Have You Talked to Your Dentist About Sex?

Among the more dangerous myths floating around these days is that oral sex is a disease-free alternative to intercourse. The fact is, not only can oral-genital contact lead to a sexually transmitted disease (STD) it can, depending on the disease, be harder to spot and more difficult to treat. Your dentist may recognize oral symptoms of an STD and instruct you to see a physician for diagnosis, according to a study published in the May/June 2002 issue of General Dentistry, the peer-reviewed journal of the Academy of General Dentistry, an organization of general dentists dedicated to continuing education.

According to the study's author, Larry N. Williams, DDS, MAGD, 60 percent of surveyed college students do not equate oral-genital contact with sex. And more than 55 percent of teen-agers admitted to engaging in oral sexual acts.

Ninety percent of those who contracted the oral component of an STD-such as gonorrhea-may be asymptomatic (meaning they do not show outward signs of being sick). The remaining 10 percent exhibit symptoms such as gum swelling and discharge, and some bleeding. These symptoms closely resemble those of another disease, necrotizing ulcerative gingivitis (NUG), also known as trench mouth or Vincent's disease, a painful bacterial infection and ulceration of the gums. NUG, unlike gonorrhea, however, has a foul odor.

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Dr. Williams says these patients may also experience flu-like symptoms. He added that while it is possible for an oral STD to be asymptomatic in the mouth, there may well be a genital component that does show symptoms. Additionally, studies have shown that 25 percent of those with genital gonorrhea may have an oral component. Gonorrhea was pegged by the Centers for Disease Control and Prevention as the second most common STD in 1997, with an estimated 600,000 cases reported every year. Patients with gonorrhea average about 24 years of age, often live in urban areas, and are more often black than white.

An oral STD is harder to treat. "Most STDs require a moist environment to survive," Dr. Williams explained. Treatment for an oral component to an STD usually includes an oral antibiotic, an intramuscular (IM) antibiotic and an oral antibiotic rinse. "The dentist should be proactive and advise the patient to seek medical care. If the dentist suspects the patient has an oral STD, then the patient probably has it elsewhere as well."

To reduce the chances of contracting an oral STD, Dr. Williams encourages individuals to practice safer sex by using a condom or a latex barrier.

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Last Updated October 2004