OROFACIAL MANIFESTATIONS AS INDICATORS OF HIV/AIDS AMONG DENTAL PATIENTS /prosthodontic courses

OROFACIAL MANIFESTATIONS
AS INDICATORS OF HIV/AIDS
AMONG DENTAL PATIENTS
– AN ANALYSIS
OF 5 CASES
INDIAN DENTAL ACADEMY
Leader in continuing Dental
Education
www.indiandentalacademy.com

PRESENTED BY
Dr. AARTHI .B
POSTGRADUATE STUDENT
DEPT. OF ORAL MEDICINE &
RADIOLOGY
MGPGI
PUDUCHERRY
GUIDE
Dr. M. JONATHAN DANIEL
PROFESSOR & HEAD
DEPT. OF ORAL MEDICINE &
RADIOLOGY
MGPGIwww.indiandentalacademy.com

ONE SMALL VIRUS...
ONE LARGE
WORLD…

Indian Dental academy
• www.indiandentalacademy.com
• Leader continuing dental education
• Offer both online and offline dental
courses

A global view of HIV infection

Total: 33 million (30 – 36 million)
Western &
Central Europe
730 000730 000
[580 000 – 1.0 million][580 000 – 1.0 million]
Middle East & North
Africa
380 000380 000
[280 000 – 510 000][280 000 – 510 000]
Sub-Saharan
Africa
22.0 million22.0 million
[20.5 – 23.6 million][20.5 – 23.6 million]
Eastern Europe
& Central Asia
[1.1 – 1.9 million][1.1 – 1.9 million]
South & South-East
Asia
[3.5 – 5.3 million][3.5 – 5.3 million]
Oceania
74 00074 000
[66 000 – 93 000][66 000 – 93 000]
North America
[760 000 – 2.0 million][760 000 – 2.0 million]
Latin America
[1.5 – 2.1 million][1.5 – 2.1 million]
East Asia
740 000740 000
[480 000 – 1.1 million][480 000 – 1.1 million]Caribbean
230 000230 000
[210 000 – 270 000][210 000 – 270 000]
Adults and children estimated to be living with HIV,
2007

Estimated number of adults and children
newly infected with HIV in 2007
Western &
Central Europe
27 00027 000
[14 000 – 49 000][14 000 – 49 000]
Middle East & North
Africa
40 00040 000
[20 000 – 66 000][20 000 – 66 000]
Sub-Saharan
Africa
[1.6 – 2.1 million][1.6 – 2.1 million]
Eastern Europe
& Central Asia
110 000110 000
[67 000 – 180 000][67 000 – 180 000]
South & South-East
Asia
330 000330 000
[150 000 – 590 000][150 000 – 590 000]
Oceania
13 00013 000
[12 000 – 15 000][12 000 – 15 000]
North America
54 00054 000
[9600 – 130 000][9600 – 130 000]
Latin America
140 000140 000
[88 000 – 190 000][88 000 – 190 000]
East Asia
52 00052 000
[29 000 – 84 000][29 000 – 84 000]Caribbean
20 00020 000
[16 000 – 25 000][16 000 – 25 000]
Total: 2.7 million (2.2 – 3.2 million)

Estimated adult and child deaths from AIDS in
2007
Western &
Central Europe
80008000
[4800 – 17 000][4800 – 17 000]
Middle East & North
Africa
27 00027 000
[20 000 – 35 000][20 000 – 35 000]
Sub-Saharan
Africa
[1.3 – 1.7 million][1.3 – 1.7 million]
Eastern Europe
& Central Asia
58 00058 000
[41 000 – 88 000][41 000 – 88 000]
South & South-East
Asia
340 000340 000
[230 000 – 450 000][230 000 – 450 000]
Oceania
10001000
[<1000 – 1400][<1000 – 1400]
North America
23 00023 000
[9100 – 55 000][9100 – 55 000]
Latin America
63 00063 000
[49 000 – 98 000][49 000 – 98 000]
East Asia
40 00040 000
[24 000 – 63 000][24 000 – 63 000]Caribbean
14 00014 000
[11 000 – 16 000][11 000 – 16 000]
Total: 2.0 million (1.8 – 2.3 million)

HIV/AIDS in India
People living with HIV/AIDS in 2007- 2.4 million
Adult (>/=15 years) HIV prevalence - 0.3%.
Highest prevalence rates in south & north-east.
Four southern states – approx. 63% of all people
living with HIV in India.

Percentage distribution of HIV burden
in states

Total HIV positive population – app. 10,000.
Prevalence among antenatal mothers has dropped
from 0.25% (2006) to 0% (2007).
UT of PUDUCHERRY

OBJECTIVES
Become familiar with some of the oral
manifestations that may present in HIV
positive individuals.
Attempt diagnosing HIV infection based on
oral lesions, when complex investigations
are not available.

CASE NO:1
Oral Candidiasis

Oral Hairy Leukoplakia

CASE NO:2 & 3
Oral Warts (child)

Molluscum Contagiosum (mother)

CASE NO:4
Poor Oral hygiene & periodontal status
Angular Cheilitis Oral Candidiasis

CASE NO:5
Kaposi’s Sarcoma

REVIEW OF LITERATURE
Navazesh M (2001)
Adults – Chr. herpetic ulcers, HZ,OHL, KS.
Paediatric pts – Candidiasis, HS ulcers, parotid
enlargement.
Less common - papilloma, periodontal diseases.
Badri M et al (2001)
S.African HIV-infected pts; found OHL/OC were
independently associated with hazard of AIDS and death,
thus can be used as a cost-effective tool for screening
patients in therapeutic interventions in resource-limited
settings.

Campo J et al (2002)
assessed 156 HIV-
infected patients and found
that high viral load (>10,000
copies/ml) and low CD4+
count (<200) were associated
with more frequent oral
candidiasis, indicating that
OC could be a useful clinical
marker.

Miziera and Weber (2006)
prospectively evaluated 124 Brazilian HIV-infected
patients who used HAART for a minimum of six months
and considered OC a clinical marker of immune failure in
patients undergoing HAART.
Ranganathan K and Hemalatha R (2006)
evaluated oral manifestations in developing countries;
found considerable regional variations.
OC-commonest;
KS, salivary gl disease - Afr & Latin Am;
Histoplasmosis- Thailand.

DISCUSSION
 Most reviews consider candidiasis to be the commonestMost reviews consider candidiasis to be the commonest
and also a clinical marker.and also a clinical marker.
 Vaseliu et al (2002) – OHL often associated with OC.Vaseliu et al (2002) – OHL often associated with OC.
 Frezzini et al (2005) – Decreased prevalence of oralFrezzini et al (2005) – Decreased prevalence of oral
lesions due to ART.lesions due to ART.
OVERALL PREVALENCE OF THE DISEASE IS ALARMING.
REPRESENTS ONLY
THE TIP of THE ICEBERG.

IMPORTANCE OF ORAL CAVITY.
ORAL HEALTH IS AN INTEGRAL PART OF PHYSICAL AND
MENTAL HEALTH.
PATIENT EDUCATION.
CLOSE COLLABORATION AMONG MEDICAL AND DENTAL
PERSONNEL IS DESIRABLE TO FULFILL THE ROLE OF
“ORAL PHYSICIAN IN HEALTH CARE”.
CONCLUSION

DIAGNOSIS IS NOT THE END,DIAGNOSIS IS NOT THE END,
BUT THE BEGINNING OFBUT THE BEGINNING OF
PRACTICE….!PRACTICE….!
-- MARTIN H.MARTIN H.
FISCHERFISCHERwww.indiandentalacademy.com

THANK YOU
“and as we let our own light shine,
we unconsciously give other people
permission to do the same. As we are
liberated from our own fear, our
presence automatically liberates
others”.
Nelson MandelaNelson Mandela

OROFACIAL MANIFESTATIONS AS INDICATORS OF HIV/AIDS AMONG DENTAL PATIENTS /prosthodontic courses

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