Early detection of HIV-related oral lesions can be used to diagnose HIV infection

Early detection of HIV-related oral lesions can be used to diagnose HIV infection, monitor the disease’s progression, predict immune status and result in timely therapeutic intervention. The treatment and management of oral HIV lesions can considerably improve oral health, quality of life and wellbeing.

Oro-dental trauma is an impact injury to the teeth and/or other hard or soft tissues within and around the mouth and oral cavity. The world prevalence of traumatic dental injuries in either dentition (primary and permanent) is around 20 per cent.
Oro-dental trauma can be caused by oral factors (e.g. increased overjet); environmental factors (for example, unsafe playgrounds or schools); risk-taking behaviour; and violence. Treatment is costly and lengthy and sometimes can even lead to tooth loss, resulting in complications for facial and psychological development and quality of life.
Noma is a necrotizing disease that affects children between the ages of 2 and 6 years suffering from malnutrition, affected by infectious disease, living in extreme poverty and with weakened immune systems.

Noma is mostly prevalent in sub-Saharan Africa, but rare cases are reported in Latin America and Asia. Noma starts as a soft tissue lesion (a sore) of the gums, inside the mouth. The initial gum lesion then develops into an ulcerative, necrotizing gingivitis that progresses rapidly, destroying the soft tissues and further progressing to involve the hard tissues and skin of the face.

In 1998, WHO estimated that there were 140 000 new cases of noma annually.13 Without treatment, noma is fatal in 90 per cent of cases. Where noma is detected at an early stage, its progression can be rapidly halted, through basic hygiene, antibiotics and nutritional rehabilitation.

Such early detection helps to prevent suffering, disability and death. Survivors suffer from severe facial disfigurement, have difficulty speaking and eating, face social stigma, and require complex surgery and rehabilitation.
Clefts of the lip and palate are heterogeneous disorders that affect the lips and oral cavity and occur either alone (70 per cent) or as part of a syndrome, affecting more than 1 in 1000 newborns worldwide.

Although genetic predisposition is an important factor for congenital anomalies, other modifiable risk factors such as poor maternal nutrition, tobacco consumption, alcohol and obesity during pregnancy also play a role. In low-income settings, there is a high mortality rate in the neonatal period.15 If lip and palate clefts are properly treated by surgery, complete rehabilitation is possible.