HIV/AIDS and Dental Health

If you, or someone you know, is living with HIV/AIDS, the American Dental Association
recommends that dental health care be part of all HIV/AIDS treatment plans. That’s because
people living with HIV/AIDS are more susceptible to infections including dental infections, which
can affect their overall health.  

What Is HIV/AIDS?
HIV (human immunodeficiency virus) is a virus that attacks a specific type of T cell known as
CD4 cells. T cells are an important part of the body’s immune system which is needed to fight
infection. 

If left untreated, HIV can destroy so many CD4 cells that a person can no longer fight off
infections and disease.  AIDS (acquired immunodeficiency syndrome) is the last state of HIV
infection where the immune system is so very weak that infection and cancer can take over. 

How is HIV transmitted?

In the United States, HIV is transmitted through sexual contact, or use of a contaminated needle
or syringe. More than 1.2 million people in the United States are living with HIV; 1 in 8 people
are unaware they have the virus. 

How is HIV diagnosed?

Symptoms alone are not enough to diagnose a person with HIV. The only way to know if you
have HIV is to get tested. Gay, bisexual, and other men who have sex with men – particularly
young black men who have sex with men – are the populations most affected by HIV. 

If you believe you have come into contact with HIV, get tested immediately. Regular testing for
HIV and other sexually transmitted diseases is recommended for anyone who is sexually active
with a new partner or multiple partners.

How is HIV treated?

There is currently no cure once you are infected with HIV, but there are ways to help control it. 

If a previously uninfected person is exposed to HIV, a medication known as post-exposure

prophylaxis (PEP) should be started as soon as possible to potentially prevent infection with the
virus. To be effective, HIV PEP must be started as soon as possible after contact and continued
for its full course, which may take as long as four weeks.

If a person contracts HIV, the virus can be controlled with treatment called antiretroviral therapy.
This involves taking antiretroviral medication and continued monitoring of how much virus is
present in a person’s blood and how many CD4 cells are present.

How Does HIV/AIDS Affect the Mouth?

Your mouth may be the first part of your body to be affected when infected with HIV.  Because
infection with HIV will weakened your immune system, this means you will be susceptible to
infections and other problems.  In your mouth, this can cause pain and tooth loss.  

People with HIV may experience the following mouth issues:

 Dry mouth 
 Thrush 
 White lesions on the sides of the tongue (oral hairy leukoplakia)
 Red band gingivitis
 Ulcerative periodontitis
 Karposi’s Sarcoma
 Outbreaks of herpes simplex virus
 Canker sores
 Mouth ulcers

Dental and mouth problems related to HIV can be painful, which can cause trouble chewing or
swallowing. This may prevent you from taking your HIV medication. It can also result in
malnutrition, as you may have trouble eating and absorbing enough essential nutrients.  A
compromised digestive system may affect the absorption of your HIV drug treatment.
 How Can I Cope with Dental and Mouth Issues Related To
HIV?
Most mouth health problems related to HIV are treatable. Talk to your dentist about what
treatment is best for you. 

The best ways to prevent these issues are to do the following:

 Visit your dentist for regularly scheduled appointments.

 Brush and floss your teeth twice daily for two minutes.
 Take your HIV medicine on schedule.
 Tell your doctor if your HIV medicine is causing dry mouth. Ask what treatment is best
for you.
 If you do not have a regular dentist, ask your primary care provider or clinic for a referral.

SURGICAL INSTRUCTIONS

PRE-OPERATIVE INSTRUCTIONS
The following pre-operative instructions should be followed for patients undergoing intravenous
anesthesia:

 You may not have anything to eat or drink (including water) for eight (8) hours prior to the
appointment.
 A responsible adult must accompany the patient to the office, remain in the office during the
procedure, and be able to drive the patient home.
 The patient should not drive a vehicle or operate any machinery for 24 hours following the
anesthesia experience.
 Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low
heeled shoes. Contact lenses, jewelry, and dentures must be removed at the time of surgery.

POST-OPERATIVE
The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from
the extraction of erupted teeth. The following conditions may occur, all of which are considered
normal:

 The surgical area will swell.

 Swelling peaks on the second or third post-operative day.
 Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of
days.
 You may have a slight earache.
 A sore throat may develop.
 Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
 If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept
moist with cream or ointment.
 There will be a space where the tooth was removed. After 24 hours this area should be rinsed
following meals with warm salt water until it is healed. This cavity will gradually fill in with new
tissue.
 There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues,
notify us.
 It is not unusual to develop bruising in the area of an extraction.
 Please take all prescriptions as directed. 

Women please note: Some antibiotics may interfere with the effectiveness of your birth control
pills. Please check with your pharmacist or physician.

GENERAL ORAL CARE FOLLOWING SURGERY:

 Do not rinse or spit for 24 hours after surgery.

 Keep fingers and tongue away from socket or surgical area.

 Use ice packs on surgical area (side of face) for first 24 to 48 hours, apply ice 20 minutes on -
10 minutes off. Bags of frozen peas work well. Use moist heat after 24 hours.
 For mild discomfort take Tylenol or Ibuprofen every three to four hours.

 For medium or severe pain use the prescription given to you.

 Drink plenty of fluids. (Do not drink through a straw).

 After the first post-operative day, use a warm salt-water rinse following meals for the first
week to flush out particles of food and debris which may lodge in the surgical area. (1/2 teaspoon of
salt in a glass of warm water. Mouthwash can be added for better taste.)
 Diet may consist of soft foods which can be easily chewed and swallowed. No seeds, nuts, rice,
popcorn, etc.

 A certain amount of bleeding is to be expected following surgery. Bleeding is controlled by

applying pressure to the surgical area using small rolled gauze for 90 minutes. After that time
remove the gauze and then you may eat or drink. If bleeding persists, a moist teabag should be
placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting blood.
Repeat if necessary. If bleeding still persists call our office.
 We suggest that you do not smoke for at least five (5) days after surgery. Nicotine may break
down the blood clot and cause a "Dry-Socket."

SPECIAL CONSIDERATIONS FOLLOWING REMOVAL OF

IMPACTED TEETH:
 Removal of impacted teeth is a surgical procedure. Post-operative problems are not unusual,
and extra care must be taken to avoid complications.

 Severity of post-operative pain will depend on the procedure and your physical condition. Take
prescribed medication for pain precisely as directed.
 Healing of the surgical site is variable.

 Swelling can be expected. Be certain to apply ice bags as directed above.

 Difficulty in opening your mouth widely and discomfort upon swallowing should be
anticipated.

 Numbness of lips and/or tongue on the affected side may be experienced for a variable period
of time.

FURTHER POST-OPERATIVE INSTRUCTIONS

What you should do following extractions and other Oral Surgery procedures follow the simple
instructions below to minimize complications and help ensure prompt recovery.

 To control bleeding
Immediately following procedure, keep a steady pressure on the bleeding area by biting firmly
on the gauze placed there by your oral surgeon. Pressure helps reduce bleeding and permits
formation of a clot in the tooth socket. Gently remove the compress after the local anesthesia has
worn off and normal feeling has returned.

After 24 hours: some oozing of blood may persist. If necessary, resume use of moist tea bags.
After bleeding has stopped, cautiously resume oral hygiene.

 To relieve pain
Immediately following procedure: begin taking medication as directed by your oral surgeon to
minimize discomfort when the anesthesia wears off and feeling is back to normal. Application of an
ice bag can also help relieve discomfort.

After 24 hours: continue to take your medication if pain persists, and use an ice bag if necessary.
 To minimize swelling
Immediately following procedure, apply an ice bag over the affected area. Use 20 minutes on
and 20 minutes off for a period of 24 hours, to help prevent development of excessive swelling
and discomfort. If an ice bag is unavailable, simply fill a heavy plastic bag with crushed ice. Tie
 end securely and cover with a soft cloth to avoid skin irritation.

After 24 hours: it should not be necessary to continue with cold applications. You may expect
swelling for four (4) days to one week and a fever of 99 degrees F to 100 degrees F.

 Oral hygiene is important

24 hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in
a glass of water.  Repeat after every meal or snack for seven days.  Rinsing is important because it
removes food particles and debris from the socket area and thus helps prevent infection and promote
healing.  Brush tongue with a dry toothbrush to keep bacteria growth down, but be careful not to
touch the extraction site.
Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or
remove the blood clot.

 Maintain a proper diet

Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids - with
meals and in between. Have what you wish, but be careful not to disturb the blood clot. Add
solid foods to your diet as soon as they are comfortable to chew.

IN CASE OF PROBLEMS
You should experience no trouble if you follow the instructions and suggestions as outlined. But
if you should have any problems such as excessive bleeding, pain, or difficulty in opening your
mouth, call us immediately for further instructions or additional treatment.
Feel free to contact us at (212) 813-0707 if any doubt arises as to your progress and recovery.

REMEMBER YOUR FOLLOW-UP VISIT

It is often advisable to return for a post-operative visit to make certain healing is progressing
satisfactorily. A follow-up visit will be scheduled. In the meantime, maintain a healthy diet,
observe rules for proper oral hygiene, and visit your dentist for regular checkups.

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