Editorial The Mouth in Human Immunodeficiency Virus (HIV) Infection

The mouth is by far the most accessible segment of the human gastrointestinal tract; this is a truism which is axiomatic to every gastroenterologist, but of all clinicians the dental surgeon must have the greatest experience in undertaking a thorough oral examination. It is, therefore, no great surprise that the majority of descriptions of oral and perioral changes (these were initially described very soon after identification of the disease) in the presence of the acquired immune deficiency viruses are to be found in the dental literature [1-4]. Dental departments therefore not only have an important part to play in suspecting (and diagnosing) a HIV infection [5], and in managing the associated complications—both infective and malignant—but must also form a close working liaison with their medical colleagues [6] and even take a part in HIV counselling [7]. It seems clear that the entire gastrointestinal tract is affected by the HIV retroviruses (there is good evidence of enterocyte [8] and colonocyte [9] involvement), and abnormalities in the orofacial structures would be anticipated [10]. But how common are these in everyday practice? In this issue of the Quarterly Journal of Medicine, a group of clinicians working at Amsterdam have analysed the prevalence of oral mucosal changes in 70 consecutive HIV