How HIV can affect your tongue and oral health

Time of India

16 hours ago

HIV (human immunodeficiency virus) doesn't just weaken the immune system; it can also show some of its earliest signs in the mouth. The tongue, gums, lips, and inner cheeks are especially vulnerable to infections and sores when the body's defences are low.
These oral problems are not only uncomfortable but can also affect eating, speaking, and overall quality of life. In fact, certain changes in the mouth may be warning signals that HIV is progressing. Knowing how HIV impacts oral health makes it easier to spot early signs, seek timely care, and protect overall wellbeing.
Common tongue and mouth conditions linked to HIV
According to the
National Institute of Dental and Craniofacial Research
, people living with HIV often experience a range of oral problems, some of which are directly related to the virus, while others are due to opportunistic infections that take advantage of a weakened immune system.
Canker sores (aphthous ulcers): These small, painful sores appear as round or oval ulcers with a red border and a yellow or gray center. They often show up on the tongue, inside the cheeks, or along the lips. For people with HIV, canker sores can be more frequent and severe. While mild ulcers usually heal on their own, severe cases may need prescription medications such as corticosteroid mouth rinses.
Oral thrush (candidiasis): According to a
study
published in NIH, this is the most common fungal infection among people with HIV. Thrush looks like creamy white or yellow patches on the tongue and can spread to the throat, tonsils, or roof of the mouth. It may cause pain, burning, or bleeding when scraped. Since HIV weakens the immune system and often causes dry mouth, the natural balance of fungi in the mouth is disrupted, allowing yeast to grow unchecked. Antifungal medications are effective, but thrush can return if the immune system remains suppressed.
Oral hairy leukoplakia (OHL): Caused by the Epstein-Barr virus, OHL produces white, fuzzy patches on the sides of the tongue. These patches may be painless but can sometimes affect taste or cause sensitivity. While not dangerous on its own, OHL is usually a sign of advanced immune suppression and is more common in untreated HIV. Antiviral drugs or topical treatments may help, but the underlying viral infection cannot be cured.
Oral herpes: The herpes simplex virus can flare up more often in people with HIV. Painful blisters or clusters of sores appear on the tongue, lips, or roof of the mouth. These sores are contagious and may spread through kissing or sharing utensils. There is no cure for herpes, but antiviral medicines can shorten outbreaks and reduce recurrence.
Oral warts: Caused by human papillomavirus (HPV), oral warts may appear as small, raised bumps or flat, cauliflower-like growths on the tongue or inside the mouth. They are usually painless but can be persistent. Cryotherapy or surgical removal can help, although warts may return. People aging with HIV or those on long-term antiretroviral therapy are at higher risk.
Oral melanin hyperpigmentation: Dark brown or black patches may develop inside the mouth, especially on the tongue and gums. These patches are usually harmless and are often linked to certain HIV medications such as zidovudine (AZT). While treatment is not usually required, medication changes can sometimes reduce pigmentation.
Why
oral health is important in HIV management
Oral problems in HIV are more than surface-level discomforts. Painful sores, fungal infections, or warts can make it difficult to eat, speak, and maintain good nutrition. Persistent lesions are also early warning signs that HIV may be progressing or that current treatment is not fully controlling the virus. Because some oral conditions—like oral thrush and OHL—are linked to specific infections, they can also help healthcare providers gauge the strength of a patient's immune system.
Preventing oral health complications with HIV
Good oral hygiene is one of the most effective ways to prevent complications. Brushing twice a day, flossing daily, and visiting a dentist at least every six months can reduce infections. People with HIV should also take these extra steps:
Stick to HIV treatment: Antiretroviral therapy strengthens the immune system and reduces the risk of oral complications.
Prevent dry mouth: Dryness increases the chance of infections. Avoid tobacco, alcohol, and overly salty foods, and drink plenty of water. Specialized mouth rinses or toothpastes can also help.
Limit triggers: Smoking, poor diet, and lack of hydration make oral problems worse. Using a humidifier at night may also help maintain moisture in the mouth.
Not all mouth sores are serious, but in the context of HIV, they should never be ignored. If you notice persistent ulcers, white patches, warts, or unexplained discoloration, schedule a medical or dental evaluation.
Oral changes may indicate that your immune system is weakening or that your treatment needs adjusting.
Other signs that HIV may be progressing include fatigue, fever, swollen lymph nodes, night sweats, and unexplained rashes. Addressing oral health early can prevent more serious complications such as bacterial infections or sepsis, which can be life-threatening with a weakened immune system.
Oral health plays a vital role in HIV management. From canker sores and thrush to herpes and warts, many oral conditions arise because of a weakened immune system.
By practicing good hygiene, keeping up with antiretroviral treatment, and seeking timely care for new symptoms, people with HIV can reduce the risk of oral complications and protect their overall health.
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