Role of the dental surgeon in the early detection of adults with underlying HIV infection/AIDS

Abstract

A review is made of the late diagnosis of human immunodeficiency virus (HIV) infection, a subject of growing interest in public health. It has been estimated that in Europe 30% of all HIV-infected people are unaware of their seropositive condition, and this in turn is associated with a poorer long-term disease prognosis and an increased risk of transmission to other individuals. The role of the dental surgeon in this context could be of great importance, since there are many oral lesions that can suggest the existence of underlying infection. The study also addresses the controversial subject of rapid HIV testing, and whether these tests should be performed on a routine basis in the dental clinic, or whether it is preferable to refer the patient to a specialized center.

Figure 1

Oral lesions found to be highly prevalent in HIV-positive patients. A) Pseudomembranous candidiasis (PMC) of the tongue and bilateral angle cheilitis. B) PMC of the palate in the same patient as before (multifocal candidiasis). C) Erythematous candidiasis (EC). D) Necrotizing gingivitis. E) Oral hairy leukoplakia (right lateral margin of the tongue). F) Oral hairy leukoplakia in the same patient (left lateral margin).

Figure 2

Other oral lesions that may be found in HIV-positive patients. A) Human papillomavirus (HPV) lesion. B) Lesion of the lateral margin of the tongue due to recurrent aphthous stomatitis. C) Plasmablastic lymphoma of the palate. D) Secondary oral tuberculosis lesion in an undiagnosed HIV-positive patient. E) Kaposi’s sarcoma of the gums. F) Oral condyloma lesion of the palate.