Frequent Oral Diseases in HIV Positive and AIDS Patients

Dr. Heddie O. Sedano, DDS

At the end of this lecture, you will be asked if you would like to take this course for continuing education units.
California Continuing Education Credits: 2 units

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Linear Gingival Erythema (LGE)

This entity, previously known as HIV associated gingivitis, is characterized by an erythematous band that follows the contour of the free gingiva with a typical chevron appearance. The attached gingiva is the site of an inflammatory reaction composed of petechia-like macules also having a reddish hue. Spontaneous bleeding is a frequent finding. The erythematous inflammatory band is obviously the result of bacterial proliferation in the gingival sulcus. The most frequently found microorganisms in this lesion are: Bacteroides gingivalis, Bacteroides intermedius, Actinomyces viscosus, Fusobacterium nucleatum and Actinobacillus actinomycetemcomitants, among others.

LGE is seen in patients with increased immuno suppression and as a rule is not associated with pain but it is considered a potential precursor of necrotizing ulcerative periodontitis. LGE does not respond to the usual therapeutic methods utilized to treat other types of gingivitis not associated to HIV infection.


This 34 year old HIV+ man presented with marked discomfort and pain of his gingival mucosas. Note the well delineated erythematous band following the contour of the free gingival margin. This phenomenon reflects inflammation as a consequence to bacterial invasion and proliferation in the gingival sulcus. Also note spotted areas of erythema, petechiae-like, on the maxillary anterior attached gingiva. The diagnosis of LGE was rendered.

Therapeutic Protocols for LGE includes: If the lesion persists in spite of the above therapy, systemic antibiotics can be prescribed i.e: