Health-Related Anxiety in the Management of Oral Soreness in an HIVSeropositive Patient

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Abstract

The number of people living with HIV (PLHIV) has been increasing since the first known case in the early 1980s.
However, PLHIV can also experience comorbidities, such as health anxiety. In the oral cavity, anxiety is often
associated with the etiology of parafunctional habits. Anxiety can be measured using self-administered instruments,
such as the Hospital Anxiety and Depression Scale (HADS) and Short-Health Anxiety Inventory (SHAI), which is
specifically used in the medical setting. Objectives: We are describing a case of HIV positive patient with health
anxiety who presented to the oral medicine clinic in our hospital with a complaint of discomfort on his lateral
sides of the tongue. Case Report: A 35-year-old male patient came to the oral medicine clinic complaining of
discomfort on his tongue, which presented for one week. The patient was alarmed by two bumps seen on the right
lateral side of his tongue and soreness on the left lateral side. Nystatin oral suspension was prescribed by a medical
doctor but discontinued by the patient. The patient was positive for HIV and took ART routinely. Extraoral and
intraoral examinations showed unremarkable findings except slightly enlarged and erythematous foliate papillae
on the left lateral side of the tongue. The patient was prescribed an antiseptic mouth rinse. After several days,
his symptoms had dissipated. Since the patient reported anxiety regarding his health and HIV status, we asked
the patient to complete the HADS and SHAI self-assessment tools to measure his level of anxiety. The patient
was shown to have anxiety using the SHAI (total score = 21). Conclusion: Health anxiety is a condition that an
individual misinterprets as a benign bodily sensation. The management of this type of patient involves addressing
the local predisposing factor of the oral complaint and maintaining oral hygiene, followed by an evaluation of
health anxiety for the basis of referral to a psychological expert.
Original languageEnglish
JournalJournal of Dentistry Indonesia
Publication statusPublished - 2020

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