Immune & Transplant
Dental Management of Patients with HIV
Routine care with standard precautions
Well-managed HIV does not contraindicate routine dental care. Standard infection-control precautions apply; consider drug interactions with antiretrovirals.
Emergency vs routine management
If EMERGENCY — what to do
- • Treat with standard infection control; check CD4/ANC/platelets before surgery in advanced disease (CD4 < 200).Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
- • Boosted regimens (ritonavir/cobicistat) raise midazolam and some drug levels — check interactions.Ref: Stockley's Drug Interactions (current edition)
If ROUTINE — what to do
- • Routine care with standard precautions.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
- • Manage HIV-associated oral lesions (candidiasis, hairy leukoplakia).Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
Clinical precautions
- • Standard universal precautions
- • Review antiretroviral drug interactions
- • Assess immune status if advanced disease
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | ROUTINE Routine care with standard precautions |
| Supragingival scaling / polish | ROUTINE Routine care with standard precautions |
| Deep scaling / subgingival RSD (subgingival calculus) | ROUTINE Routine care with standard precautions |
| Root canal treatment | ROUTINE Routine care with standard precautions |
| Simple extraction (1–3 teeth) | ROUTINE Routine care with standard precautions |
| Surgical / bony extraction | ROUTINE Routine care with standard precautions |
| Implant placement | ROUTINE Routine care with standard precautions |
References
- HIV — dental management
- Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
- Stockley's Drug Interactions (current edition)
Related guides
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.