Oral Disease Associated with HIV- Management in a Resource-Poor Country

Under conditions of limited resources, it is recommended that there be emphasis on prevention and educating adult HIV/AIDS patients and older children to take responsibility for the maintenance of their oral health. Conventional health care providers are required to accommodate patients who also consult traditional healers or self-medicate with natural remedies, and endeavour to determine the benefit thereof. Where language barriers exist, special care should be taken to ensure that patients understand how to use prescribed medication. With candidiasis as the most common oral complication, it should not be merely accepted that available antifungal drugs are effective.

In the case of HIV/AIDS orphans, particularly those living in child-headed households, a multi-disciplinary approach is required, with all members of the team trained to recognise possible signs and symptoms of an underlying immune deficiency. Among young children oral candidiasis is also the strongest indicator of an underlying HIV-infection, however, obtaining consent to have a child tested for HIV can pose a significant challenge. Carious teeth harbour candida and unless removed, remain a source of potential infection, and re-infection, in an immunocompromised individual. Portable dental equipment taken to food and services delivery sites where these children congregate, proved to be the most effective model for delivery of oral health care. Although there is limited evidence of the spread of oral warts among children in orphanages, in the absence of treatment this condition is of concern to the management of such institutions. Regular tooth brushing, even without tooth paste, is successful in reducing oral yeast carriage. Care should also be taken to ensure that each child uses only his/her own toothbrush as it can be a vehicle of transmission of oral yeasts among children.