Acquired immunodeficiency syndrome – A pedodontist ’ s perspective

AIDS was believed to be associated with a certain group of people, later the belief changed when the disease start encroaching other set of people. As science evolved, the knowledge about transmission of the virus grew and the evidences for the maternal transmission of the virus were found. Among children, most cases of infection by HIV are transmitted vertically, i.e., from mother to child. As they have an immature immune system, which may cause the rapid and severe progression. Children who are vertically infected present considerable weight loss, delayed development, delayed dental eruption, fewer permanent teeth, prolonged retention of primary teeth and various number of dental anomalies. The most important comeback by the science was by the establishment of antiretroviral protocols which has reduced the occurrence of oral changes. There been a decline in the rate of HIVrelated oral manifestations following the introduction of HAART. Many studies evaluating the efficacy of HAART demonstrated positive results and better lifestyle of the infected children. It is clearly known fact that there are considerable regional variations in the oral manifestations of HIV infection, depending both on the populations studied and on the clinical expertise available, among other factors. This review article explains the manifestations, dental implications and the various treatment regimens to be followed in pediatric patients. Key word: AIDS, pediatric dentistry, HIV, HAART, oral manifestations, dental caries Introduction Before 1983, it was believed that AIDS (acquired immunodeficiency syndrome) was restricted to a specific group of people. In the following year, the first cases were reported of the syndromes affecting children. [1] Among children, most cases of infection by HIV are transmitted vertically, i.e., from mother to child. The immune system of newborn children is immature and hence the progression of the disease is rapid and severe. [2] Children who are vertically infected present considerable weight loss and delayed development. [3-7] They may also present the following changes: delayed dental eruption, fewer permanent teeth, prolonged retention of primary teeth and a slightly larger number of dental anomalies. The establishment of antiretroviral protocols has reduced the occurrence of oral changes. [9, 10] However, some authors have reported delayed development even with the use of antiretroviral drugs. [11] The introduction of highly active antiretroviral therapy (HAART) in the mid1990s was an important landmark with therapeutic effects and dramatic changes in the clinical prospects of HIV infection. The rate of HIV-related oral manifestations has declined following the introduction of Dr Aum B Joshi 3 year, MDS Student Dr Manju Gopakumar MDS, Professor Dr Amitha M Hegde MDS, Senior Professor and Head Department of Pedodontics and Preventive Dentistry AB Shetty Memorial Institute of