The acute (primary) stage of HIV infection may be accompanied by mild, flu-like symptoms, while the longest stage of infection, latency, is asymptomatic. Oral HIV symptoms generally do not occur until stage 3, when the immune system has begun to falter but AIDS has not yet developed. Monitoring oral health can be a good way to trace the general development of HIV disease.
According to Medline Plus (a service of the National Library of Medicine and the National Institutes of Health), gingivitis is one of the three major oral symptoms of early symptomatic HIV disease. In gingivitis, plaque and tartar become lodged around teeth and cause inflammation of the gums. Persons living with HIV who develop gingivitis may experience bleeding gums that become bright red. Complications of gingivitis in persons living with HIV include conditions such HIV-NUG (HIV-related trench mouth) and HIV-NUP (HIV-related necrotizing ulcerative periodontitis), both of which can lead to serious and permanent oral injury. Dentists can help patients clear tartar and plaque away from the gumline to alleviate gingivitis.
Another oral symptom of early symptomatic HIV infection is hairy leukoplakia, white-looking irritations of the mucous membranes of the mouth. According to dermnetnz.org, leukoplakia appear to be folded up or corrugated and have fuzzy protrusions. Leukoplakia may be associated with an underlying Epstein-Barr virus infection that reappears as the immune system is weakened. Leukoplakia respond to antiretroviral treatment for HIV.
One of the most characteristic early oral indications of HIV infection is thrush, which is a fungal infection caused by the fungus candida (the condition is also called candidiasis). According to the Gay Men's Health Crisis (GMHC) website, thrush appears as white patches or red dots throughout the mouth and may cause crusting at the corners of the mouth. Other symptoms of thrush include chest pain, nausea, difficulty swallowing, and food not tasting right. The condition can be treated with an oral anti-fungal medication.
Other Oral Symptoms
A number of other conditions can cause sores in or around the mouth. These include oral manifestations of cancers like Kaposi's sarcoma and lymphoma, herpes viruses, human papilloma virus, dry mouth and ulceration. Thebody.com reports that 90 percent of people living with HIV will develop oral symptoms.
Thebody.com recommends that people living with HIV disclose their status to dentists so that progression of HIV-related symptoms can be monitored. It is also important to find a dentist who is accepting and has the expertise to diagnose and treat HIV-related conditions of the mouth.