HIVG and HIVP: Oral Diseases With HIV

HIVG and HIVP: Oral Diseases With HIV

Being Alive; April 1992
Robert E. Schelenz, DDS

One of the more common conditions which afflict HIV+ patients intraorally are HIVG and HIVP. These are conditions of gingivitis (minor gum problems) and periodontitis (major gum problems) specifically related to HIV+ patients. It is important to note that HIVG and HIVP differ from traditional gingivitis and periodontitis. HIVG, which inadvertently leads to HIVP, is a very rapidly progressing disease which leads to loss of gum tissue and supportive bone in an amazingly short period of 3-6 months. Tooth loss normally follows within 6-9 months of onset of the disease. In non-HIV+ patients, the time span from gingivitis to periodontitis to eventual tooth loss can be as long as 30 years. It is, therefore, extremely important that this condition be diagnosed and treated early and aggressively.

SYMPTONS OF HIVG AND HIVP

Self-examination and searching for the telltale signs of this disease (HIVG and HIVP) in its earliest stage is very critical. Some of the typical signs which are characteristic of HIVG and HIVP are:

- easily bleeding gums with a red band running along the gum line near the necks of the teeth

- deep non-localized pain described as "deep jaw pain"

- the appearance of spaces or dark holes between teeth covered with a whitish grey membrane

- extremely bad breath.

Individuals who manifest one or several of these conditions should immediately seek the advice of their health care professional.

It should be noted that gum tissue destruction and bone loss cannot be regenerated and permanent damage to gums and supporting bone will result. As a consequence, these teeth will look longer, will become loose, protrude, or become extremely painful, making it impossible to eat. Needless to say, it is of utmost importance that HIVG and HIVP be prevented at all cost.

Current research indicates that the above mentioned diseases are not related to T-cell counts but tend to be directly correlated to oral hygiene and nutrition. Therefore, meticulous oral hygiene, as described in my article in the May 1991 issue of the Being Alive Newsletter, should be followed as closely as possible.

TREATMENT PROTOCOL

Treatment for patients afflicted with HIVG and HIVP is antibiotic therapy with a series of deep cleanings of the teeth surrounding the infected areas and the debridement of the tissues in the affected areas. Postoperative mouth rinses are also prescribed in many instances.

Experience tells us that HIVG and HIVP, if treated early and aggressively, can be arrested with minimal damage to gums and bone. If proper hygiene protocol is followed, subsequent to treatment, recurrence of HIVG and HIVP is slight.

Unfortunately, patients who were prone to gum disease prior to becoming HIV+ are more prone to HIVG and HIVP and should see their dental health care professional on a frequent basis.

(Robert E. Schelenz, DDS, is in private practice in Encino and can be reached at 818.990.4121.)
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