Hesperian Health Guides
Chapter 12: HIV and Care of the Teeth and Gums
Many things in the world have changed since Where There Is No Dentist was first published in 1983. One of the most profound changes has been the spread of HIV and AIDS worldwide. Although millions of people are now infected with HIV, the illness is still surrounded by fear and disinformation. This chapter explains HIV and AIDS, what they mean for people who are infected and for oral health workers, and how we can all work together to prevent the spread of HIV and make sure everyone with HIV has access to ART medicines so they can live long, healthy lives.


Mary and David
Mary was 17 years old. She and her boyfriend David were expecting a baby. David was Mary’s first boyfriend and he was very attentive and kind to her. But David had not been well lately. His mouth had been very sore and smelled bad all the time. Although he did not seem to have problems with his teeth, it was hard to chew or swallow, and white spots appeared on the roof of his mouth. Mary thought he should go to see the dental worker at the health center. At first David refused. He said he did not want to talk about it in a nervous voice. Finally David agreed to go if Mary would go too.
David said he wanted to see the dental worker by himself. So Mary sat in the waiting room while David saw the dental worker.
After a while the dental worker came out and asked Mary to come into the room. David was sitting on a chair looking worried. He tried to give Mary a smile, but she could see his heart was not in it. The dental worker asked David if she could tell Mary what she had found in David’s mouth. David agreed, so the dental worker explained to Mary that David did not have any problems with his teeth. He had infections in his mouth, gums, and throat. This was why his mouth was sore and smelled bad all the time.
The dental worker said she would give David the oral care he needed. But she also said she thought David’s problem might be caused by a serious infection called HIV. That would explain why his body is weak and he is unable to fight off the infection in his mouth. But to be sure, David should get a blood test for HIV. And because HIV can be passed from one person to another she encouraged Mary to get tested too. She explained that the sooner you find out if you have HIV, the sooner you can start taking medicines that help you and your baby live long and healthy lives.

problem in David's mouth, but I think he has a serious infection.
if you have HIV you can protect yourselves and your baby.
This story shows why it is important for dental workers to know about infections in the mouth that may be caused or made worse by HIV. With correct and up-to-date information, dental workers can give the good dental care everyone deserves, and can help prevent HIV from spreading to other people or to themselves.
Health and dental workers must give people with HIV the care they need. Make sure your health system provides the resources (equipment, medicines) you need to give good care.