Management of third molar surgery in HIV-positive patients

Third molar surgery is a common procedure performed by oral and maxillofacial surgeons. This kind of surgery is predictable, and complications are infrequent. Immune deficiency is one of the considerations for the prevention of complications. HIV patients may be immune deficient. Third molar surgical procedures are associated with bleeding and increased risk of infection. Improvement in oral hygiene must be encouraged, such as pre-operative scaling. Prophylactic antibiotics and history of anti-retroviral therapy should be considered.

7 cases of third molar surgery in HIV patients were handled at the oral and maxillofacial surgery department. Intraoral examination showed typical lesions of HIV patients such as oral candidiasis, hairy leucoplakia, necrotizing ulcerative periodontitis, oral ulcers and also pericoronitis of third molars. Radiological examination showed impacted teeth in the upper and lower the third molar region. Third molar treatment was carried out as elective surgery under general anaesthesia. Prophylactic antibiotics were given to the patients as standard of care.

Treatment planning for HIV-positive patients follows the same sequence as with other patients, and the priorities are to remove local infection and prevent further dental disease. Third molar surgery in HIV-positive patients can improve dental health which can affect the quality of life. Prophylactic antibiotic should be used to prevent infections. Bleeding control also needed to avoid complications.