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What language for AIDS. HIV infection in the mouth: signs, causes and prevention

Ulcers in the mouth are defects in the mucous membrane that affect all layers of the epithelium, and have bases, walls and edges. They can develop against the background of dental diseases, traumatic injuries or general somatic pathologies.

Table of contents:

Causes of mouth ulcers

These defects appear in the following diseases:

  • recurrent;
  • herpetiform;
  • recurrent necrotizing periadenitis (Setton's aphthae);
  • aphthas of Bednar;
  • Vincent's stomatitis;
  • traumatic injuries (in particular, the tongue and gums);
  • acute necrotizing gingivostomatitis;

Ulcers in diseases / injuries of the soft tissues of the mouth

Ulceration can be triggered by local trauma, as well as infection of a viral, bacterial and fungal nature.

Recurrent aphthous stomatitis

Recurrent is a chronic inflammatory disease, which is manifested by the periodic appearance of single or multiple painful aphthae (ulcerations) of various localization. They can form on the mucous membranes of the lips and cheeks, palate and tongue. If such a defect is constantly injured, the formation of a long-term non-healing ulcer is possible. After its healing (epithelization), cicatricial changes remain.

Predisposing factors for the recurrence of this pathology are intestinal diseases (), microtraumas during hygiene procedures, and in women - menstruation.

The healing time of the sore is on average from one to one and a half weeks.. With a complicated course of the disease, an increase in the number of aphthae is not excluded, and the time for complete epithelialization of defects increases to two weeks and even 1 month.

Herpetiform stomatitis

Herpetiform stomatitis is manifested by the formation on the lower surface of the tongue and in the region of the bottom of the mouth of multiple small defects that do not have clear boundaries. Outwardly, the ulcers resemble herpetic eruptions, but their bottom has a gray tint. This disease young women (up to 30 years) are more susceptible. Healing usually proceeds without the formation of cicatricial changes, and takes from one to one and a half weeks.

note

With a simple form of stomatitis, multiple sores appear in the oral cavity, covered with an easily detachable white film. Similar defects in childhood may be a sign of a fungal infection ().

Recurrent necrotizing periadenitis

With the so-called. Setton's aphthae in the submucosal layer of tissues forms a seal, and then ulcers with raised edges appear in this zone. Defects are characterized by pain and the presence of an inflammatory infiltrate. Primary localization of ulceration in recurrent necrotizing periadenitis - side surfaces tongue, cheeks and lips. It is problematic for patients to talk and eat due to severe pain . Epithelialization of defects takes months, and the cure of the pathology itself can take up to several years.

Afty Bednar

This disease is characteristic exclusively for childhood. They are localized in the hard palate. Covered with a white-yellow bloom, Bednar's aphthae are usually considered as traumatic erosions that develop as a result of insufficient high level oral hygiene or chronic chafing of the hard palate.

Stomatitis Vincent

Vincent's stomatitis is a viral disease that develops against the background of a weakened immune system. The formation of ulcers with a gray coating and a putrid odor is combined with bleeding gums and signs of general intoxication of the body.

Traumatic injuries

Prosthetic ulcers are localized directly under the orthopedic structure. After correction of the prosthesis, epithelialization of the defect occurs within one and a half to two weeks.

The appearance of ulcerative lesions can sometimes be triggered by pharmacological drugs, as well as exposure to chemical factors (acids and alkalis), as well as high temperature.

Local manifestations of general diseases

In some cases, ulcers on the oral mucosa are only a clinical manifestation of a serious general pathology.

Tuberculosis

Ulcers against the background of tuberculosis of the oral mucosa are nothing more than a secondary manifestation. They appear due to the penetration of mycobacteria through microscopic damage to the epithelium. Their localization is variable - the floor of the mouth, cheeks and tongue can be affected. On the early stage development, "classic" tubercles are formed. Then they disintegrate with the formation of small in diameter and shallow defects with a loose base and uneven edges. These ulcers tend to increase in size. They are characterized by severe pain. In addition to local manifestations, against the background of oral tuberculosis, there is also a general deterioration in the patient's condition.. A specific plaque appears on the tongue, body weight decreases. There are also (excessive sweating) and an increase in overall body temperature.

Syphilis

Plisov Vladimir, dentist, medical commentator

HIV infection is a deadly pathology caused by a special virus called “human immunodeficiency”. It is characterized by the presence of opportunistic organisms and the risk of acquiring oncology.

Causes of HIV in the mouth

The disease occurs as a result of infection with AIDS or HIV. The anomaly is transmitted in the following ways: sexual, parenteral and perinatal. After acquiring HIV, the development of AIDS occurs in 20% of patients in the first 5 years and in 50% in the first 10 years.

Most of the transmission of HIV is through sexual contact. If we are talking about the parenteral method, then it means the transportation of an anomaly through a blood transfusion or by taking blood products, as well as as a result of the use of instruments in the dentist's office, syringes and needles in the process of puncturing the skin or oral mucosa with an infected instrument. In perinatal infection occurs through the birth canal or breast milk.

HIV is also transmitted through biological fluids, which include tears, saliva, and more.

What happens with HIV infection in the mouth?

First of all, with such an ailment, herpes occurs on the mucosa. oral cavity. This phenomenon is very painful with constant relapses of stomatitis, often without remissions. In parallel, damage to the genital organs occurs. Formations attack the palate, tongue, lips, and then turn into erosion and ulcers of considerable size. The ulcer resembles a crater with uneven edges and a bottom with a touch of gray white color. The severity of the disease in the last stages leads to death.

Often the patient is affected by herpes zoster. Especially often with AIDS. Herpes zoster is both mild and severe with endless relapses.

With HIV, human papillomavirus occurs, which attacks the oral cavity, skin and other areas. The nodules have numerous protrusions.

Villous leukoplakia is noted in patients belonging to the HIV-seropositive group. If this disease occurs, the doctor will definitely refer the patient to be examined for HIV infection. In 75% of cases, the result is positive.

Stages of HIV infection:

  • Incubation.
  • Primary anomaly.
  • Acute infection.
  • Asymptomatic.
  • Generalized lymphadenopathy of persistent type.
  • secondary disease.

The first stage lasts from several weeks to a couple of months. Then comes the period of acute infection, which manifests itself within 3 weeks. At this stage, fever, skin rash, night sweats, vomiting, nausea, etc. occur.

The asymptomatic stage does not always occur. Sometimes instead of it immediately comes the next stage or even the secondary disease. At these stages, there is an increase in lymph nodes with their gradual growth.

As the anomaly develops, other diseases are added. Stage 3A lasts about 3-5 years from the first infection, as a result, the number of C04 lymphocytes decreases to 400 cells per 1 mm3. After 5-7 years, HIV passes into stage IIIB, and after 7-10 years - stage IIIB.

At the very end of the course of the disease, the pathology of organs that carry a vital function occurs, after which death occurs.

Manifestation of HIV infection in the mouth

This infection is acquired by a person for life. For many, for several years in a row, the pathology has no symptoms, but at the same time, patients will be sources of infection for other people.

The clinical picture of HIV is varied. Accompanying signs are formations of one type or another, as well as infections of an aggressive nature.

Patients with HIV in the oral cavity are pursued by constant relapses and remissions, symptoms increase up to the last stages, there are special indicators in laboratory studies. The final stage in the development of the disease is AIDS, which is fatal.

Diagnosis of an anomaly

Candidiasis is determined based on bacteriological scraping. If Candida fungi are found, the diagnosis is confirmed.

It is necessary to distinguish the disease from other pathologies that have a similar clinical picture:

  • Leukoplakia of the true type.
  • Galvanism.
  • contact allergy.
  • Lichen planus.
  • Leukoplakia of a smoker.
  • Hyperplastic candidiasis.

In addition to the above symptoms of HIV infection, there are other signs in the oral cavity: weight loss for no reason, pneumonia of the pneumocystis type, diseases of the internal organs and, first of all, the nervous system.

To make a correct diagnosis, the doctor will clarify what diseases the patient suffered from earlier, whether he took corticosteroids and other drugs that cause disruptions in the immune system. Of great importance are sexual contacts, especially working conditions at work.

HIV infection is confirmed in the laboratory by the detection of specific antibodies. Popular is the ELISA assay. In people suffering from this disease, the number of leukocytes and lymphocytes decreases, the percentage of immunoglobulins (mainly G and A) increases.

Treatment of pathology

Most oral diseases related to HIV can be cured. For this, it is important to consult a doctor in a timely manner in order to carry out the necessary therapeutic measures.

Proper treatment tactics guarantee a prosperous and long life even with HIV.

What do you need to know about prevention?

HIV infection is an insidious disease, so all measures must be taken to prevent its occurrence.

Disinfection and sterilization - major events to avoid this anomaly. It is quite enough to follow certain rules that prevent infection with the hepatitis B virus and other agents of an infectious nature. This will protect the person from HIV.

In addition to sterilization, it is important to be extremely careful when working with blood and other fluids of the body (saliva, tears, etc.).

It is necessary to be extremely careful in procedures where the invasion of the skin or mucous membrane is carried out using a needle and other instruments.

Many dental procedures result in blood. Given that HIV infection in the mouth occurs predominantly through the blood, dentists are at risk. Therefore, doctors and nurses must adhere to preventive measures in their work. It will be necessary to protect exposed parts of the body from patients' biological fluids, washing hands thoroughly with soap and water. Hands must be washed after each change of gloves.

If contact with blood or other fluids is planned, wearing gloves is essential. If there is a risk of splashes and blood particles on the doctor's face, a mask and goggles should be worn. Exercise extreme caution when working with a scalpel, needle and other sharp instruments. All disposable medical devices must be destroyed immediately after the procedure.

dental instruments

There are tools that carry the risk of injury with their sharp ends. When cleaning them, it is necessary to wear additional special durable gloves and exercise caution. If the doctor has an exudative skin lesion, he should not perform invasive procedures and work with patients who have infections.

Sterilization of instruments is an important condition in the work of a doctor. HIV is extremely sensitive to high temperatures, so heating is necessary to prevent transmission of the disease through working devices. Such procedures include high-temperature dry air treatment, boiling. There are disinfectants that successfully fight such an infection. It's 30% hydrogen peroxide, 2% glutaral solution. It is necessary to soak the tool in them for half an hour.

Equally important is the thorough disinfection of all drill tips, table and other surfaces. Antiseptics should be used to prevent the development of the disease on the tissues of the body.

Disinfection of such materials as an impression, a device for diagnosing a bite, orthopedic and orthodontic constructions is carried out.

After each patient, the doctor rinses all drill tips under water, removes particles and residues of materials using detergents. Then it dries, treats with a disinfectant and rinses it off with distilled water.

What to do in critical situations?

If contact with patient fluids has occurred, but the skin is not damaged:

  1. Wipe the area with peroxide, alcohol or other disinfectant.
  2. Rinse with soapy water, wipe again with alcohol.

In the case when the biomaterial was on the mucous membranes, it is necessary to rinse the mouth with alcohol, drip albucid into the nose (if the liquid got into the nose), rinse the eyes large quantity water and inject a few drops of albucid (if contact with the mucous membrane of the eyes has occurred).

If the dentist is pricked or cut, it is important to follow these steps:

  1. Remove gloves immediately.
  2. Remove the first drops of blood from the wound surface.
  3. Wipe the area with alcohol, hydrogen peroxide, iodine solution.
  4. Wash hands using soap, rinse with water and treat with alcohol.
  5. Glue the patch and fix the fingertip.
  6. If you need to finish the job, use new gloves.

Language AIDS is a fairly common phenomenon, affecting approximately eighty percent of all infected people. Most often, ulcers, erosions and neoplasms appear on the surface of this organ and on the mucous membrane of the oropharynx, which indicate the presence of concomitant diseases in the body. The tongue with HIV (see photo) can be affected by a fungal or bacterial infection, as well as a virus. On it, in addition to ulcers and erosions, depending on the type of concomitant disease, small solitary or focal rashes, neoplasms, as well as plaque may occur. different color. Photos of the tongue of an HIV patient are given in this article as a good example.

Fungal diseases that affect the tongue with HIV infection

It is impossible to give an unambiguous answer to the question of what the tongue looks like with HIV with the addition of a fungal infection. It directly depends on the specific disease. The most common disease that affects the oral cavity and this organ is candidiasis. It is divided into three types. With pseudomembranous, the white tongue of an HIV-infected person is not covered with a continuous coating, but with frequent foci of rashes with light, flaky scales. They are easily separated, without causing any discomfort to the patient at this moment. A photo of the tongue in HIV infection accompanied by pseudomembranous candidiasis is presented on the site as a good example.

With atrophic candidiasis, the form of which is considered one of the most dangerous, there are no comforting forecasts in terms of a complete cure. Bright red, often bleeding plaques on the tongue with HIV are the main symptom of this disease. Such rashes extend to the gums and oral cavity. Initially, they are determined not only visually, but also by the sensations of itching and severe burning. Over time, these symptoms become dull, turning into aching, pronounced pain. A hyperplastic lesion in oral candidiasis characterizes a white coating on the tongue with HIV, see (photo). A small adhesive rash covers the entire surface of this organ and extends to the gums and palate. Ulcers with this type of candidiasis can bleed and even fester over time.

Experienced professionals sometimes compare them appearance with stomatitis, but there is one main difference that helps in visualizing the disease for its further diagnosis. With hyperplastic candidiasis, formations in the oral cavity do not have clear contours. In shape, they resemble lacerations, while with stomatitis, relatively even round plaques are formed.

Cracks and ulcers in the tongue with HIV are caused by another equally common disease of the oral cavity. We are talking about cheilitis, which in people with immunodeficiency syndrome most often manifests itself in an angular form. In addition to the above organ, it often affects the lips, as well as the skin area under them and in the corners of the mouth. Ulcers and cracks can also form in these areas. Eczematous cheilitis in patients with immunodeficiency virus is expressed differently. Its development is evidenced by a black coating on the tongue with HIV. In the acute stage, the disease is accompanied by the appearance of small, often growing hairs, which give this organ such a shade.

Bacterial rash on the tongue with HIV: photos, symptoms, types of diseases

Diseases of a bacterial nature also often affect the oral cavity of people with the immunodeficiency virus. In AIDS patients, the tongue is primarily affected by bacteria. They account for from forty to fifty percent of neoplasms, ulcers and other pathologies that also occur on the gums and oropharyngeal mucosa. The most common among them are staphylococci and streptococci. What is the language for HIV and these comorbidities?

It is covered with ulcers that do not heal for a long time and sometimes bleed. The ailments caused by these bacteria are fraught with great danger, because in addition to the defeat of the tongue with HIV, they threaten the oral cavity and the entire body. They often bring with them diseases such as pneumonia, bronchitis, laryngitis, tracheitis, and so on. Indeed, with improper treatment or with its insufficient effectiveness, bacteria quickly descend from the oral cavity into the larynx and lower respiratory tract. Since the immunity of people with the immunodeficiency virus is greatly weakened, it can be extremely difficult to cure the above ailments in them, as well as to stop the spread of staphylococcus or streptococcus from the oral cavity to other organs. Such a lesion of the tongue with HIV is expressed in the form of a white-yellow plaque, round pink ulcers with red focal points in the center and painful sensations that do not subside day or night and are poorly removed even with strong painkillers.

Fusospirochetosis also manifests itself as a rash and plaque on the tongue with HIV. This disease can lead to gingivitis with delayed or ineffective treatment. In this case, the bacteria spread rapidly in the oral cavity and can descend into the organs of the respiratory tract. One of the most terrible complications of furoprochetosis is the penetration of bacteria into the periodontal area. Striking it, pathogens in the literal sense of the word eat it up to the alveolar bone, in which, as a result of this disease, dangerous destructive changes can also occur. With fusospirochetosis, it is painful for people to touch the mouth. This makes it difficult to care for the language of an HIV patient, as well as for his gums and oropharyngeal mucosa.

Necrotizing gingivitis, in addition to plaque on the tongue with HIV, the photo of which leaves an unpleasant impression, has a lot of other symptoms. It affects the entire oral cavity, including the gums and mucous membranes. The joints of the gums with the teeth with this disease become like pieces of rotting meat. Patients with necrotizing gingivitis complain of severe pain, which is often confused with toothache, as well as bleeding gums. Fibrous tongue with HIV, the photo of which clearly demonstrates the severity of the disease, is another sign of this form of gingivitis. In this case, the tissues of this organ acquire an inhomogeneous porous structure. Over time, cracks appear on them, which, like the gums, bleed and cause pain and discomfort. It is worth noting that necrotizing gingivitis is also characteristic of people without immunodeficiency syndrome. It can manifest itself against the background of advanced periodontal disease, severe stress, as well as general weakened immunity. However, the identification of this ailment serves as a wake-up call for medical professionals that the patient may have an undiagnosed immunodeficiency virus. This is evidenced by the above symptoms of HIV on the tongue. It is extremely difficult to confuse them with the clinical picture of other diseases. After all, qualified doctors know what language is with HIV (photos of the pathologies of this organ are in most specialized books and teaching aids).

Viral warts on the tongue with HIV: photos and diseases with this symptom

The most terrible and difficult to treat viral disease is hairy leukoplakia. This disease affects the face and mouth. The color of the tongue with HIV in this case is whitish. The disease is characterized by hair growths with a keratin component in places unusual for such a phenomenon. We are talking about the surface of the tongue, on which, with this type of leukoplakia, small ulcers with a white scaly coating form, from which small, but dense hairs grow in later stages. In the early stages, hairy leukoplakia is often confused with hyperplastic candidiasis. This happens until hairs appear from the neoplasms. White coating on the tongue with HIV (see photo) in this case - not the main symptom. That is why laboratory tests are used to diagnose hairy leukoplakia, since imaging in the early stages can be erroneous.

Herpes is a disease no less dangerous for people with immunodeficiency syndrome, the treatment of which people who are not infected with this terrible disease, as a rule, pay little attention to. The tongue affected by herpes with AIDS, the photo of which is given as an example, is covered with small watery warts. They may be solitary or focal. In patients with the immunodeficiency virus, they do not dry out over time, but degenerate into yellowish-brown ulcers. That is why a yellow tongue with HIV can be a sign of the acute stage of herpes. On the initial stage, before the appearance of watery warts, red focal spots appear, which are accompanied by severe itching and burning. A white tongue with HIV (see photo) may also indicate the onset of herpes, since the watery vesicles at first resemble spots of this color.

Etiology: Caused by the human immunodeficiency virus (HIV), a retrovirus (discovered in 1984). The targets for the virus are T-lymphocytes, namely T-killers.

In children, infection occurs: 1) from a sick or infected mother through the placenta, birth canal, with breast milk. HIV transmission from infected mothers occurs in 25-30% of cases; 2) when transfusing virus-infected blood; 3) through injections in case of non-compliance with the rules of antiseptics. If infection occurs through the placenta or blood transfusion during the neonatal period, the prognosis is extremely poor. The danger is also great in children with hemophilia, when each successive administration of blood products activates HIV.

The main sources of AIDS are a sick person and virus carriers, in whom the virus persists for life. Progressive immunodeficiency dramatically inhibits the ability of the immune system to resist pathogens of various infectious diseases, as well as emerging malignant cells (Kaposi's sarcoma). The patient becomes defenseless and usually dies from infections that do not pose a danger to most ordinary people.

AIDS is an epidemiological disease that mainly affects the immune system, which determines the variety of clinical manifestations and poor prognosis.

In the epidemiology of AIDS, co-facors play an important role, i.e. factors contributing to its spread. These include: promiscuity among homo- and bisexuals, the growth of sexually transmitted diseases in the country, viral diseases that further reduce the body's defenses (especially viral hepatitis B and related to the herpes group), tuberculosis, age, repeated infusions of blood products in patients with hemophilia exacerbate the sensitivity of these individuals to HIV.

In children, the course of this disease is more malignant, which is determined by the immaturity of their immune system. However, as in adults, the disease goes through several stages (periods) of the course. However, it should be remembered that immunodeficiency manifests itself at a relatively late stage of the disease, and immediately after infection, a strong immune response occurs at the level of T- and B-lymphocytes, antibodies are produced to antigens of the virus envelope and T-killers, which react both against surface antigens of HIV and and against the antigens of its core. These defensive reactions can keep the infection in check for several years, which explains the long incubation period. However, in children, the average duration is 2 years, while in adults it is up to 8 years. It is characterized by fever for 2-10 days with enlarged lymph nodes, liver, spleen. Patients have arthralgia, myalgia, tonsillitis, pharyngitis, the number of blood lymphocytes decreases (the picture resembles mononucleosis). Then everything seems to disappear without a trace.


However, after a certain period of time (in children it may be several months, in adults, as a rule, years), symptoms of the disease begin to be detected in a person.

In the second period, the syndrome of generalized lymphadenopathy) in more than 50% of cases, there is an increase in the cervical, chin, submandibular, parotid lymph nodes. They are usually soft, elastic, mobile. Enlarged lymph nodes are one of the earliest signs of the disease.

In the third period - the AIDS-associated complex (this is still pre-AIDS) there is an increase in temperature to 38-39 degrees C, weakness, lethargy, severe fatigue, loss of appetite, progressive weight loss (more than 10%), bowel dysfunction. During the same period, children early age there may be a cessation of physical development (with a predominant lesion of the central nervous system), a decrease in weight gain.

And AIDS itself is the addition of opportunistic infections (primarily pneumocystis pneumonia), malignant tumors (occurs in 40% of cases, of which Kaposi's sarcoma accounts for 85% of cases, malignant lymphomas - 10%).

During this disease, there are periods of exacerbations and temporary improvement. It can last from several months to 4-5 years. The outcome is lethal.

The most important immunological feature of children with AIDS is the presence in their blood of an exceptionally high content of immunoglobulin and, at the same time, the inability to produce antibodies when injected with antigens that cause normal conditions formation of antibodies, in particular to HIV.

Manifestations on the mucous membrane are diverse and may be the initial signs of the disease (along with a systemic increase in lymph nodes, weight loss, objective sensations). No pathognomonic symptoms were identified. As a rule, this is a manifestation of opportunistic infections, of which the most common (several months ahead of others) various forms candidomycosis. The most characteristic are thrush (acute pseudomembranous candidiasis) in severe or moderate form, acute atrophic candidiasis, chronic hyperplastic candidiasis.

Symptoms of atrophic candidiasis (oral mucosal erymatosis) are manifested by bright red spots without deposits on the mucous membrane of the lips, cheeks, palate, and tongue - strip-like areas of deep desquamation, usually located along the midline. The remaining parts of the tongue are covered with a white coating. In chronic hyperplastic candidiasis in patients in different parts of the mucosal mucosa, flat plaques or uneven bumpy growths of white color (nodular form) are determined. With the localization of lesions in the corners of the mouth, candidal cheilitis (mycotic seizures) develops, often with the appearance of chronic cracks. In the absence of treatment, these elements of the lesion increase in size, thicken, and become covered with crusts.

Treatment is local or systemic. Nystatin, clotrimazole, ketokenazole are used. Relapses are possible.

Bacterial infections also appear in the mouth. A fairly common disease is ulcerative necrotic gingivostomatitis. The disease often recurs. Some patients have an aggressive course with loss of soft tissues of the gums, bone structures with sequestration. Treatment: antiseptic rinses, metronidazole topically and orally.

In patients with HIV and HIV-infected, an aggressive form of the course of periodontitis occurs with a generalization of the pathological process in periodontal tissues, and sequestration of interdental alveolar bone structures is often observed. The disease is not amenable to local treatment.

Viral infections of the mucosa are most often manifested by recurrent herpes infection, herpes zoster, and the appearance of papillomas on the mucosa. The elements of the lesion often recur, ulcerate, are painful, and are located atypically.

Primary and recurrent herpes, like herpes zoster, should be treated with acyclovir, eovirax. Papillomas are removed surgically.

The most characteristic alarming and early sign of the manifestation of infection in the OM in AIDS risk groups, HIV-seropositive homosexuals is “hairy” leukoplakia (VL). It can be of different sizes and localization, one- and two-sided.

Hairy leukoplakia is manifested by massive white growths with conically elongated processes or folds that protrude above the surface of the mucous membrane, resembling hair. Most often they are located on the lateral surfaces of the tongue, extending to its posterior and ventral surfaces. The mucous membranes of the cheeks, palate, and floor of the mouth can also be affected. As in leukoplakia, the plaque lesion is firmly attached to the base, the surface is smooth to wrinkled, gray-white in color (similar to candidiasis, hyperkeratotic lichen planus, carcinomatosis).

There is no effective treatment for hairy leukoplakia. The value of this symptom is in its prognostic value: the probability of developing HIV in patients with hairy leukoplakia is 48% by 16 months and 83% by 30 months after the diagnosis of VL. Approximately 1/3 of VL patients will develop HIV. Thus, the diagnosis of VL is an indicator of immunodeficiency and HIV infection. The presence of VL is an indication for testing for HIV. A viral etiology of VL is suspected.

To the specific manifestations of AIDS on the oral mucosa (more often on the skin) is Kaposi's sarcoma (vascular tumor). It is localized on the hard and soft palate, papillae of the root of the tongue. The defeat is symmetrical. According to the literature, it is found in all risk groups for HIV, in 50% of them - in the mouth. ORM may be the site of the only or first localization of the tumor. The lesion begins with the appearance of flat spots, single or multiple, bluish, reddish, blackish in color, or nodular growths with a diameter of 5-10 mm to 5 cm. Later, the spots darken, increase in size, divide into lobes and ulcerate. The lesions are painful to the point of ulceration. When located on the gum, Kaposi's sarcoma looks like an epulis. It is characterized by a sluggish course, exophytic growth, loose consistency, and a great tendency to malignancy. She is soft and painless.

Sarcoma may be the only sign of the disease or may be associated with manifestations of an opportunistic infection.

Of the other tumor-like formations on the oral mucosa in AIDS, there are lymphomas (which may be the only symptoms of the disease) and squamous cell carcinoma, usually located on the tongue.

Of the other manifestations of the disease against the background of reduced reactivity in the oral cavity, the following are described: CRAS, diseases of the salivary glands, idiopathic thrombopenic purpura, which is manifested by hemorrhages in various parts of the oral mucosa, xerotomy, various forms of glossitis, cheilitis, exacerbation of chronic periodontitis, which tends to turn into osteomyelitis.

The treatment is specific, carried out by infectious disease doctors.

Prevention: identification of risk groups, anamnestic data, careful processing of instruments, explanatory work among the population.

Protection of medical staff: gloves, goggles, mask, treatment of instruments, as in case of hepatitis B, disposable needles and syringes, avoid cuts to hands, treat them with chlorhexidine, 4% solution, work with natural tips.

HIV suppresses and depresses the immune system at the cellular level, making the body susceptible to any infections and viruses. The immune system becomes not resistant to opportunistic and pathogenic microflora.

Scientists have found that the mucous membrane of the mouth (especially the tongue) is the first to react to the presence of a virus in the body. Permanent diseases of the teeth and oral cavity for specialists signal a possible infection.

Symptoms of HIV in the mouth with a photo

There is a conditional gradation of HIV symptoms in the oral cavity, depending on the degree of their relationship:

In patients with HIV, the painful condition of the oral cavity is chronic with periodic exacerbations, relapses and remissions. Gradually, the situation worsens, clinical symptoms intensify, and periods of rest are practically absent. The mucous membrane suffers even from frivolous pathogens that the immune system healthy people are immediately rejected.

On medical photos characteristic symptoms are very clear:

Stages of HIV infection in the oral cavity

In the medical literature, there are several typologies of HIV stages. One of the most understandable and common is the classification, which involves 4 stages of the development of the disease, and each of them is accompanied by various manifestations.


Stages of immunodeficiency:

  1. incubation period;
  2. the period of primary manifestations (acute, then asymptomatic infection);
  3. persistent generalized lymphadenopathy;
  4. stage of irreversible secondary immunodeficiency.

Diagnostics

With any suspicion of the development of HIV infection, it is necessary to immediately undergo a comprehensive differential diagnosis.

Diagnostic measures:

  1. PCR reaction (identification of immunodeficiency virus RNA);
  2. immune botting technique (detection of individual antibodies to HIV);
  3. linked immunosorbent assay;
  4. immune status check.

Sometimes, with conflicting or blurred indicators, additional studies are prescribed. Doctors examine the blood for the presence of antibodies to the herpes simplex virus, toxoplasma, cytomegalovirus infection (manifested as a severe cold), etc.

Timely medical examination great importance both for the patient himself and for his environment. From the moment of infection to the onset of the first symptoms, it can take almost 5 years. During this time, a person may be unaware of the problem, but be a carrier and distributor of the virus. An acute deterioration in oral health is the best signal for disease in its early stages.

Treatment of dental diseases caused by HIV

The presence of the immunodeficiency virus implies a complex treatment that is able to maintain the necessary vital functions of the body. It is based on the intake of various antiretroviral drugs.

Dental ailments provoked by HIV are subject to timely and thorough treatment. Suppressed immunity and internal microflora cannot resist pathogens, so ailments progress rapidly. Therapy includes treatment in the dentist's office and taking medications (broad-spectrum antibiotics, antiviral, antifungal drugs, corticosteroids, etc.).

Diseases of the teeth

Dental clinics provide safe and quality treatment. In this case, disposable instruments are used, and reusable instruments are carefully sterilized (in environment the virus dies at temperatures above 60 degrees). Dentists carry out all the necessary manipulations - they treat caries, fill teeth, and carry out prosthetics. However, they approach the issue of surgical intervention very carefully.

Doctors often encounter HIV-periodontitis. It has all the signs of ordinary periodontitis (inflammation of periodontal tissues), but is characterized by rapid progression. This means that the patient can lose teeth very quickly. The therapy represents the classical measures to combat periodontitis, taking into account the main course of the patient's medications.

Gingivitis

Gingivitis in the mouth is an inflammation of the gums. Depending on the form and degree of development, the patient has various signs, including swelling, redness, itching or burning, bleeding, atrophy or enlargement of the gingival papillae, and the formation of necrotic ulcers.

Treat gingivitis comprehensively:

  1. sanitation of the oral cavity and professional cleaning (we recommend reading: how is the sanitation of the oral cavity carried out?);
  2. careful treatment with antiseptic preparations;
  3. taking antibiotics or antiviral medications;
  4. taking antihistamines;
  5. use of healing gels and ointments.

Candidal stomatitis

Candidiasis (thrush) occurs in more than 90% of those infected. Stomatitis in this case can be atrophic, hypertrophic or pseudomembranous. Most often, the last type of candidal stomatitis is manifested.

Thrush is characterized by classic symptoms:

With candidiasis, antifungal drugs that inhibit Candida fungus, antimycotics, the use of pharmacy antiseptics, careful oral hygiene, and diet are indicated. With extensive lesions of candidiasis, healing agents are used.

Other diseases

Almost all HIV patients experience hairy leukoplakia (Epstein-Barr virus). It appears as a permanent white or gray coating on the tongue. The mucosa is covered with folds and rough plaques. The occurrence of pathology is provoked by malfunctions in the immune system.

That is why the treatment has an immunomodulatory focus:

  1. antiretroviral therapy;
  2. immunotherapeutic treatment;
  3. antiviral medicines;
  4. antimycotics;
  5. drugs based on retinoic acid;
  6. in advanced cases, the affected areas are excised surgically or with a laser.