HIV and the mouth

Symptoms

The formation of sores; pain, discomfort

Affected Areas

Mostly soft parts of the mouth like the cheeks and sides of the tongue

Diagnosis

With strong history of aphthous ulcers, or when other possible causes are ruled out

Treatment

Systemic and topical corticosteroid, occasionally thalidomide

Prevention

None

Symptoms

The formation of mouth sores; pain, difficulty swallowing

Affected Areas

Anywhere in the mouth. May appear in the throat as well

Diagnosis

Biopsy

Treatment

Ganciclovir, foscarnet

Prevention

None

Symptoms

Ongoing dryness of the mouth

Affected Areas

In the mouth and throat

Diagnosis

Observations of reduced saliva flow, examination of one’s medication regimen

Treatment

Artificial saliva, chewing sugarless gum, and drinking plenty of liquids

Prevention

It’s hard to anticipate bouts of dry mouth, but most treatments will work for prevention too

Symptoms

Inflammation of the gums, swelling, bleeding, bad breath, breaks in the seal between the gums and teeth

Affected Areas

The gums and teeth

Diagnosis

The presence of typical signs/symptoms

Treatment

A thorough professional cleaning, chlorhexidine rinse

Prevention

Follow the guidelines for good oral health; particularly thorough brushing, flossing and regular dental visits

Symptoms

White streaky, hairy patches that can’t be scrapped off. Otherwise, none

Affected Areas

Usually sides of the tongue; May appear in other parts of the mouth

Diagnosis

Biopsy

Treatment

None; Severe cases: high dose acyclovir

Prevention

None

Symptoms

The formation of sores or small blister-like bubbles; pain, discomfort

Affected Areas

Primary HSV: lip and gums. Recurrent HSV: lip, hard parts of the mouth like the roof and the back of the tongue

Diagnosis

A history of herpes, the presence of typical physical signs/symptoms

Treatment

Acyclovir

Prevention

Acyclovir may be used in the presence of frequent recurrence

Symptoms

The formation of sores and small blister-like bubbles

Affected Areas

Anywhere in the mouth

Diagnosis

Biopsy

Treatment

Famciclovir or acyclovir

Prevention

None

Symptoms

Cough, fever, fatigue

Affected Areas

All over the mouth

Diagnosis

Biopsy, culture

Treatment

Amphotericin B, itraconazole

Prevention

None

Symptoms

The formation of warts that are cauliflower-like, spiky, or slightly raised with a flat surface

Affected Areas

The inner lining of the mouth

Diagnosis

Biopsy

Treatment

The only treatment available is the surgical or laser removal of the warts

Prevention

None

Symptoms

Red or purple patches or swellings either raised or flat; may become painful

Affected Areas

Commonly on the roof of the mouth. May also appear on the gums, tongue and back of the throat.

Diagnosis

Biopsy

Treatment

Small lesions: vinblastine, surgical removal, radiation, carbon dioxide laser. Large lesions: radiation. Treating KS with systemic chemotherapy should be help reduce or eliminate oral lesions as well.

Prevention

None

Symptoms

Profound red banding along the teeth

Affected Areas

Where the teeth and gums meet

Diagnosis

The presence of typical signs/symptoms

Treatment

Thorough professional cleaning, chlorhexidine rinse

Prevention

Follow the guidelines for good oral health; particularly thorough brushing, flossing and regular dental visits.

Symptoms

Lesions include firm masses and persistent sores. May simply show up as a small lump.

Affected Areas

In the mouth, near the tonsils

Diagnosis

Biopsy

Treatment

Chemotherapy

Prevention

None

Symptoms

Oral lesions occur as sores

Affected Areas

Sores appear on the roof of the mouth.

Diagnosis

Culture, secondary tests that may indicate MAC.

Treatment

Numerous options include: clarithromycin, azithromycin plus ethambutol, rifabutin, rifampin, ciprofloxacin, amikacin, etc. Some drugs, particularly clarithromycin, may interact with common anti-HIV meds. Talk to your doctor or pharmacist about possible drug interactions.

Prevention

Avoid exposure to MAC organisms, like boil drinking water, don’t eat raw foods, etc.

Symptoms

Some symptoms of NUP may exist, but characterized mostly by large sores.

Affected Areas

Sores will form on the roof of the mouth and gums. Other symptoms appear in the gums and teeth.

Diagnosis

The presence of typical signs/symptoms

Treatment

Thorough professional cleaning, chlorhexidine rinse, antibiotic therapy with metronidazole.

Prevention

Follow the guidelines for good oral health; particularly thorough brushing, flossing and regular dental visits.

Symptoms

Pain, spontaneous bleeding of the gums, rapid destruction of gum tissue and supporting bone; tooth loss in advanced cases.

Affected Areas

The gums and teeth

Diagnosis

The presence of typical signs/symptoms

Treatment

Thorough professional cleaning, chlorhexidine rinse

Prevention

Follow the guidelines for good oral health; particularly thorough brushing, flossing and regular dental visits.

Symptoms

Pain, loss of taste, distortion of taste, burning, discomfort

Affected Areas

All over the mouth, possibly the throat, sometimes the corners of the lips

Diagnosis

Biopsy, culture

Treatment

Systemic: fluconazole, ketoconazole, itraconazole Topical: nystatin, miconazole

Prevention

Mouth rinses (chlorhexidine), nystatin, miconazole

Symptoms

The formation of sores

Affected Areas

On the tongue

Diagnosis

Prior diagnosis of a TB lung infection plus biopsy of the oral sore.

Treatment

Systemic antibiotics intended to treat TB throughout the body.

Prevention

For individuals who may have been exposed to or are at risk to get TB, isoniazid is usually used.

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