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Adv Dent Res 19:139-145, April, 2006
© 2006 International and American Associations for Dental Research

(B2) Periodontal Diseases and Other Bacterial Infections

Presented at the Fifth World Workshop on Oral Health and Disease in AIDS, Phuket, Thailand, July 6–9, 2004, sponsored by Prince of Songkla University, Thailand, the International Association for Dental Research, the World Health Organization, the NIDCR/National Institutes of Health, USA, and the University of California-San Francisco Oral AIDS Center.

M. Umadevi1, O. Adeyemi2, M. Patel3, P.A. Reichart4, and P.G. Robinson5,*

1 Department of Oral and Maxillofacial-Pathology, Ragas Dental College and Hospital, Chennai, India
2 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
3 Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, Faculty of Health Sciences, South Africa
4 Department of Oral Surgery and Dental Radiology, Center for Dental Medicine, Charité, University of Medicine Berlin, Berlin, Germany; and
5 Dental Public Health, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA, UK

Correspondence: * corresponding author, peter.g.robinson{at}sheffield.ac.uk

The workshop addressed the following questions with respect to periodontal diseases and bacterial infections seen in HIV infection: (1) What is linear gingival erythema? Is it prevalent only in HIV disease? A crude Delphi technique was used to ascertain whether LGE existed, but a consensus could not be reached. It was agreed that a diagnosis of LGE should be considered only if the lesion persists after removal of plaque in the initial visit. (2) Do periodontal pockets contribute to viremia in HIV infection? At present, the data are not available to answer this question. (3) Do anti-viral drugs reach the sulcular fluid in significant concentrations? No one at the workshop was aware of data that could answer this question. (4) Does concurrent tuberculosis infection modify the oral manifestations of HIV infection? Though analysis of data from the developing countries does suggest an association between tuberculosis and oral candidiasis, more data and multivariate analysis considering immunosuppression as a confounding factor are necessary, for any conclusions to be derived. (5) What pathogens are involved in periodontal diseases in HIV infection? Periodontal disease may be initiated by conventional periodontal pathogens. But the progression and tissue destruction depend upon the presence of typical and atypical micro-organisms, including viruses, their by-products, increased secretion of potentially destructive inflammatory mediators, and overwhelming host response. (6) How can we diagnose the diseases seen in HIV infection? The answer can be obtained only with data from controlled and blinded studies. It is necessary to design collaborative multi-center longitudinal studies. The results obtained from such large sample sizes can contribute eventually to interpretation of the outcome.

KEY WORDS: Oral • HIV • linear gingival erythema • periodontitis • bacterial • tuberculosis






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