STDs and Related Conditions

• Herpes Simplex Virus
• Gonorrhea
• Hepatitis
• Syphilis
• Epstein-Barr Virus
• Cytomegalovirus

Herpes Simplex Virus

Oral Effects
There are two major types of herpes simplex virus (HSV). HSV-1 causes cold sores. It also causes some skin infections. HSV-2 usually causes infections in and on the genitals (male or female sex organs). However, HSV-1 can occur on the genitals, and HSV-2 can be found other places on the body.

Most people are first infected with HSV-1 during childhood. Infection happens through close contact with family members, or through contact with saliva or nasal secretions from other children. The first time children are infected, they may have a fever, a sore mouth, and red and inflamed gums. Teens and young adults with first infections may have inflamed gums, mouth ulcers and a sore throat. Adults infected for the first time may have a sore throat or tonsillitis. They also occasionally have sores in the mouth.

After the first infection, the virus hides in nerves near the skin. In some people, the virus never returns or "reactivates." Other people have reactivations or secondary herpes episodes or outbreaks. These episodes produce sores (called cold sores) on the lips.

Doctors don't know why the virus "turns on" again, but stress can be a factor. This includes mental and emotional stress, as well as dental treatment, illness, trauma to the lips or sun exposure.

At the Dentist
If you have a cold sore, you should avoid non-emergency dental treatment. You may have problems opening your mouth.

You may be worried that going to the dentist will bring on a cold sore. Research has found that taking antiviral medicine before you visit the dentist can help decrease the chances of cold sores. You may want to consider taking this medicine before dental visits if you have had cold sores develop after dental visits in the past.

Gonorrhea

Oral Effects
Gonorrhea does not usually affect the mouth. Some people have the bacteria that cause gonorrhea in their throats. They may get a sore throat. Some people have sores in the mouth. Some have red, swollen tissue in their mouths or throats.

At the Dentist
If you have active gonorrhea in your mouth, try to avoid non-emergency dental treatment.

Hepatitis

Oral Effects
Hepatitis rarely affects the mouth or teeth.

At the Dentist
Hepatitis can affect the way your body breaks down drugs. It also can affect the way your blood clots. Your dentist should talk with your physician about your condition and any medicines you are taking.

You can transmit hepatitis to dental care personnel through blood or blood-contaminated saliva. Dental care personnel are often vaccinated for type A and type B hepatitis. There is no vaccine for type C hepatitis.

If you have hepatitis, make sure your dentist is aware of your condition.

Syphilis

Oral Effects
After syphilis infection, people may get sores in their mouths. The sores may look gray, white or like a yellow-centered ulcer. They may show up as early as 3 days or as late as 10 weeks after the person is first infected. Mouth sores related to syphilis are usually called "mucous patches" if the patch is white-gray in color.

At the Dentist
Avoid non-emergency dental treatment.

Epstein-Barr Virus

Oral Effects
The most common disease associated with Epstein-Barr virus (EBV) is infectious mononucleosis, also called mono or "kissing disease." Symptoms include fever, fatigue, enlarged glands and sore throat. The virus is in saliva and moves easily from person to person by the exchange of saliva. There is more virus in a person's saliva when he or she has a fever.

Epstein-Barr virus infection may also cause a mouth sore (lesion or patch) called hairy leukoplakia, which looks white. It usually shows up on the side of the tongue. It's most common in people with weakened immune systems. No treatment is needed for hairy leukoplakia. It will go away if you take antiviral drugs. But it usually returns after drug therapy is stopped.

Epstein-Barr virus has also been associated with cancer of the upper part of the throat.

At the Dentist
Avoid having non-emergency dental treatment.

Cytomegalovirus

Oral Effects
Cytomegalovirus (CMV) is a type of herpes virus. Many people may have CMV and not know it. You may get a sore throat when you are first infected. CMV usually is reactivated only in people with weakened immune systems. In unusual cases, it can cause enlarged salivary glands and mouth sores.

At the Dentist
Your dentist might want to biopsy certain oral sores to help in his or her diagnosis of CMV. Your dentist also may refer you to your physician for tests.

Dentists and dental personnel who treat you will use "universal precautions" to prevent the spread of infection. This includes wearing gloves, a mask and a gown and following infectious-disease precautions for all patients. Therefore, they will not become infected from treating you. However, you should remember that other people you associate with may become infected.