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Are the oral manifestations associated with HIV infection really relevant to the practising South African dentist? A comparative analysis of oral HIV studies in South Africa.

This comparative analytical review of oral HIV in South Africa, Africa and the West shows that relatively little work has been done on the African continent in this field of study. Direct epidemiological comparisons of these studies with each other are difficult but were made between these regions for overall prevalence values, mode of transmission and individual lesion presentation (candidiasis, oral hairy leukoplakia, periodontal disease, Kaposi's sarcoma, salivary gland disease, oral ulcers and other lesions). Apparent differences exist between the reported prevalence values of oral candidiasis, periodontal disease, Kaposi's sarcoma and tuberculous ulcers, the significance of which is uncertain. There is a need to standardise research methodologies. This would enable appropriate comparisons to be made and a better understanding of the implications of the oral HIV disease process in South Africa and elsewhere on the continent.

AIDS-Related Opportunistic Infections↗

Raynaud disease with oral manifestations.

A young women with a history of Raynaud phenomenon, without underlying disease, manifested spasms of the tongue at times when the episodes of the hands were most severe. Striking changes in the appearance of the tongue occurred.

Adult↗

Oral manifestations of AIDS: an overview.

Infection with the human immunodeficiency virus (HIV) may cause a variety of oral lesions, such as candidiasis, periodontal disease, hairy leukoplakia, Kaposi's sarcoma and a number of miscellaneous lesions and conditions. One hundred HIV-infected patients, including AIDS patients, referred to a University Hospital in Amsterdam, were examined orally. Most patients were initially seen by the Department of Internal Medicine, the oral examination by a well-trained dentist being part of the routine screening of all HIV-infected patients. In 80 per cent of all patients one or more HIV-related lesions of the oral mucosa was recorded. In 6 per cent of those patients the oral lesion was the first manifestation of the HIV infection. Hairy leukoplakia was observed in 15 per cent of all patients. Candidiasis proved to be the most common oral disease. In patients with full-blown AIDS the pseudomembranous form of candidiasis was the most common one, while in HIV-infected patients the erythematous type prevailed. These results emphasize the role of the dentist in making an early diagnosis of HIV infection.

Acquired Immunodeficiency Syndrome↗

Pediatric infection with the human immunodeficiency virus (HIV): head, neck, and oral manifestations.

The increasing incidence of HIV infection in the pediatric population is of concern for the practicing dentist. Long incubation periods of the virus, combined with difficulty in detection, results in many undiagnosed cases of prenatal and natal infections with HIV. As a result, many dentists will unknowingly treat HIV-positive children. This article presents most common features of pediatric HIV infection, placing special emphasis on manifestations which affect the head, neck, and oral tissues.

AIDS Dementia Complex↗

Oral manifestations in patients with Sjögren's syndrome.

OBJECTIVE: To investigate oral signs and symptoms in patients with Sjögren's syndrome (SS), and to compare results with a group of healthy individuals. METHODS. Each individual completed a questionnaire designed to investigate his/her perception of oral health and dryness, as well as a list of signs and symptoms associated with xerostomia. An oral clinical evaluation was performed. RESULTS: A total of 81 subjects were studied, 21 with primary SS, 29 with secondary SS, and 31 healthy individuals. Patients with SS considered that their oral health was poor. Oral dryness was perceived as intense. Symptoms most commonly expressed were: sensitivity to acids (68%), difficulty eating dry foods (66%), and sensitivity to spicy foods (58%). Dryness of the lips (76%) and the tongue (68%) were also among the most frequent complaints. Oral findings of patients with SS included cervical or atypical caries in 83%, fissured erythematous tongue in 70%, and oral candidiasis in 74%. Significant differences were found when results obtained from patients with SS were compared with the healthy group. CONCLUSION: The oral health of this group of patients with SS was deficient. Adequate management of dry mouth was not achieved, mainly for the modifiable components such as dental decay and oral candidiasis. Therefore. treatment and prevention plans are mandatory. These measures might help to reduce the discomfort associated with oral dryness and to reduce dental loss.

Female↗

Oral manifestations of leukemia.

Signs and local symptoms of leukemia in the oral cavity include paleness of the oral mucosa with gingival bleeding that develops into painless gingival hyperplasia, hemorrhages, and ulcerative necrotic lesions. These findings are common clinical manifestations of leukemias and frequently herald the onset of the disease. Because of their clinical importance, all such lesions deserve the full attention of dentists and physicians.

Adolescent↗

Oral manifestations of metabolic bone disease: vitamin D and osteoporosis.

Metabolic bone diseases are disorders of bone remodeling and characteristically involve the entire bony skeleton. Metabolic bone diseases exhibit their effects throughout all skeletal tissue, and very often are first diagnosed from abnormalities appearing in the oral cavity or on dental radiographs. This article presents major metabolic bone diseases that are often manifested in the oral cavity. It discusses the physiology of vitamin D and the major bone disorders associated with abnormal levels of this hormone. Osteoporosis, the most common metabolic bone disease in elderly patients, also will be discussed. With the expanding older population, osteoporosis has become a major health problem and poses special concerns for the dental practitioner.

Abscess↗

Familial pemphigus vulgaris with oral manifestations affecting two Greek families.

Two families of Greek origin with oral pemphigus vulgaris are reported. Both are fully documented cases of familial pemphigus in Greek Mediterranean patients. In the first family, a sister and a brother developed oral mucosal pemphigus lesions within a 5-year period, and a cousin had died from the disease 20 years earlier. In the second family, a daughter, a son and their mother developed the disease 2, 4 and 6 years apart. HLA typing has been performed and disclosed striking associations and similarities between the members of each family. Review of the fully documented cases of familial pemphigus vulgaris is also presented in a tabular form.

Adult↗

Psoriasis with oral manifestations.

A forty-seven year old woman had skin and oral lesions of three year's duration. The skin lesions were clinically and microscopically diagnosed as psoriasis. Oral examination revealed extensive involvement of the entire mucosa with white, elevated, circinate lesions. Biopsies of oral mucosa were interpreted as histologically similar to the characteristic dermal findings in psoriasis. Anesthetic mouth rinses afforded symptomatic relief; however, although there was definite improvement, the oral lesions have persisted.

Biopsy↗

Oral manifestations of hereditary sensory and autonomic neuropathy type IV. Congenital insensitivity to pain with anhidrosis.

OBJECTIVE: Hereditary sensory and autonomic neuropathy type IV (congenital insensitivity to pain with anhidrosis) is a rare disorder. In this study, we investigated the oral and dental manifestations associated with hereditary sensory and autonomic neuropathy type IV. STUDY DESIGN: Eighteen patients with hereditary sensory and autonomic neuropathy type IV whose ages ranged from 1 year 0 months to 22 years 3 months were examined for oral signs and symptoms of tooth abnormalities, malocclusions, soft tissue disorders, tongue papilla atrophy, and morphologic abnormalities of hands and fingers. RESULTS: All 18 patients showed congenital insensitivity to pain and anhidrosis. Oral self-mutilations, such as autoextraction of teeth and severe biting injuries (with resultant scarring) of the finger tips and oral soft tissues (tongue, lip, and buccal mucosa), were found in most patients. In infant patients the condition was typically characterized by decubital ulcers on the ventral surface of the tongue, resulting from trauma of the incisal edge of erupting mandibular primary incisors during sucking or nursing. These ulcers led to several local and systemic problems, such as tongue bleeding, infection, malnutrition, and halitosis. A large number of missing teeth and a high incidence of dental caries were additional characteristic findings. Such oral self-mutilations were found to decrease with age and with the intellectual, social, and/or emotional development of the patients. However, not all of the mutilations were completely eliminated. Two patients had partial dentures to replace missing teeth. CONCLUSIONS: Our study suggests that early diagnosis and specific dental management for patients with hereditary sensory and autonomic neuropathy type IV are important for prevention of the characteristic oral and dental problems accompanying this disorder.

Adolescent↗