Periodontal diseases and HIV infection

Abstract

The workshop considered six related questions about periodontal changes seen in HIV infection. 1) To what extent are specific periodontal changes associated with HIV? 2) Are conventional periodontal diseases modified by HIV infection? The changes associated with HIV appear to be modified presentations of conventional diseases. Research should identify initiation and progression factors for necrotizing diseases. 3) What is the role of geography and transmission groups? These questions cannot be answered without greater standardisation of research methods. 4) Has the epidemiology of these changes changed with the advent of new therapies? The data required to answer this question should be available soon but this question is irrelevant to the vast majority of people with HIV. 5) What pathogens are involved in periodontal changes seen in HIV infection? The role of Candida spp. and other potential pathogens requires further investigation. 6) What management protocols are suitable for the periodontal diseases? The significance of periodontal diseases among people with HIV in developing countries is not known. Further research is needed of the effectiveness of interventions especially necrotizing disease in developing countries. The quality of research of these diseases would be enhanced by standardized approaches. A list of relevant variables might prevent their omission from studies.

Skin and Mucocutaneous Manifestations: Useful Clinical Predictors of HIV/AIDS

“…Severe periodontal diseases have been associated with the alterations in the host immune system, which can predispose to gingivitis and the development of periodontitis. Moreover, the relevance of the immune system in the protection of the periodontal tissues has been documented and the impairment of this system could aggravate the periodontal status [28] Previous studies have shown that the microbiology of gingivitis and periodontitis in the HIV patients may differ significantly in comparison to these periodontal pathologies in immunecompetent individuals [29,30].…”

Occurrence of yeasts, enterococci and other enteric bacteria in subgingival biofilm of HIV-positive patients with chronic gingivitis and necrotizing periodontitis

“…The presence of the anaerobic bacteria, enterobacteria and superinfecting microorganisms may be relevant in the gingivitis and periodontitis etiology, especially in immunodeficent patients (1,14,16). However, the role of the enteric bacteria plays in the periodontal diseases etiology remains unclear, and it must be an alert to clinicians who use systemic antibiotics, such as ciprofloxacin as an adjunct in the periodontitis treatment in such patients (18).…”

“…Previous studies have shown that microbiology of gingivitis and periodontitis in HIV patients may differ significantly in comparison to these periodontal pathologies in immunecompetent individuals (1,16). These peculiarities are not related to the distribution of the strictly anaerobic (14), but probably it can involve superinfecting microorganisms and other pathogenic agents normally not involved in periodontal infections, such as fungi and enteric organisms (1,17).…”

“…Most of the HIV patients receive medicaments to control the viral infection and opportunistic diseases, this however produces a severe selective process on subgingival biofilm, leading to the elimination of members of the indigenous microbiota and giving conditions to the periodontal colonization by minor components of oral microbiota and superinfecting organisms (16,17).…”

Human Immunodeficiency Virus and Oral Health

“…Patients with NUP and necrotizing stomatitis frequently complain of extreme pain and spontaneous bleeding. 21 Severe deep-aching jaw pain can be one of the hallmarks. "Punched-out" dental papilla, soft tissue and bone necrosis, spontaneous bleeding, deep seated pain, mouth odour, reddish in appearance, spontaneous exfoliation of teeth, necrosis of the bone, and swelling are common.…”