Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS) are systemic conditions with significant
oral manifestations, many of which may appear
before systemic symptoms.
📌 Recommended Article :
PDF 🔽 Oral manifestations of human immunodeficiency virus in children ... Oral manifestations of human immunodeficiency virus (HIV) in children represent a critical clinical area, as early lesions can be among the first indicators of underlying immunosuppression.
The oral cavity often reflects the patient’s immune status, making dental professionals key contributors to
early detection, monitoring disease progression, and improving quality of life.
Advertisement
This article reviews the
oral manifestations of HIV/AIDS, organized from
early-stage lesions to those typically associated with
advanced immunosuppression.
✅
Early Oral Manifestations of HIV Infection
Early lesions often appear when immune suppression begins and may be the
first clinical indicator of HIV infection.
➤ Oral Candidiasis
▪️ Most common oral manifestation of HIV
▪️ Appears as
pseudomembranous (white plaques), erythematous, or angular cheilitis
▪️ Easily detachable plaques that leave an erythematous surface
▪️ Strongly associated with declining CD4+ cell counts
➤ Linear Gingival Erythema
▪️
Persistent red band along the gingival margin
▪️ Minimal plaque accumulation
▪️ Poor response to conventional periodontal therapy
▪️ Considered an early immunologic alteration
📌 Recommended Article :
Dental Article 🔽 Herpangina in Children: Causes, Symptoms, and Treatment of This Viral Infection ... Herpangina is a common viral illness that primarily affects children under the age of five. It is marked by a sudden onset of fever, sore throat, and small ulcers or blisters in the back of the mouth—typically on the soft palate, uvula, and tonsils.
✅
Intermediate-Stage Oral Lesions
As immune function declines, more aggressive and destructive lesions may develop.
➤ Necrotizing Ulcerative Gingivitis (NUG) and Periodontitis (NUP)
▪️ Rapid periodontal tissue destruction
▪️ Severe pain, spontaneous bleeding, and fetid odor
▪️ Loss of attachment and alveolar bone
▪️ Strongly linked to immunosuppression
➤ Oral Hairy Leukoplakia
▪️
White, corrugated lesions on the lateral borders of the tongue
▪️ Caused by Epstein–Barr virus
▪️ Non-removable and usually asymptomatic
▪️ Indicates moderate to advanced immunodeficiency
📌 Recommended Article :
PDF 🔽 Guide for the surgical management and oral pathology of the pediatric patient ... To perform a surgical procedure in pediatric patients, we must take into account a series of special considerations, such as knowledge of anatomy, dental development and eruption, behavior and behavior of the patient.
✅
Advanced Oral Manifestations in AIDS
These lesions are typically associated with severe immune compromise and advanced disease stages.
➤ Kaposi’s Sarcoma
▪️ Vascular neoplasm associated with
Human Herpesvirus 8 (HHV-8)
▪️ Appears as
purple, red, or brown macules or nodules
▪️ Common sites: palate, gingiva, tongue
▪️ May interfere with speech and mastication
➤ Non-Hodgkin’s Lymphoma
▪️ Rapidly enlarging ulcerated masses
▪️ Commonly affects gingiva, palate, or jaw bones
▪️ Aggressive behavior and poor prognosis
➤ Chronic Viral Infections
▪️ Recurrent herpes simplex ulcers
▪️ Cytomegalovirus-related oral ulcers
▪️ Persistent, painful, and slow healing
📌 Recommended Article :
Video 🔽 What is Oral Candidiasis? - Everything you need to know - Symptoms, diagnosis and treatment ... The Candida Albicans fungus, responsible for oral candidiasis, lives in our oral cavity together with other microorganisms but does not generate any pathological alteration.
✅
Clinical Importance for Dental Professionals
Oral lesions in HIV/AIDS patients are not merely local findings; they provide insight into systemic immune status, treatment adherence, and disease progression. Dentists play a crucial role in
early referral, diagnosis, and interdisciplinary care.
📊 Comparative Table: Routes of HIV Transmission
| Mode of Transmission |
Description |
Preventive Measures |
| Unprotected Sexual Contact |
Exposure to infected semen or vaginal fluids |
Condom use, PrEP, regular testing |
| Blood Exposure |
Sharing contaminated needles or transfusions |
Sterile instruments, screened blood products |
| Vertical Transmission |
Mother-to-child during pregnancy or breastfeeding |
Antiretroviral therapy during pregnancy |
| Occupational Exposure |
Needlestick injuries in healthcare settings |
Universal precautions and post-exposure prophylaxis |
💬 Discussion
The progression of
oral manifestations in HIV/AIDS closely parallels immune deterioration. Early recognition of oral lesions allows for prompt diagnosis and initiation of antiretroviral therapy, significantly improving prognosis. With modern treatment, many classic lesions have decreased in prevalence; however, they remain clinically relevant, particularly in undiagnosed or untreated individuals.
📌 Recommended Article :
Dental Article 🔽 Oral Manifestations of STDs: Diagnosis, Signs, and Dental Management ... Several infections, including syphilis, HIV, herpes simplex virus (HSV), gonorrhea, and human papillomavirus (HPV), present oral signs that may be the first indication of systemic illness.
✍️ Conclusion
Oral manifestations are key indicators of HIV infection and disease progression. From early fungal lesions to advanced neoplastic conditions, the oral cavity provides valuable diagnostic information. Early detection and appropriate management by dental professionals contribute significantly to improved patient outcomes and systemic disease control.
🎯 Recommendations
▪️ Perform thorough oral examinations in all patients
▪️ Consider HIV testing referral when suggestive lesions are present
▪️ Maintain strict infection control protocols
▪️ Collaborate with medical professionals for comprehensive care
▪️ Educate patients on oral hygiene and routine dental visits
📚 References
✔ Greenspan, J. S., & Greenspan, D. (2019). Oral manifestations of HIV infection. Clinical Infectious Diseases, 68(6), 993–998. https://doi.org/10.1093/cid/ciy556
✔ Patton, L. L., Epstein, J. B., & Kerr, A. R. (2020). Adjunctive oral diagnosis in HIV disease. Journal of the American Dental Association, 151(3), 170–178. https://doi.org/10.1016/j.adaj.2019.11.004
✔ World Health Organization. (2023). HIV-associated oral lesions and conditions. WHO Press.
✔ Shiboski, C. H., et al. (2021). Oral disease burden in HIV patients. Oral Diseases, 27(1), 3–12. https://doi.org/10.1111/odi.13441
📌 More Recommended Items
►
Webinar: What are Oral Potentially Malignant Disorders?
►
Oral Manifestations of Systemic Diseases: Updated Clinical Review
►
Oral Dermatitis Treatment: A Complete Guide for Dentists in 2025
