Hiv-Positive Children Do Not Develop Hiv-Related Oral Lesions, Study Shows

BUFFALO, N.Y. -- A University at Buffalo dental study designed to determine the extent of peridontal lesions in HIV-positive children and to find ways to relieve or alleviate them, has found that most of the children examined didn't have the lesions, despite harboring the disease-causing bacteria in their mouths.

"We were surprised to discover that periodontal lesions aren't a problem for these children," said Paulette Tempro, D.D.S., associate professor of periodontics in the UB School of Dental Medicine and lead researcher on the study. "This finding raises some intriguing questions about the difference in the pathogenesis of HIV infection in children."

Periodontal disease, she noted, is common in adults with HIV because of their compromised immune systems.

The researchers found that HIV-negative children living with HIV-positive children harbored -- albeit in smaller concentrations -- the same periodontal-disease-causing bacteria, which is usually associated with adult periodontitis, but not often found in children.

"It is unusual for normal, healthy kids to harbor adult pathogens," she noted. "Under normal circumstances, as children grow older, they pick up a more complex microflora from care takers. Adult pathogens usually appear after puberty. This finding hints that there are factors other than those associated with age that determine when a child becomes colonized with adult bacteria."

She pointed out that few studies have been done on periodontal disease in children because it is considered rare, so information is scanty. "It's possible the pathogens we found are normal for this population of low-income children," Tempro said.

The findings were reported at the annual meeting of the American Association for Dental Research. The study is part of a three-year UB dental school project aimed at increasing delivery of dental care to low-income minority populations.

The study involved children infected perinatally with HIV who were living in households with non-infected children. The initial report included data from 32 HIV-negative and 40 HIV-positive children. To date, a total of 119 have been included. All children were between 2 and 16 years of age.

After performing an oral examination, the researchers collected plaque samples from all of the children and analyzed them for evidence of four types of bacteria known to cause periodontal lesions.

The study opens new avenues for research into the origination and development of periodontitis and the patterns of pediatric AIDS, but it points also to the need for closer monitoring of HIV-negative children living in households with HIV-positive siblings, Tempro said.

"Children with AIDS generally receive excellent care. They are followed very closely medically. This study shows that health-care professionals also should ask about and do follow-up exams on the other children in the household. Harboring these pathogens puts them at risk for periodontal disease and perhaps other infections as well."

Also involved in this study were John Jandinski, D.M.D., and Patricia Murray, D.D.S., both of the University of Medicine and Dentistry-New Jersey, who recruited the children and collected the samples.