HIV and periodontal health: a study of military personnel with HIV

Article Abstract:

Results are presented from a study of the oral health of members of the US Army who are infected with HIV (human immunodeficiency virus, which causes AIDS). This ongoing study is part of a collaborative effort by the Walter Reed Army Institute of Research and the National Institute of Dental Research which began in 1987. Since 1985, all military personnel on active duty have been screened for HIV antibodies (an indication of HIV infection); thus, the development and progression of symptoms in infected individuals can be documented. This report concerns 230 patients who tested positive for HIV antibodies. The extent of disease progression was rated using the Walter Reed Staging Classification System, which assigns patients to one of six disease categories. Stages 1 and 2 include HIV-infected persons without symptoms, while stage 6 corresponds to frank AIDS. Oral examinations were carried out by a specialist with additional training in HIV-related diseases. Results showed that 44 percent of those examined were in disease stages 1 or 2; the remainder were in stages 3 to 6 (14 patients had stage 6 disease). Slightly fewer than one-third of the patients had oral symptoms of the type commonly associated with HIV infection. These include oral candidiasis (16 percent of the patients), oral hairy leukoplakia (in 14 percent), aphthous ulcers (2 percent), and other conditions. A greater proportion of the subjects with low levels of T4 lymphocytes (a type of white blood cell that is depleted in HIV infection) had oral symptoms: approximately 41 percent of the patients with fewer than 400 T4 lymphocytes per millimeter had pathological changes, compared with 16 percent of those with more than 400 T4 lymphocytes per millimeter. Smokers had a higher prevalence of most types of oral lesions. Most patients (of 189 tested) had bleeding gums, and one-quarter had at least one gum area that had become necrotic (dead tissue). In contrast to diseases of the mucous membranes, the patterns of periodontal disease (of the gums and tissues that support the teeth) were not correlated with the extent of HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Development and progression, HIV infection, HIV infections, Diseases, Military personnel, Periodontal disease, Periodontal diseases

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Scientific progress in understanding oral and pharyngeal cancers

Article Abstract:

Dentists are in a unique position to identify the early stages of oral cancer while it is still easily treated. Oral cancer affects 30,000 Americans annually, and 9,000 will die from the disease. Smoking and drinking are the strongest risk factors and there may be a genetic component that affects the metabolism of alcohol. Surgery and radiation therapy are the major treatments and chemotherapy may be useful in patients with recurrent disease. However, the five-year survival rate is only about 50%.

Analysis, Mouth cancer, Throat cancer, Pharyngeal cancer

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The Surgeon General's report on America's oral health: opportunities for the dental profession

Article Abstract:

The Surgeon General's report, Oral Health in America, stated that Americans' oral health has improved but there are still disparities in the provision of dental care. The report, which was released in May, 2000, offers dentists an opportunity to improve the delivery of dental care to all Americans.

Health aspects, Reports, Americans, Tooth diseases, United States. Public Health Service

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