Approaching patients with immune disorders – What is a reasonable treatment objective?

In light of recent news about the changing approach to dental care providers with HIV/AIDs being permitted to participate in care again after a long ban, I thought we could focus today on discussion immune system disorders in the patient.

Immune System Disorders

Some forms of periodontal disease may be more severe in individuals affected with immune system disorders, and patients with HIV may experience especially severe forms of periodontal disease.

Incidence of necrotizing periodontal diseases may increase in the patient with AIDS. Special considerations for immune system disorder patients with periodontal disease include:

1.  Consultation/coordination of treatment with patient’s physician as necessary.

2.  Controlling associated mucosal diseases and acute periodontal infections.

3.  If indicated, administration of systemic or local medications in a manner that avoids opportunistic infections and adverse drug interactions.


Outcome Assessment

The predictability of the outcome may be enhanced through close medical/dental coordination. Satisfactory outcome of therapy in systemic disorder patientss may include:

1.  Significant reduction of clinical signs of gingival inflammation;

2.  Reduction of probing depths;

3.  Stabilization or gain of clinical attachment;

4.  Reduction of clinically detectable plaque to a level compatible with gingival health;

5.  Control of acute symptoms.


Because of the complexity of systemic factors, it may not be possible to control periodontal diseases. A reasonable treatment objective here is to slow progression of the periodontal disease which may be characterized by:

1.  Persistent inflammation/infection of the gingival tissues;

2.  Persistent or increasing probing depths;

3.  Lack of stability of clinical attachment;

4.  Persistent clinically detectable plaque levels not compatible with gingival health;

5.  Radiographic evidence of progressive bone loss.


In patients where the periodontal condition does not resolve, additional therapy may be required as well as further evaluation of the patient’s systemic condition.

I hope this article was enlightening, especially in relation to new events. If you have any comments, or questions, about this subject get in touch. Leave your thoughts in a comment here, or find me on social media:

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