The orofacial complications of HIV infection are diverse, include opportunistic infection and malignancy and in many instances are region specific. Although effective management strategies to treat HIV-associated oral disease have been developed in North America and Europe, the evidence base on which these rely remains inadequate. Although there is no doubt highly-active antiretroviral therapy has had a profound impact on the pattern of oral disease seen in countries where it has become widely available, in the resource poor environment where access remains restricted, other therapeutic interventions need further investigation in well-designed, prospective studies. These will inform treatment protocols tailored to these locations. This review highlights the international variance in therapeutic intervention for HIV-related orofacial disease.