HIV and the mouth

January 2007     View PDF     En español

Starting and keeping good oral health

Taking care of your mouth and teeth is a very important, yet often overlooked, part of maintaining your general health. Good oral health can help you prevent or catch infections early. It can also give you clues as to the state of your overall health and the health of your immune system.

General guidelines for good oral health suggest that you: (1) thoroughly brush your teeth, at least once a day; (2) use toothpastes or rinses that contain fluoride; (3) floss once a day; (4) regularly use a mouthwash; and (5) regularly visit your dentist. Most of these are basic things to do, but they’re often not followed.

Brushing
A good brushing should take at least two minutes, not the 30 seconds or less that most people devote to it. The way you brush is also important. It’s recommended that you brush with a gentle, circular motion and slowly work your way from one side of your mouth to the other. Keep bristles at a 45° angle to the gum line when brushing your front teeth and gums. Pay special attention to areas you tend to neglect, like the back of your front bottom teeth, the sides of wisdom teeth and the back side of your lower teeth below your tongue. You should also brush your tongue to remove bacteria causing bad breath. It’s important to avoid scrubbing your teeth, which may cause small cuts or scrapes.

Toothbrush and toothpaste
Dentists recommend toothbrushes with soft bristles because hard ones can cause the gums to bleed and recede, leaving unprotected areas prone to infection. Toothbrushes should be replaced every month or two.

Electric toothbrushes can sometimes be more effective for people unwilling or unable to spend a lot of time and attention brushing. However, they may be expensive for some, and sometimes people stop using them once the novelty wears off.

The most important concern about toothpaste is whether or not it has fluoride. Aside from that, specific brands and flavors are more of a personal choice and needs.

Dental floss
To floss, use a long length of floss and wrap the ends around your index fingers. Gently push it between your teeth and all the way to the gums. If you rarely or never floss, you may find some slight bleeding. This will stop once your gums get used to it and your flossing becomes a habit. If it continues to be difficult or painful to do, consider using a waxed floss or check with your dentist to see if you’re flossing properly.

Mouthwash
Using a mouthwash at least twice a day can add fluoride to your teeth, kill bacteria often responsible for bad breath, reduce plaque that can cause cavities, and prevent gum disease.

Many prescription and over-the-counter mouthwashes are effective, but most contain up to 25% alcohol. Since this amount of alcohol can cause a burning sensation, some may find it necessary to use an alcohol-free rinse. Most alcohol-free mouthwashes are as effective as those with alcohol.

Dental visits
Regardless of a person’s HIV status, regular visits involve going to the dentist about every six months. The visits allow your dentist to find infections and conditions early and treat them before they become a problem.

Also, studies show that cavities in people living with HIV can act as fungal reservoirs. Thus, treating cavities promptly may reduce infections like thrush. Also, dental professionals who have expertise in treating people living with HIV routinely check for oral signs of HIV-related illnesses to observe the progression of HIV disease.

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