For instance, as the T-Cell counts drop in AIDS patients, they are more at risk for opportunistic infections that frequently appear in the mouth, he said. Viral infections such as herpes and hairy leukoplakia and fungal infections such as candidiasis are often detected and can be treated by the dentist, he explained. Dentists often treat these patients aggressively with chlorahexidene and antibiotics and they may have to remove some tissue that has died due to this more active form of periodontitis. With some medical treatments, such as radiation or chemotherapy, it is essential for both the dentist and physician to communicate before medical or dental treatment begins. Some states may require consent for such consultations.
Radiation dries up salivary flow in patients, leading to rapid tooth decay.
Dr. Carpenter recommends that most dental treatment be done before radiation and that afterwards, dentists prescribe fluoride to ward off cavities. Dentists often may give these patients artificial saliva in the form of toothpaste, mouth rinse or chewing gum. He said that, in these patients, dentists should prescribe antibiotics to prevent bacteria that travels from the mouth to the heart from becoming infectious. In healthy people, this does not occur, but in patients with certain cardiovascular diseases, these bacteria seem to adhere and grow, causing damage which can result in death. After detection and referral to a physician for diagnosis, dentists must be careful with patients on medications prescribed for high blood pressure.