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  Posted by: Dental Design      1st December 2020

World AIDS Day on 1st December is a widely recognised international health day. It is an opportunity to raise awareness about human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). It also presents a chance to celebrate successes such as increased access to treatment and prevention services for these diseases.[i]

Dental professionals will be aware that HIV is a virus that leads to immune deficiency in humans. There is no vaccine or cure, yet there is effective treatment available to control the virus, support the immune system and extend life. Over the last decade, incidence of HIV has greatly reduced and, due to new medication and combination therapy, many individuals have been able to achieve undetectable levels of HIV viral load, which significantly minimises the chances of transmission. Nevertheless, HIV is still a serious health concern. In the UK, it is estimated that 1 in 14 people living with HIV do not know they have the virus and can therefore pass it on. Furthermore, over 4,300 new cases are diagnosed each year. [ii]

Obviously, the mission is to prevent new infections with a target to achieve zero HIV transmissions by 2030. But for now, dental professionals still have a vital role to play in early detection. By recognising the oral manifestations that may relate to HIV infection, clinicians are able to refer patients to appropriate care provision for prompt treatment and better health outcomes.[iii] Oral lesions are among the earliest clinical signs of HIV and are important indicators in the detection of infection, for prediction of viral infection progress and the progression to AIDS.[iv] They are observed in 79-90 percent of HIV positive patients during different stages of the disease and lesions strongly associated with HIV infection include:

  • Candidiasis – Erythematous – Pseudomembranous
  • Hairy leukoplakia
  • Kaposi’s sarcoma
  • Non-Hodgkin’s lymphoma
  • Periodontal disease – Linear gingival erythema – Necrotizing (ulcerative) gingivitis – Necrotizing (ulcerative) periodontitis[v]

As well as detecting symptoms that may be related to HIV, the dental team are also crucial for providing the comprehensive care required to help HIV patients maintain their health and quality of life. People with HIV/AIDS have an increased risk for oral health problems as the disease compromises the immune system and makes it harder for the body to fight off opportunistic infections. In addition, due to the side effects of medication or treatment, these patients commonly experience oral changes that not only cause discomfort, but may also lead to difficulties with eating or sleeping. For example, some drugs cause taste changes, resulting in loss of appetite or alterations to food choices and eating patterns, which, in turn, can weaken the body’s ability to cope with the virus and affect the patient’s overall health. Some anti-HIV drugs can also decrease the production of saliva, making the mouth dry and more vulnerable to bacteria. Consequently, the patient is at increased risk of developing tooth decay and periodontitis. Dental problems such a tooth decay and gum disease also have the potential to change the patient’s appearance and affect their self-esteem. Fortunately, dental professionals are ideally placed to help these patients by increasing oral hygiene awareness and making sure that those diagnosed with HIV have the support and knowledge they need to prevent further complications.

Dental hygienists and dental therapists are fighting viruses and bacteria on a daily basis and need to continually update their knowledge through education. The British Society of Dental Hygiene & Therapy (BSDHT) provides its members with the highest level of information, research and development opportunities to help maintain the very best level of patient care.

 

For more information about the BSDHT, please visit www.bsdht.org.uk,

call 01788 575050 or email enquiries@bsdht.org.uk

 

[i] World Health Organisation. World AIDS Day. 1 December. https://www.euro.who.int/en/health-topics/communicable-diseases/hivaids/world-aids-day [Accessed 21st September 2020]

[ii] National AIDS Trust. HIV in the UK Statistics – 2018. https://www.nat.org.uk/we-inform/HIV-statistics/UK-statistics [Accessed 21st September 2020]

[iii] Reznik D.A. et al. Managing dental patients with HIV. Journal of Multidisciplinary Care. Decisions in Dentistry. Dec 1 2015.  https://decisionsindentistry.com/article/managing-dental-patients-with-hiv/ [Accessed 21st September 2020]

[iv] Pakfetrat A. et al. Oral manifestations of Human Immunodeficiency Virus-Infected Patients. Iran J. Otorhinolaryngol. 2015 Jan: 27(78):43-54. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344974/#:~:text=According%20to%20the%20result%20of,ulcer%20(4%2C5). [Accessed 21st September 2020]

[v] Vaseliu N et al. Oral manifestations of HIV infection. Texas Children’s Hosptical. Baylor International Pediatric AIDS Initiative. https://bipai.org/sites/bipai/files/13-Oral-Manifestations.pdf [Accessed 21st September 2020]


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