Marked parotid enlargement either uni- or bilateral has been often reported in AIDS patients. This change in size represents a form of sialoadenitis which is due to infection by the cytomegalovirus. Patients with this type of sialoadenitis frequently present an associated xerostomia. Needle aspiration biopsy treated with special stains have demonstrated the presence of viral inclusion bodies compatible with those seen in cytomegalovirus infection. Rarely the submandibular, sublingual and minor salivary glands are affected.

Xerostomia represents a serious problem in these patients because it induces the rapid development of caries as well as oral candidiasis. Several medications used in AIDS patients can increase the degree of xerostomia i.e antidepressant, antianxiety and antihistamines. These patients can be medicated with saliva substitutes and topical application of fluoride in order to prevent caries development. Chewing of sugarless lemon drops is also recommended to stimulate salivary production.