Oral Manifestations Caused by HIV: How to Treat Them?

Oral manifestations caused by HIV are usually a common symptom in these patients. Their defenses are impaired and, therefore, they are more susceptible to infections and even some types of cancer that can occur in the mouth.

HIV is the human immunodeficiency virus. People infected by this agent suffer damage to their immune system, as their white blood cells are attacked.

The most common oral manifestations caused by HIV

Many oral manifestations are the first symptoms of the disease, therefore, it is very important to pay special attention to them. Sometimes HIV is suspected and later confirmed from them.

Multiple HIV positive patients have mouth lesions associated with their underlying pathology. These tend to appear in an exacerbated manner, lasting longer, larger, more frequently and more difficult to treat than in cases without HIV.

The presence of lesions in the mouth will affect the quality of life of the patient. They can hurt, bleed, ooze, and disturb chewing, swallowing, and speaking. Thus, the person will see his diet and taking medications compromised.

Herpes simplex, warts, hairy leukoplakia, and candidiasis are often the most common mouth infections. Canker sores, gingivitis, and dry mouth are also common complaints in these patients.

HIV, for its Spanish form, or HIV, for its acronym in English, is the name for the viral agent that causes acquired immunodeficiency syndrome.

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Herpes simplex or cold sores

As we already mentioned, it is much more difficult for these patients to fight infections. Herpes simplex or cold sores is one of the viruses that most frequently causes oral manifestations caused by HIV.

The infection manifests as red sores in the mouth or small, raised, red bumps liquid content, which break easily. They are usually located on the palate or around the lips, where they are known by the name of fever sores.

They are very painful and annoying. In HIV patients, this infection, which is very uncomfortable in itself, tends to be longer and more severe. It is contagious and those who suffer from it should avoid sharing food and utensils that they put in their mouth.


To treat this infection a doctor may prescribe acyclovir, an antiviral medication that will decrease discomfort, shorten the duration, and help reduce the frequency of new outbreaks. In addition, the patient should continue with the usual treatments for HIV, unless the doctor indicates otherwise.


The appearance of this oral manifestation caused by HIV is due to infection with the human papillomavirus (HPV, according to its acronym in English). Warts are small, rough bumps, growths, or bumps that appear on the mucosa inside the mouth or on the lips. They can be white, gray, or pink. Some are cauliflower-shaped, others plate-shaped, or can be seen as projected masses.

They are generally painless, but can be uncomfortable or uncomfortable. If they are located in an area with a lot of chewing trauma, they hurt and bleed. In the event that they break and liquid comes out, they are contagious. HPV is associated with oropharyngeal cancer, so it is very important to pay special attention to this type of lesion in the mouth.


Warts found inside the mouth are surgically removed. They can be laser cut or cryosurgery, which is cold removal, freezing the lesion.

If they are located on the lips, they can be treated with local application creams prescribed by the doctor. Anyway, it is possible for them to reappear after any of these treatments that we mentioned.

Hairy leukoplakia

Hairy leukoplakia is one of the most characteristic oral manifestations caused by HIV in these patients. It is caused by the Epstein-Barr virus, the same as mononucleosis.

This virus, in general, only affects people with weakened immune systems, so the presence of a hairy tongue should make us suspect of HIV. Sometimes it is even the first sign of the disease.

Hairy leukoplakia is the presence of whitish hair-shaped plaques on the surface of the tongue, especially to the sides of it. They do not come off when brushing the tongue or come off when rubbed. They can also be seen on the cheeks or on the inside of the lips. They do not hurt and are not contagious, but their bad appearance is a concern for the patient.


It does not require specific treatment. General medication to reduce the viral load received by the patient with antiretrovirals is usually sufficient and contributes to the disappearance or reduction of this lesion.


Canker sores, also known as sores, are round or oval wounds or ulcers that occur on the lining of the inside of the mouth. Their appearance is white or yellow and they are surrounded by a red inflamed halo.

Their most annoying symptomatology is the intense pain they produce, especially during chewing or ingesting irritating foods, such as very hot, salty or spicy foods. They are not contagious.

They are located in the mucosa that is inside the cheeks, inside the lips and on the sides of the tongue. Canker sores are one of the oral manifestations caused by HIV that appear more frequently and more seriously in these patients. Lesions tend to be larger, more numerous, and take longer to clear up.


Canker sores do not need a specific treatment, since they usually remit spontaneously. But yes medication can be used to control the painful symptoms they cause.

For milder cases, using creams or mouthwashes locally may decrease pain. Some have local anesthetics. It is recommended to use them a few minutes before eating so that feeding is not so painful. Mouthwashes that include alcohol should be avoided.

In the most serious cases, the doctor may indicate the use of an anti-inflammatory and will control. If necessary, he will readjust the treatment for HIV.

There are natural alternatives that can help relieve the pain caused by canker sores. The use of ice, chamomile, calendula tea or honey can make the course of these lesions less painful. In any case, if you decide to use a natural element, it should be done responsibly and conscientiously, never neglecting the treatment prescribed by the doctor.


Gingivitis It is the inflammation of the gums due to the accumulation of batteries on them. They look red, swell, bleed easily, and hurt.

Although gingivitis can occur in the mouth of anyone with poor oral hygiene, HIV positive patients develop this pathology more easily. It can become chronic or evolve into more serious forms.

Severe cases of the disease lead to necrosis of some sectors of the gingiva or to rapid movement and loss of teeth. It is also associated with the risk of heart disease and strokes.

Gingivitis is more aggressive in HIV patients, causing heavy bleeding from the gums.


The control and treatment of this pathology is good oral hygiene. Correct tooth brushing should be carried out, frequently, with a soft brush and toothpaste. In addition, it should be supplemented with regular flossing. The dentist may prescribe antimicrobial mouthwashes.

A consultation with the dentist will always be timely, since several times it is necessary to perform a dental cleaning to remove the tartar accumulated under the gums.

Read also: Gingivitis or inflammation of the gums

Dry mouth

Dry mouth is the decrease or absence of saliva in the mouth because the person does not produce enough. This problem is associated with the AIDS virus itself, but also with HIV treatments.

Saliva in the mouth helps chew and digest food and has a protective role, promotes self-cleaning and prevents infections. Without saliva, these patients accumulate a lot of bacterial plaque that predisposes them to suffer inflammation of the gums, cavities or worsen the other oral manifestations caused by HIV.

The mouth feels dry, sticky, and may burn. The lips can also become dry and chapped.


It is important to tell your doctor that you are feeling dry mouth. As we already mentioned, several times this symptom is due to HIV medication and the doctor can correct it.

To counteract dry mouth, it is very useful to drink plenty of water and frequently. Chewing gum or consuming sugar-free hard candies stimulate salivary flow.

In addition, you should avoid the consumption of alcohol, salty foods and tobacco that will worsen the situation. Tooth brushing and flossing are very necessary to control bacterial plaque and keep your mouth clean. If the case is very severe, the dentist may recommend the use of artificial saliva.


Candidiasis is an infection by a fungus called Candida. This fungus is part of the normal flora of the mouth and patients with a healthy immune system keep it in balance. But in HIV patients the population of Candidas it can get out of control causing infection.

They look like white, yellow, or red patches in the mouth. It can occur in any sector, being more common on the back of the tongue, the palate or the corners of the lips. Scraping them can be removed, but doing so bleeds and leaves a red area. Although they do not hurt, they can give a burning sensation.

It is not contagious, but if it is not treated it can spread to other areas of the body. The dentist will be the one who identifies it and makes the diagnosis, since depending on the location it usually changes its way of manifesting itself.

Tooth brushing is important for all people, but it is relevant to the oral manifestations of HIV.


The treatment of this fungus is through antifungals. It is usually started with antifungal mouthwashes or lozenges that dissolve in the mouth.

HIV may make the infection more resistant and need to be supplemented with systemic antifungals. In these more severe cases, antifungal pills are prescribed to take by mouth. They can reappear after treatment.

Some tips on oral manifestations of HIV

As we already told you, mouth manifestations caused by HIV are quite common. They can alter chewing, eating and even taking medication in patients who suffer from them.

For this reason, tell your doctor if you notice any of the problems we mentioned. It is important not to neglect or stop HIV treatment.

Further, Visiting the dentist regularly and regularly will help to diagnose and treat these injuries early. Correct oral hygiene will also control and prevent these manifestations.