Having recently commemorated World AIDS Day, let us have a quick talk about your Dental Visit and HIV/AIDS. HIV /AIDS is a viral disease that affects cells of your immune system (important cells which help your body combat diseases). It targets cells that have the CD4 receptor on their surface such as T cells, monocytes, dendritic cells and macrophages. The CD4 receptor is used by the cell to signal to other parts of the immune system that there is a foreign body or toxin in so it can fight against it. As such, once a person gets infected with HIV/AIDS, his /her immunity is reduced, making the said person susceptible to all forms of diseases he would have easily combatted before. Today, HIV is no more a death sentence. The disease can be controlled with the intake of antiretroviral drugs, increasing the life expectancy and quality of life of the individual.
DO I NEED TO TELL MY DENTIST I AM HIV POSITIVE EVEN IF I GO FOR A ROUTINE DENTAL CHECK UP?
You would notice that your dentist would ask questions concerning medical conditions you have had or are currently having, surgeries had in the past, medications you are taking and those you are allergic to, and even more recently: COVID-19 related questions. Do not feel self-conscious. Be open to give answers and volunteer information willingly. Clearly mention to the clinician if you are HIV positive.
You will not be discriminated against… Neither will you be branded.
IF I DO NOT MENTION THAT I AM HIV POSITIVE, WILL MY DENTIST KNOW?
Interesting question here. As a clinician, I have attended to patients who have initially denied having any medical condition but who eventually open up about being HIV positive. I have also attended to patients who have openly mentioned their condition and the drugs they were on. Trust me, the latter is the easier option.
You may not be successful in keeping your HIV positive status from your dentist because, the infection has some oral manifestations. This means that some signs in your mouth can make the dentist suspect so. For example, in an HIV positive patient, a dental infection which could have been easily controlled by the body may form excess pus (a fluid made up of dead an dying cells of the body and bacteria like the offensive fluid that exudes from a boil) and spread to other parts of the body including the upper and lower jaws, the side of the face, the chest, lungs, the blood… This spreading infection has the potential to kill!
They may also present with a whitish growth in the mouth or tongue which may either be oral thrush or hairy leukoplakia.
Sometimes a reddish band occurs on the gum just around the teeth- this is known as HIV gingivitis. The teeth may also become loose and may even fall out in a case of HIV associated periodontitis. In some cases, this HIV related periodontitis may further progress by spreading into adjacent soft tissues and bone resulting in a condition known as Necrotizing stomatitis of periodontal origin.
The HIV infected individual may also present with ulcers or swelling in the mouth and facial region. These may be signs of a cancer of the mucous membranes of the mouth, nose and throat, soft tissues, skin and lymph nodes and other internal organs known as Kaposi Sarcoma.
Whether HIV positive or not, you will need to visit your dentist if you have any of the symptoms described above so you can be appropriately treated. Indeed, some of these signs may occur in patients who do not have HIV while some HIV positive individuals may also show no signs. Only an HIV test will confirm the presence of the virus or not. Then again, an HIV positive person who is taking his drugs would also need to have periodic dental reviews so that any such signs found in the mouth can be detected early and treated.
HOW SAFE AM I AT THE DENTIST? CAN I CONTRACT THE VIRUS THERE?
Sharp instruments can transmit HIV/AIDS and your dentist is very much aware of that. Sharp instruments such as needles, scalpels, sutures are carefully disposed off after each single use. Other instruments that may be reused are carefully disinfected and then sterilized. Be rest assured that your dentist himself/ herself will not touch them if they are not. Indeed, every surface you come into contact with is cleaned and disinfected after every patient. So far as you’re not visiting a quack, you’re totally safe!