Oral Health›Health conditions and your mouth

HIV and Oral Health

HIV can make some mouth problems more likely, and effective treatment has made many of them less common. Here is what to look out for, how to protect your teeth, and your right to dental care.

Updated September 2026·By the OHA editorial team·8 min read·How we write
Key takeaways
  • HIV weakens the immune system, which can make mouth problems such as thrush, dry mouth, gum disease, ulcers, cold sores, warts and hairy leukoplakia more likely.
  • HIV treatment protects the immune system, and the US National Institute of Dental and Craniofacial Research (NIDCR) says it has made some mouth problems less common. Most can be treated.
  • Some HIV medicines can dry the mouth. Tell your doctor, and keep taking your treatment as prescribed.
  • The American Dental Association recommends that dental care is part of every HIV treatment plan: brush twice a day, clean between your teeth and see a dentist regularly.
  • In the UK, Australia and the US, the law protects people living with HIV from discrimination by dental practices, and practices use the same infection control for every patient.

HIV (human immunodeficiency virus) weakens the immune system. The NHS says there is currently no cure, but with treatment most people with HIV can live a long and healthy life. NIDCR says people with HIV are at special risk of mouth problems, because HIV makes it harder to fight off infection.

How can HIV affect the mouth?

NIDCR lists some of the most common problems as a long-lasting dry mouth, gum disease, mouth ulcers, warts, cold sores, thrush, hairy leukoplakia and tooth decay. The American Dental Association's (ADA) MouthHealthy site says they can make chewing or swallowing painful, which may make it harder to take HIV medicine and eat well.

Oral thrush

Thrush (oral candidiasis) is a fungal infection. NIDCR describes white or yellowish patches, sometimes red areas, that leave redness or bleeding if wiped away, and sometimes a burning feeling. It is not contagious and is treated with prescription antifungal lozenges, mouthwash or tablets. See oral thrush.

Mouth ulcers and cold sores

NIDCR describes aphthous ulcers (canker sores) as painful red sores, sometimes with a yellow-grey film, on the tongue or inside the cheeks and lips. They are not contagious and can be treated with a pharmacy cream or, on prescription, a steroid mouthwash or tablets. Herpes sores are usually on the roof of the mouth, and on the lips are called cold sores. NIDCR says these are contagious, and a prescription tablet can shorten outbreaks. See mouth ulcers and cold sores.

Oral hairy leukoplakia

Oral hairy leukoplakia is caused by the Epstein-Barr virus. NIDCR describes white patches that do not wipe away, sometimes thick and "hairlike", usually on the side of the tongue. They are not usually painful and often need no treatment.

Warts

NIDCR describes small white, grey or pinkish rough bumps that look like cauliflower. The ADA's guidance for dentists links them to human papillomavirus (HPV). A doctor can remove them surgically or by freezing, but they can come back.

Gum disease and tooth decay

NIDCR lists gingivitis (inflamed gums), periodontitis (bone loss around the teeth) and tooth decay. MouthHealthy also lists "red band gingivitis", a red line along the gums, and ulcerative periodontitis, a severe form of gum disease. The ADA's guidance for dentists says gum disease together with less saliva makes decay more likely. See gum disease.

Other conditions

MouthHealthy also lists Kaposi sarcoma, which healthdirect Australia names among the cancers that can develop with AIDS. The NHS lists a weakened immune system, for example from HIV, among the risk factors for mouth cancer.

How does HIV treatment change this?

HIV is treated with antiretroviral therapy (ART), medicines that stop the virus from multiplying. The NHS says the aim is an undetectable viral load (too little HIV in the blood to measure), and that with the right treatment most people with HIV do not develop AIDS. The Better Health Channel (Victoria) says AIDS is now very rare in Australia.

NIDCR says ART has made some mouth problems less common, and the most common ones can be treated. The ADA's guidance for dentists says they still occur, and can be found by a thorough examination of the mouth. MouthHealthy advises taking your HIV medicine on schedule.

Dry mouth and HIV medicines

Saliva protects teeth from decay and keeps bacteria and fungi in check (NIDCR). The ADA's guidance for dentists says some antiretroviral medicines can reduce saliva, and MouthHealthy says to tell your doctor if your HIV medicine is drying your mouth. NIDCR suggests sipping water or sugar-free drinks often, sugar-free gum or sweets, a mouthwash and toothpaste made for dry mouth, a humidifier at night, avoiding tobacco, alcohol and salty foods, and asking about artificial saliva. See dry mouth and medicines that affect your mouth.

Looking after your mouth

The ADA recommends that dental care is part of all HIV treatment plans. MouthHealthy suggests regular dental appointments, brushing twice a day for two minutes and cleaning between your teeth (see cleaning between your teeth). If you do not have a dentist, it suggests asking your doctor or clinic for a referral; see also finding a dentist.

The ADA's guidance for dentists says all dental practices should be able to provide routine care for people with HIV, and nearly all people with HIV can have routine treatment, including oral surgery. Your dentist may check with your HIV doctor first, for example if recent blood tests showed a low platelet count, which can affect clotting.

Your right to dental care

Some people living with HIV worry about how a dental practice will react. In a 2015 UK survey of 1,528 people living with HIV (published in the British Dental Journal and listed by the UK Health Security Agency), 15% said they had been treated differently from other patients in the previous year and 14% had avoided their dental practice because of their HIV.

The same infection control for everyone

  • UK: NHS England's infection control manual says standard precautions are for "all patients whether infection is known to be present or not".
  • Australia: the Australian Dental Association's infection control guidelines (2024) say patients living with a blood-borne virus such as HIV need the same precautions as other patients, and should not feel they have to hide their medical history because of how staff act.
  • US: the ADA says dental teams should follow standard precautions for all patients.

What the law says

  • UK: GOV.UK says you are treated as disabled under the Equality Act 2010 from the day you are diagnosed with HIV (the Act does not apply in Northern Ireland). The National AIDS Trust says the Act covers health services, including dental surgeries.
  • Australia: the Australian Dental Association's guidelines say refusing to treat, or imposing extra conditions on, a patient living with a blood-borne virus breaches anti-discrimination laws.
  • US: HIV.gov says federal laws, including the Americans with Disabilities Act, protect people with HIV from discrimination, and names dentists' offices among places that may be covered. Complaints go to the HHS Office for Civil Rights, usually within 180 days.

If something goes wrong, see complaints about dental care.

Where to get support

  • UK: the NHS lists the Terrence Higgins Trust helpline, 0808 802 1221, and the National AIDS Trust for information about your rights.
  • Australia: the Better Health Channel lists Thorne Harbour Health (formerly the Victorian AIDS Council), Living Positive Victoria and Positive Women. South Eastern Sydney Local Health District lists Positive Life NSW, ACON and the Australian Federation of AIDS Organisations (AFAO).
  • US: HIV.gov has an HIV services locator, and the HHS Office for Civil Rights takes calls on (800) 368-1019.
When to see a dentist
  • You notice white or red patches, sores, lumps or warts in your mouth, or a burning feeling.
  • Your gums are red, swollen or bleeding.
  • Your mouth feels dry most of the time.
  • Chewing or swallowing hurts, making it harder to eat or take your medicines (MouthHealthy).
Get help urgently
  • The NHS says to ask for an urgent dental appointment, or contact NHS 111, if you think you have a dental abscess, for example intense toothache or a swollen face or jaw.
  • Call 999 or go to A&E (or your local emergency number) if you find it hard to breathe, speak or swallow, have a lot of swelling in your mouth, or cannot open your mouth (NHS).

Frequently asked questions

Can a dentist refuse to treat me because I have HIV?

No. In the UK, Australia and the US this is unlawful discrimination, and the ADA says all dental practices should be able to provide routine care for people with HIV.

Do I have to tell my dentist I have HIV?

The National AIDS Trust (UK) says it is your decision whether you tell someone, and that your HIV status is protected health information. The ADA says a full medical history helps a dentist plan safe treatment.

Are other patients at risk at the dentist?

healthdirect Australia says HIV is not spread by saliva, kissing or sharing cups. The ADA notes that saliva can become mixed with blood during dental procedures, which is why dental teams use standard precautions for every patient.

Sources

  1. HIV/AIDS and oral health problems, NIH National Institute of Dental and Craniofacial Research, accessed September 2026
  2. HIV, AIDS and oral health, American Dental Association (MouthHealthy), accessed September 2026
  3. Human immunodeficiency virus (HIV), American Dental Association, accessed September 2026
  4. HIV and AIDS, NHS, accessed September 2026
  5. Mouth cancer: causes, NHS, accessed September 2026
  6. Dental abscess, NHS, accessed September 2026
  7. National infection prevention and control manual: chapter 1, standard infection control precautions, NHS England, accessed September 2026
  8. Definition of disability under the Equality Act 2010, GOV.UK, accessed September 2026
  9. HIV: know your rights, National AIDS Trust, accessed September 2026
  10. The people living with HIV STIGMAsurvey UK 2015: stigmatising experiences and dental care, UK Health Security Agency research portal (British Dental Journal, 2018), accessed September 2026
  11. HIV infection and AIDS, healthdirect Australia, accessed September 2026
  12. HIV and AIDS, Better Health Channel (Victoria), accessed September 2026
  13. Guidelines for infection prevention and control, fifth edition, Australian Dental Association, 2024, accessed September 2026
  14. Resources for people with HIV, South Eastern Sydney Local Health District (NSW Health), accessed September 2026
  15. Civil rights, HIV.gov (US Department of Health and Human Services), accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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