HIV and the mouth

January 2007     View PDF     En español

Abnormal cell growth

Abnormal cell growth (called neoplastic lesions) is essentially growths of tissue that may be harmless (benign) or cancerous. The most common cancers associated with HIV, which can affect the mouth, include Kaposi’s sarcoma (KS) and lymphoma.

Kaposi’s sarcoma (KS)
Kaposi sarcoma (KS) is the most common AIDS-related cancer, reported in about 15% of people with AIDS. Commonly KS is on the skin, although over half the people with it report oral lesions as well. Sometimes oral lesions, that appear as patches or swellings, are the first obvious signs of KS. Their color can be red or purple and they can be either raised or flat. The roof of the mouth is the most common site, but they also occur on the gums, tongue and at the back of the mouth, near the throat.

Oral KS usually is not painful, but it can occasionally become painful because of ulcers or other infection. Sometimes, KS lesions may interfere with chewing or talking. Good oral hygiene and professional cleaning are important in managing oral KS.

Treating KS in the mouth will vary based on the extent of the problem and if it interferes with quality of life. If a KS lesion isn’t bothersome, no treatment is an option. If treatment is necessary, depending on the degree of the overall KS, it can range from treating a single lesion (directly injecting chemotherapy or surgical removal) to treating it systemically (throughout the body) by injection into a vein. Many patients find that once they are on effective anti-HIV therapy, the KS lesions resolve.

In addition, not every purple lesion is KS. If you have any silver filling that is under the gum, the gum may turn purple. For more information, read the publication, Kaposi Sarcoma.

Lymphoma
Lymphoma is more rare than KS and generally more serious. Oral symptoms, which may simply be a small lump in the mouth or near the tonsils, are often the first sign of lymphoma. The lesions include firm masses and persistent ulcers. It’s possible to detect this condition early by having regular dental exams. Lymphoma can only be diagnosed with a biopsy. No one specific treatment is used to treat the oral lesions of lymphoma, but depending on the person’s condition, they’re often offered chemotherapy.