Despite the increasing need of dental treatment and diagnostic and predictive values of oral lesions in HIV-infected patients, oral and salivary changes are still neglected by many clinicians. The oral cavity has long been recognized as the site
of
residence of an extremely varied and complex microbial flora with marked potential to probe the host defenses and saliva is the most important factor to maintain oral environment. Thus, this study was performed to investigate the oral hygiene
condition,
oral manifestation, oral microorganisms and salivary changes in HIV-infected patients.
Thirteen(11 males and 2 females) patients were included and their mean age was 39.5±8.1 years. Seven patients visited for routine oral examination and others wanted dental treatments. The patients were asked for difficulties during oral
functional
movements, medication for oral symptoms, and the feeling of dry mouth. And, the patients were examined for tooth condition(DMFT rate), the status of oral hygiene (Green and Vermillion's debris index(0-6) & calculus index(0-6)). And oral
mucocutaneous
lesions.
The stimulated whole saliva was collected and the CFU counts of general oral flora, Streptococcus mutans, and Candida albicans, total protein, albumin, IgA, IgG and IgM were measured. The patients were prescribed peroxidase-containing
toothpaste(Biotene(r)) and re-examined after 1 month. Seven patients (53.8%) suffered form difficulties during oral functional movements, and six(46.2%) from dry mouth. Four(30.8%) already used drugs for oral symptoms. Their mean DMFT rate,
debris
index, and calculus index were 18.52±13.67(%), 2.60±1.235, and 1.83±1.34 respectively. Candida-associated lesions were detected in 4 patients, 1 pseudomembranous type, 2 erythematous type, and 1 angular cheilitis. One case of hairy
leukoplakia,
2
cases of erythematous gingival band, and 2 cases of tongue atrophy were also found.
The mean CFU counts of general flora, Streptococcus mutans, and Candida albicans were 244.67±588.26(×10E5), 226.25±296.73(×10E4), and 131.67±208.04(×10E3), respectively. The mean values of total protein and albumin were
103.18±20.32(mg/100ml) and
103.40±75.76(mg/100ml). The mean values of IgA, IgG, and IgM were 20.47±13.82, 4.31±2.99, and 0.36±0.52(ug/ml), respectively. the CFU counts of microorganisms decreased greatly after use of peroxidase-containing toothpaste, though the small
number
of subjects limited the value of results. Other salivary parameters did not show any consistent change after use of peroxidase-containing toothpaste.
The above results showed the increased need of dental treatment in HIV-infected patients. As the progress in the treatment of the current epidemic HIV disease results in more patients living longer in a state of significant immunosuppression,
managing
oral problems may become an increasingly common challenge. And, further researches for developing new medication for relieving oral symptoms will have to be done.
|