One of the most common effects of the Human Immunodeficiency Virus (HIV) is mouth sores. When the immune system weakens so much that the body can’t fight off infections, mouth sores make it painful to eat and drink.
When do HIV Mouth Sores Appear?
HIV has various stages where it develops. Usually, mouth sores start showing up in stage 3 of the disease, also known as the symptomatic stage. During this stage, HIV has compromised the immune system so that the body cannot fight other infections and diseases. Apart from mouth sores, this stage also includes weight loss, severe diarrhea, fever, constant coughing, and other symptoms. 
Early-Stage HIV Mouth Sores
Since HIV patients have compromised immune systems, the chances of getting mouth sores are greater. Mouth sores aren’t a common symptom of HIV, but people tend to develop various forms of mouth sores with HIV since their immune system can’t fight off the infection. Many people end up having blisters around the mouth, while others may develop canker sores or aphthous ulcers.
What do HIV Mouth Sores Look Like?
They develop inside cheeks and lips and around the tongue. Mouth lesions or canker sores are usually red, but yellow or gray films may sometimes cover them. Even though these aren’t direct symptoms of HIV, the chances of having these are higher for someone with HIV.
Thrush or yeast infection may also cause mouth sores during HIV. White, yellow, or red patches can occur anywhere inside the mouth with this infection. Chances of procuring this infection increase for HIV patients.
Acute HIV Mouth Sores
They can become highly painful and difficult to manage alongside HIV, especially when they are something like HPV (Human Papillomavirus). A study showed that 48% of HIV female patients also suffered from HPV rather than 28% of those without HIV. Small white bumps or warts occur outside or inside the mouth in HPV, which can bleed if picked. Apart from oral warts, genital warts are also a symptom of HPV. 
While there is no known cure for HPV, the symptoms are also quite uncommon and undetectable in people. If topical medication fails, then warts need to be removed surgically.
Are HIV Mouth Sores Painful?
Mouth sores during HIV can become painful, making chewing and swallowing quite tedious for the patients. Canker sores occur inside lips and cheeks and around the tongue and can be painful, but they aren’t contagious. Candidiasis or thrush leads to patches inside the mouth that are not only sore but may also bleed.
Oral herpes is usually caused by HSV (Herpes Simplex Virus) in patients with HIV. The sores may be clear, pink, red, or yellow and are highly contagious. These are immensely painful, and some forms of these sores are entirely resistant to treatment. 
HIV Mouth Sores vs. Canker Sores
Canker sores are medically known as aphthous ulcers. These are mouth lesions that are painful and don’t go away by themselves. They’re located inside the lips, cheeks, and around the tongue, which are sensitive places in the mouth, making it unbearable for the person to eat, drink, and even talk properly.
Canker sores aren’t a symptom of HIV but are a frequent problem faced by HIV patients. Canker sores are also caused by a deficiency of certain minerals such as iron and zinc. Eating hot or spicy food can increase the pain in canker sores. 
They tend to occur when the body can’t protect itself from various infections and viruses. Mouth sores in HIV are different, and canker sores have a greater tendency to develop in HIV patients. Canker sores aren’t contagious, and OTC pills prescribed by a doctor can treat a mild case. In severe cases, corticosteroid pills may be used after a doctor prescribes them.
What are the Signs of HIV in the Mouth?
Having oral health problems is one of the first signs of contracting HIV. Some of the basic issues starting with oral health include:
HIV causes salivary glands to swell, producing less saliva and a chronic dry mouth. Saliva protects the gums and teeth from plaque and infections. Initially, people with a dry mouth will have trouble eating dry food; there might even be inflammation on the tongue, causing pain. A dry mouth also causes bad breath. This might be one of the first signs of catching HIV and starting treatment. 
Oral Herpes or Ulcers
Another initial symptom of HIV is red sores, which could be canker sores or herpes. Getting them checked by a doctor and following the right treatment can cure them completely.
HIV Mouth Sores Treatment
There are multiple ways that doctors can treat HIV mouth sores or oral infections related to HIV. Fungal or bacterial infections such as candidiasis or thrush are treatable with pills or mouth creams. Canker sores and other mild forms of mouth sores can be treated using OTC pills, but in certain severe cases, corticosteroid mouthwash may be prescribed by the doctor.
Acute mouth sores such as warts inside or around the mouth may require removal through surgical procedures like cryotherapy. In cryotherapy, the wart is frozen before being removed. A much more serious case of mouth sores or oral health problems may require aggressive treatment to attack the infection rather than simply treating the symptoms.
HIV is a serious condition that leads to the lifelong disease AIDS, and it is highly necessary to control and treat the symptoms right at the beginning. Mouth sores are not only symptoms of HIV but are also linked to the condition, as patients with HIV are more prone to catching infections and diseases. However, HIV mouth sores have various treatments through which they are curtailed and treated. Dentists can detect oral symptoms, so visiting your dentist can help you cure mouth sores initially.
Disclaimer: This article is only a guide. It does not substitute the advice given by your own healthcare professional. Before making any health-related decision, consult your healthcare professional.
Editorial References And Fact-Checking
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- Fatahzadeh, M., & Schwartz, R. A. (2007). Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. Journal of the American Academy of Dermatology, 57(5), 737–766. https://doi.org/10.1016/j.jaad.2007.06.027
- National Center for Biotechnology Information. (2019, August 15). Canker sores (mouth ulcers): Overview. NCBI. Retrieved September 25, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK546250/
- Tartaglia, E., Falasca, K., Vecchiet, J., Sabusco, G. P., Picciano, G., Di Marco, R., & Ucciferri, C. (2017). Prevalence of HPV infection among HIV-positive and HIV-negative women in Central/Eastern Italy: Strategies of prevention. Oncology letters, 14(6), 7629–7635. https://doi.org/10.3892/ol.2017.7140
- HIV/AIDS & Oral Health. (n.d.). National Institute of Dental and Craniofacial Research. Retrieved September 16, 2022, from https://www.nidcr.nih.gov/health-info/hiv-aids#:%7E:text=Some%20of%20the%20most%20common,tongue)%2C%20and%20dental%20caries.