HIV

• What is HIV?

  Human immunodeficiency virus
• How many stages does HIV have?

  Four stages
• What is the CD4 count in Stage 1 of HIV?

  CD4+ cell count = < 400
• What lesions are associated with Stage 1 HIV?

  NUG and candidal infections
• What is the CD4 count in Stage 2 of HIV?

  CD4+ cell count = < 200
• What lesions are associated with Stage 2 HIV?

  NUP and major opportunistic infections
• What is the CD4 count in Stage 3 of HIV?

  CD4+ cell count = < 100
• What are the consequences of Stage 3 HIV?

  Leads to fatal opportunistic infections
• What is the CD4 count in Stage 4 of HIV?

  CD4+ cell count = < 50
• What is the expected outcome in Stage 4 HIV?

  Death within 12 months
• What is the normal range for CD4 count in healthy adults?

  500 to 1,200 cells/mm³
• What are CD4 cells?

  Helper T cells that fight infection
• Do patients have a legal obligation to inform dental professionals of their HIV status?

  No legal obligation to inform
• Can dental professionals refuse treatment to HIV positive patients?

  No, they cannot refuse treatment
• How is HIV transmitted?

  Through blood, sexual contact, breastfeeding
• What is the risk of HIV transmission during dental treatment?

  No risk if standard protocols are followed
• What are standard infection protocols in dental treatment?

  Wearing PPE and sterilizing instruments
• What oral conditions are associated with HIV?

  Gingivitis, perio, NUP/NUG, ulceration
• What is the role of the DHT in managing HIV patients?

  • Educate and motivate for good oral hygiene
  • Provide periodontal treatment and restorative care
  • Regular maintenance and dietary advice
  • Fluoride application
• What should a patient rinse with before ultrasonic treatment?

  CHX 0.2% for 1 minute
• What is the first step in periodontal treatment?

  Education and motivation with full mouth PMPR
• What should be done if code 3/4 sextants remain after step 1?

  Undergo RSD for calculus removal
• What is the healing period after RSD?

  Three-month healing period
• What should the DHT promote to prevent calculus build-up?

  Use of interdental brushes
• How often should duraphat FV be applied?

  2-4 times annually
• What should the DHT advise regarding fluoride toothpaste?

  Brush before breakfast and after meals
• What should be recommended for mouthwash use?

  Use at a different time to brushing
• What should be applied to molars to prevent caries?

  Fissure sealants
• What dietary advice should be given to HIV patients?

  Cut down on sugary snacks and drinks
• What technique can the DHT demonstrate to improve oral hygiene?

  Modified bass brushing technique
• How can xerostomia be managed?

  Sip water and avoid dry foods
• What treatments can be used for candidal infections?

  Nystatin, fluconazole, alcohol-free CHX
• How often should high-risk patients be recalled?

  Every three months
• How often should bitewing radiographs be taken?

  Every six months until no new lesions
• What should be done if no new lesions are found?

  Move to 12-month radiograph recall
• What care should be provided for patients with high CD4 counts?

  Provide palliative care for quality of life