentures are stained, a small amount of vinegar or bleach may be added to the water. Rinse in water afterwards.
Dentures should fit well to maintain a healthy mouth. It may help to add a small amount of denture adhesive (available from your chemist) to the fitting surface of the denture.