ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION
description
Transcript of ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION
![Page 1: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/1.jpg)
ORAL HEALTH IN WOMEN
ORAL MANIFESTATIONS OF HIV INFECTION
![Page 2: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/2.jpg)
DENTAL HEALTH CARE PROVIDER
TEAM APPROACH
![Page 3: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/3.jpg)
EPIDEMIOLOGY OF HIV-RELATED ORAL MANIFESTATIONS IN
WOMEN
![Page 4: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/4.jpg)
Epidemiology of HIV-Related Oral Manifestations in Women: A Review
Oral Lesions in 15% of HIV-Infected Women
Most Common Oral Lesion - Candidiasis Prevalence of Hairy Leukoplakia and
Kaposi's Sarcoma Significantly Less Common in Women
Oral Dis 1997 Sep;3(3):206.
![Page 5: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/5.jpg)
Many Manifestations of HIV Disease are Similar in Men & Women
Other Conditions Differ In Frequency:– HIV-Infected Men 8 X’s More Likely to
Develop Kaposi's Sarcoma – Women Have Higher Rates of
Esophageal Candidiasis & Herpes Simplex Infections
![Page 6: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/6.jpg)
CHANGING PREVALENCE OF
ORAL MANIFESATIONS
![Page 7: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/7.jpg)
Overall Prevalence of Oral Lesions Has Decreased (47.6%-37.5%)
Hairy Leukoplakia (25.8%-11.4%) & Necrotizing Periodontal Diseases (4.8%-1.7%) Decreased
![Page 8: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/8.jpg)
HIV Salivary Gland Disease Increased (1.8%-5.0%)
Candidiasis (20.3%-16.7%), Aphthae (3.7%-3.0%), Oral Warts (2.2%-4.0%), Herpes Simplex Virus Lesions (1.8%-2.0%) and Kaposi’s Sarcoma (1.1%-0.3%) Unchanged
![Page 9: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/9.jpg)
HIV/AIDS Women's Health: Oral Lesions in HIV-Positive Women
Reduced in HAART Therapy
503 HIV+ women over 6 years Incidence of EC fell to 2.99 percent
from 5.48 percent PC fell to 2.85 percent from 6.70
percent No changes were seen in HL or warts
Women's Health Weekly (03.25.04)
![Page 10: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/10.jpg)
CANDIDIASIS
![Page 11: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/11.jpg)
Reported in 7-93% of HIV+ /AIDS
Patients
![Page 12: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/12.jpg)
FOUR MAJOR TYPES
Pseudomembranous Hyperplastic Erythematous (Atrophic) Angular Cheilitis
![Page 13: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/13.jpg)
PSEUDOMEMBRANOUS
White or Yellow Patches Easily Removed w/ Scraping
Yielding Bleeding Surface Any Mucosal Surface (Palate,
Buccal or Labial Mucosa, Tongue)
![Page 14: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/14.jpg)
HYPERPLASTIC CANDIDIASIS
White Plaques Can’t Be Removed w/ Scraping
Buccal Mucosa Most Common Site in HIV+ Patients
![Page 15: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/15.jpg)
ERYTHEMATOUS (ATROPHIC)
Fiery Red Surfaces to Hardly Discernible Pink Spots
Most Common Location - Palate & Dorsum of Tongue
Spotty Areas in Buccal Mucosa
![Page 16: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/16.jpg)
ANGULAR CHEILITIS
Common in Elderly Fissures Radiating From
Angles of Mouth
![Page 17: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/17.jpg)
PREDISPOSING FACTORS
![Page 18: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/18.jpg)
SYSTEMIC FACTORS
Age Use of Antibiotics Xerostomia Nutritional Deficiencies Immunosuppression Gastric Reflux
![Page 19: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/19.jpg)
LOCAL FACTORS
Ill-Fitting Dentures Poor Prosthesis Hygiene Heavy Smoking Topical Medications
![Page 20: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/20.jpg)
CANDIDIASIS TREATMENT
Nystatin Oral Susp– 480 ml– Rinse w/ One Tablespoonful QID
Clotrimazole (Mycelex) Troches– 10 mg Troches– 3-5 Times a Day for 7-14 Days
![Page 21: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/21.jpg)
Ketoconazole (Nizoral)– 200 mg– 200-400 mg Daily for 7-14 Days
Fluconazole (Diflucan)– 100 mg Tabs– 2 Tabs First Day, Then 1 Tab Daily for 14
Days Itraconazole (Sporanox)
– 100 mg Tablets– 1 tablet B.I.D. for 14 days
![Page 22: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/22.jpg)
OROFACIAL VIRAL INFECTIONS IN
IMMUNOCOMPROMISED HOST
![Page 23: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/23.jpg)
HAIRY LEUKOPLAKIA
First Identified Among HIV+ Individuals
Never Described Before AIDS Epidemic
![Page 24: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/24.jpg)
CLINICAL PRESENTATION
Painless White Patches Do Not Rub Off Lateral Borders of the Tongue Surface May Be Smooth,
Corrugated or Markedly Folded Thick, Hair-Like Projections
![Page 25: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/25.jpg)
DIFFERENTIAL DIAGNOSIS
Hyperplastic Candidiasis Geographic Tongue Lichen Planus Frictional Keratosis Leukoplakia
![Page 26: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/26.jpg)
HAIRY LEUKOPLAKIA - PATHOGENESIS
Epstein-Barr Virus
![Page 27: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/27.jpg)
HAIRY LEUKOPLAKIA TREATMENT
Appears to Be Little Advantage in Treating
Surgical Removal–Laser
Acyclovir Topical Vitamin A
![Page 28: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/28.jpg)
HUMAN PAPILLOMA VIRUS
LESIONS
![Page 29: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/29.jpg)
HUMAN PAPILLOMA VIRUSES
More Than 100 Human Papilloma Virus (HPV) Types
24 Associated with Oral Lesions
![Page 30: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/30.jpg)
HPV ORAL LESIONS
Warts, Papillomas Condyloma Acuminatum Verruca Vulgaris Focal Epithelial Hyperplasia Dysplasia / Carcinoma
![Page 31: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/31.jpg)
HUMAN PAPILLOMA VIRUS LESIONS
![Page 32: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/32.jpg)
CONDYLOMA ACUMINATUM
Sexually Transmitted Appears 1-3 Months After
Exposure Multiple Wart-Like Lesions Lips, Lingual Frenum & Tongue
![Page 33: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/33.jpg)
TREATMENTCONDYLOMA ACUMINATUM
Surgical Removal Cryotherapy Laser Therapy Medications
![Page 34: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/34.jpg)
KAPOSI’S SARCOMA
![Page 35: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/35.jpg)
Originally Described in 1872 - Idiopathic
Multiple Sarcomas of the Skin
![Page 36: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/36.jpg)
Previously Uncommon in USA
Elderly Jewish Men of Eastern European or Mediterranean Descent
Usually Involved Lower Extremities Indolent Course 1981 - Fulminant, Aggressive Form
Occurring in Young Homosexual Men w/ AIDS
![Page 37: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/37.jpg)
>50% of AIDS Patients w/ KS Display Oral Lesions
Remains Significant Cause of Morbidity & Mortality in HIV Infected Patients
![Page 38: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/38.jpg)
CLINICAL PRESENTATION Angiomatous Malignancy of Skin,
Mucosa, and Internal Organs Most Common Intraoral Locations
– Palate– Gingiva
Non-Elevated Macules, Nodules or Papules
Brown, Blue, Purple
![Page 39: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/39.jpg)
KAPOSI’S SARCOMAPATHOGENESIS
Sexually Transmitted Cofactor Human Herpes Virus 8 (HHV 8)
![Page 40: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/40.jpg)
TREATMENT Treatment Reserved for Lesions
Which Interfere w/ Function or Esthetics
Laser Excision Cryotherapy Radiation Intralesional Injection w/ Vinblastine
![Page 41: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/41.jpg)
CANCER IN PATIENTS WITH
AIDS
![Page 42: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/42.jpg)
AIDS AND CANCER
Roche et al, NJ Med 2001,Jan;98(1);27-36 2460 Persons w/ AIDS and Cancer 2159 Males, 301 Females 50% Kaposi’s Sarcoma 33% Non-Hodgkins Lymphoma Lung, Oral, Cervical, Hodgkins Lymphoma,
Other Digestive
![Page 43: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/43.jpg)
RECURRENT ORAL
ULCERATIONS
![Page 44: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/44.jpg)
RECURRENT APHTHOUS
STOMATITIS
![Page 45: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/45.jpg)
EPIDEMIOLOGY Prevalence in General
Population 10-20% 67-85% Develop Prior
to Age 30 Familial Disposition
![Page 46: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/46.jpg)
MINOR APHTHAE Superficial Erosion with Fibrinous
Coating & Red Halo Single or Multiple Lesions 2-3 mm’s to Over 10 mm’s in
Diameter Persists for 7-10 Days Painful
![Page 47: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/47.jpg)
MAJOR APHTHAE
Large Painful Ulcerations Single or Multiple Lesions Persists Up to 6 Weeks Heal w/ Scarring
![Page 48: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/48.jpg)
GENERAL RULE
Aphthae Occur on Mobile Mucosa
Herpetic Lesions Occur on Tissue That is Firmly Bound Down
![Page 49: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/49.jpg)
FACTORS ASSOCIATED WITH APHTHAE
Psychological (Stress) Trauma Socio-Economic S.
sanguis Endocrine Immunosuppression Hereditary Hypersensitivity Chemicals in Food
![Page 50: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/50.jpg)
TREATMENT
Chlorhexidine Topical Steroids
–Lidex Gel .05% Aphthasol Cream 5%
![Page 51: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/51.jpg)
HERPES SIMPLEX INFECTIONS
![Page 52: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/52.jpg)
RECURRENT HERPETIC STOMATITIS
Attenuated Form of Primary Infection
Tissue Firmly Bound Down Vesicles Burst to Form Ulcers Coalesce Heals in 7-10 Days
![Page 53: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/53.jpg)
HERPES LABIALIS
![Page 54: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/54.jpg)
SYSTEMIC ANTIVIRALS
Acyclovir (Zovirax) 200 mg CapsulesOne Capsule 5 Times a Day
Valacyclovir (Valtrex) 1 gm CapletsTwo Caplets Twice a Day
Famciclovir (Famvir) 125 mg TabletsOne Tablet Twice Daily
![Page 55: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/55.jpg)
TOPICAL ANTIVIRALS
Zovirax (Acyclovir) Ointment 5%– 15 Gram Tube– Apply TID
Denavir (Penciclovir) Cream 1%– 2 Gram Tube– Apply Every Two Hours
![Page 56: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/56.jpg)
AIDS RELATED PERIODONTAL DISEASE
Linear Gingival Erythema Necrotizing Ulcerative Gingivitis Necrotizing Ulcerative Periodontitis Necrotizing Ulcerative Stomatitis
![Page 57: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/57.jpg)
LINEAR GINGIVAL ERYTHEMA
A Persistent, Linear Erythematous Gingivitis Which Bleeds Easily
Resistant to Treatment Spontaneous Remission
![Page 58: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/58.jpg)
NECROTIZING ULCERATIVE GINGIVITIS
Also Known as ANUG Acute Gingivitis Characterized by
Ulceration & Necrosis of the Gingival Margin & Destruction of the Interdental Papilla
Gingival Pain
![Page 59: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/59.jpg)
NECROTIZING ULCERATIVE GINGIVITIS
Profuse Gingival Bleeding Fetid Odor No Involvement of Osseous Tissues Associated w/ Stress, Anxiety,
Malnutrition & Smoking
![Page 60: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/60.jpg)
NECROTIZING ULCERATIVE PERIODONTITIS
Severe Deep Pain Spontaneous Gingival Bleeding Extensive Soft Tissue Necrosis Severe Loss of Periodontal
Attachment
![Page 61: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/61.jpg)
NECROTIZING ULCERATIVE PERIODONTITIS
Rapid Onset & Progression Bone May Be Exposed Associated with Low CD4 Counts
![Page 62: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/62.jpg)
NECROTIZING ULCERATIVE STOMATITIS
Necrosis of Significant Areas of the Oral Soft Tissue & Underlying Bone
![Page 63: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/63.jpg)
INTRAORAL PIGMENTATION
Racial Pigmentation Smoking Amalgam Tattoo Addison’s DiseaseHeavy Metal Poisoning Puetz-Jeger SyndromeMedicationsBirth Control PillsMinocyclineAZT
![Page 64: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/64.jpg)
SALIVARY GLAND DISEASE
Xerostomia Bilateral Parotid Gland Enlargement
Occurs in HIV Infected Individuals Histology Has Been Described as
Resembling Autoimmune Salivary Gland Disease w/ Cystic Changes
![Page 65: ORAL HEALTH IN WOMEN ORAL MANIFESTATIONS OF HIV INFECTION](https://reader035.fdocuments.net/reader035/viewer/2022081504/56814fa0550346895dbd5e17/html5/thumbnails/65.jpg)
Thanks for Coming!
Jacqueline M. Plemons DDS, MS6031 Sherry LaneDallas, TX 75225
(214)[email protected]