By Nor Azlida Mohd Nor and Goh Yet Ching

In Malaysia, recent data from the Ministry of Health indicate that Human Immunodeficiency Virus (HIV) notifications remain a public health concern, with younger individuals increasingly affected.

More than 40 per cent of new HIV infections now occur among those aged 20–29, highlighting a worrying shift towards younger age groups. Majority of these new cases are attributed to sexual transmission, reflecting changing behavioural patterns and highlighting the need for more targeted prevention and education initiatives.

Overlooking oral health

Although major advances in HIV treatment have transformed the condition into a manageable chronic illness, one area that continues to be overlooked is oral health.

For many people living with HIV (PLHIV), the mouth is often the first place where signs of weakened immunity appear. Research shows that up to half may experience at least one HIV-related oral condition in their lifetime. The most frequently reported problems include persistent oral thrush, dry mouth, painful ulcers, gum disease, and in more severe cases, oral hairy leukoplakia and Kaposi sarcoma.

These conditions can affect basic functions such as eating, swallowing and speaking, and may even reduce the effectiveness of medications if swallowing becomes difficult. Importantly, the presence of certain oral lesions can also signal that the immune system is becoming suppressed, serving as an early clinical indicator that individuals should seek further health management.

It is also important to acknowledge that despite the advancement in HIV treatment, some medication can cause changes in the mouth. Conditions such as changes in taste, dryness, hyperpigmentation or burning sensation may be encountered. These changes may be frustrating or worrying.

Stigma and misinformation

Unfortunately, stigma and misinformation continue to discourage many PLHIV from seeking dental treatment. Some individuals still believe that they may be turned away by clinics, while others fear disclosing their HIV status. These barriers result in delayed treatment and poorer oral health outcomes.

When people feel comfortable talking openly with their doctor or dentist about what they’re experiencing, small adjustments or simple treatments can make a big difference. The key is honest communication and knowing that support is available.

Beyond the more familiar problems like oral thrush or oral ulcers, many PLHIV may also face gum diseases that can progress quickly when the immune system is weakened. The gum diseases may be seen in a heterogenous spectrum, leading to pain, bleeding or even tooth mobility.

The good news is that these issues can usually be managed with early dental care. Without timely attention, this problem may lead to long term and irreversible damage. Regular dental check-ups make a big difference. They allow dental teams to step in early and prevent small concerns from becoming bigger health challenges.

Oral health plays a much bigger role in everyday life than most of us realise. A healthy mouth allows people to enjoy their meals, speak without discomfort and feel at ease when interacting with others.

Protecting a person’s confidence

For PLHIV, taking care of their mouth is even more important because it helps prevent infections and supports their body to stay strong during treatment. When dental care is easy to access and free from judgement, it does more than protect teeth. It helps protect a person’s confidence, comfort and overall well-being.

By recognising these challenges and dealing with oral problems early, we can make sure that people living with HIV feel supported, respected and cared for in every part of their health journey.

From a public health perspective, improving oral health for PLHIV requires both clinical and community efforts. Clinically, dental practitioners must remain updated on evidence-based guidelines for managing patients with HIV and maintain a non-discriminatory practice environment.

Standard infection control procedures used in dental clinics are fully adequate for treating all patients, including those with HIV. Therefore, refusal of care based on HIV status is both unethical and unnecessary.

Community awareness is equally important. Public education can help dispel myths about HIV transmission in dental settings and encourage individuals to prioritise oral hygiene. Basic oral hygiene habits such as twice-daily tooth brushing with fluoridated toothpaste, flossing, reducing sugary foods and avoiding tobacco can significantly reduce oral problems. For PLHIV, regular dental check-up is vital to detect early signs of infection or medication-related oral changes.

As Malaysia continues its effort to curb rising infections, understanding the oral health implications of HIV is crucial for safeguarding the overall well-being of young people who may be newly diagnosed. By addressing stigma, improving access to health care, and raising community awareness, we can support the quality of life of people living with HIV.

This reminder is especially timely as the world marks World AIDS Day on 1 December, a day dedicated to raising awareness, reducing stigma and supporting those affected by HIV.

-- BERNAMA

Assoc Prof Dr Nor Azlida Mohd Nor and Dr Goh Yet Ching are affiliated with the Faculty of Dentistry, Universiti Malaya.