By: Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center
You know when you’re tired, stressed, and haven’t been eating well? Then, your immune system is like, “Cool! Here are a few mouth sores to add to the mix?” 😡 Well, for those living with HIV, a weakened immune system is generally part of the package. This means that, if you are living with HIV, you might be one of the between 32 and 46 percent of people that develop HIV mouth sores because… why not? Ugh. 🙄
Luckily, most problems with your teeth, gums, tongue, or mouth are preventable! And, even if something comes up, it can be treated quickly and effectively.
Let’s start with something we should all brush up on. 🪥
Sinking our teeth into common types of HIV mouth sores
So, you’re feeling some irritation in your mouth. 😬 Before we jump to any conclusions, let’s fill you in on the most common types of issues you might be experiencing. ⬇️
Fair warning, this could get a bit graphic #tryingnottothrowupinmymouth: 🤮
- Canker sores: Or, as it’s known by ~sexy sciencey~ people, Aphthous ulcers. These are very common. They are the painful red sores that sometimes get that looovely yellow-greyish film on top.
- Cold sores: These come in the form of blisters on your lips or the roof of the mouth, commonly known as herpes.
- OHL: Oral Hairy Leukoplakia. You’ll notice these when you have white patches that don’t wipe away. They often appear on the side of the tongue and can have an almost ‘hairy’ appearance -- hence the name!
- Angular Cheilitis: These cracks on the corner of your mouth are often caused by fungus or malnutrition. They may indicate you could lack vitamin B2, zinc, or iron in your diet.
- Oral Warts: These are caused by HPV. A doctor can remove these warts using techniques like cryosurgery.
- KS: Kaposi’s Sarcoma is a type of cancer, and is often associated with HIV. It can appear as reddish-purple lesions, often on the roof of your mouth. The best way to prevent (and sometimes treat) KS is by consistently taking HIV medication as prescribed.
- Periodontal (gum) disease: A bacterial infection of your gums, common in people with untreated HIV; a weakened immune system isn't always strong enough to keep your mouth free of harmful bacteria. Gum disease causes red, swollen gums that bleed easily, plus bad breath. If things look bad, it's time for a trip to the dentist!
- Thrush: This yeast infection can show up anywhere on your body. In the mouth, it takes the shape of yellow, patchy areas with a cottony, furry feeling. Treating it often involves a simple pill that dissolves in your mouth.
Overall, treatments for these HIV mouth sores range from special mouth rinses and creams to more aggressive approaches. The important thing to remember is that if you have a sore that does not go away or heal within 7 to 10 days, it’s time to see your doctor or dentist. 🧑⚕️
Taking care of those pearly whites
The easiest way to prevent HIV mouth sores is, of course, by brushing your teeth. Dentists advise us to brush our teeth at least twice daily, ideally after every meal, and floss once daily. Incorporate these guidelines into your daily dental routines, and those molars and gums will be shining in no time. ✨
Another aspect of dental care is, surprisingly enough, saliva. HIV can cause the salivary glands to swell, which reduces saliva production. Saliva protects the teeth and gums, so it's good to keep your mouth full of spit! This means reducing symptoms of dry mouth.
To treat dry mouth, you can use products for temporary relief, like gels or sprays that help your mouth stay moist and comfortable. 🌊 There are also a few techniques to increase the amount of saliva you produce, like chewing sugar-free gum or switching from sugary drinks to water.
Even if you’re doing all of this, even if you’re flossing every day, even if you’ve got the whitest pearly whites 🦷 out there… you should still visit your dentist every six months! They’ll do a routine cleaning and a general exam, which can identify and remove cavities before they become an issue. They’ll also assess your gum health, check for infections, sores, and more. Catching these issues earlier is the best way to address them. 🙌
What should I be avoiding ~ like the plaque? ~
See what we did there? 🤓
Oral health affects your overall health! Bacterial infections that begin in your mouth can ramp up quickly to something that travels across your entire body, which can be dangerous! They can also affect your appetite and nutrition. 🍽️ 🍎 You might be on HIV medicine that needs to be taken with food to be effective. In this case, a bacterial infection could impact how well the medicine absorbs into your body. And, if your medication doesn't have the chance to be absorbed and get to work, you're in for a slew of other problems... no thank you!
To set yourself up for success and prevent HIV mouth sores, you should definitely quit smoking. Smokers are more likely to experience oral infections than non-smokers. They also have a higher risk of mouth cancer, tooth loss, decay, and complications after dental procedures.
I’ve still got an HIV mouth sore: Now what?
Luckily, you can do quite a few things about HIV mouth sores. The easiest is to reduce the pain by cutting out acidic or spicy foods, which will help to reduce pain. You can also talk to your doctor about some effective over-the-counter medications. It's also essential to have regular dental care. If you’re unsure where to begin or whether you have the funds to get started, don’t worry! You have loads of options available to you:
- Federally-funded community health centers: These facilities provide free or reduced-cost health services, including dental care. Call 1-888-Ask-HRSA to learn more.
- CARE Act-funded dental clinics: The dentists in these clinics are often experts in dental care for people living with HIV. However, they tend to have waiting lists. Here's where you can find a dental clinic in your area.
- Dental schools: These are also a great bet, as cities often have dental or dental hygiene schools that provide excellent care at reduced rates. Here’s how to check for a program near you.
- Public health or community-based primary care clinics: These clinics provide treatment at a lower cost or free of charge. You can call your local Department of Health to find a clinic or check the US Department of Health and Human Services service locator.
Finally, we want to quickly touch on mental health. Living with HIV can affect your mental well-being, impacting your ability to care for your teeth, gums, and oral health. It's completely natural and understandable. 💜
There are many services out there to help you! We’ve also spoken about tackling loneliness, HIV support groups, and stories from others living with HIV that are probably going through similar challenges. If you need help, there are communities out there waiting to welcome you with open arms. 🤗
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