References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Mouth problems are among the most common health issues in people living with HIV, particularly when CD4 counts are low or HIV is untreated. Conditions range from oral thrush and mouth ulcers to gum disease and more serious conditions. With effective treatment, many of these problems become much less common, but good oral hygiene and regular dental care remain important.
Here’s what to watch for.
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Common Oral Conditions in HIV
| Condition | Symptoms | When It’s More Likely |
|---|---|---|
| Oral thrush (candidiasis) | White patches on tongue, palate or cheeks that can be scraped off | CD4 below 200 |
| Oral hairy leukoplakia | White, ridged patches on sides of tongue that cannot be scraped off | CD4 below 200 |
| Mouth ulcers (aphthous) | Painful round sores inside the mouth | Any CD4 level |
| Gingivitis and periodontitis | Red, swollen, bleeding gums; loose teeth | More severe with low CD4 |
| Kaposi’s sarcoma | Purple or red lesions on palate or gums | Low CD4 |
| Herpes simplex | Cold sores around lips or inside mouth | Any CD4, more frequent with low |
| Dry mouth | Reduced saliva, difficulty swallowing | Some medications, dehydration |
Treatment
- Oral thrush — antifungal treatment (nystatin mouthwash, fluconazole tablets)
- Mouth ulcers — topical treatments, steroid mouthwash if severe
- Gum disease — dental cleaning, improved oral hygiene, antibiotics if needed
- Herpes — aciclovir or valaciclovir
- KS — ART plus specialist treatment if needed
- Dry mouth — sip water frequently, sugar-free chewing gum, saliva substitutes
Looking After Your Mouth
- Brush twice daily with fluoride toothpaste
- Floss or use interdental brushes daily
- Visit the dentist at least twice a year
- Tell your dentist you have HIV — it’s confidential and helps them give better care
- Don’t smoke — smoking worsens all oral conditions
- Limit sugary foods and drinks
- Stay hydrated
Dental Care and HIV
NHS dental care is available to everyone with HIV. Dentists follow standard infection control procedures and cannot refuse treatment because of your HIV status. You’re entitled to the same care as anyone else.
Read more: HIV and the immune system | Kaposi’s sarcoma | What is HIV?
Frequently Asked Questions
Should I tell my dentist I have HIV?
Yes. It helps them give you better care and watch for HIV-related oral conditions. Your HIV status is confidential within the dental team.
Can a dentist refuse to treat me?
No. Refusing dental treatment because of HIV is unlawful discrimination under the Equality Act 2010.
Will ART fix my mouth problems?
Starting effective treatment often resolves or reduces oral conditions, especially thrush and hairy leukoplakia. Good oral hygiene remains important regardless.
Related reading
- A to Z of Sex: Sexual Health Terms Explained
- Alcohol and HIV: What You Need to Know
- Anxiety and HIV: Coping and Getting Support
- Are All STIs Curable?
- Blood Problems and HIV: Anaemia, Low Platelets and More
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
