You might find it interesting to know that there is a link between sexually transmitted infections and the mouth.
We see sex everywhere; on TV and in magazines but our lips shut tight when it comes to discussing STIs. So let’s break down this taboo, open up and get down to it (pardon the pun) and discuss why the mouth may hold key clues.
What is a sexually transmitted infection?
A sexually transmitted infection (STI) is an infection that is passed on through sexual contact (oral, vaginal or anal sex) or through other means (shared needles, mother-foetus in the uterus or contact with infected blood).
They can be bacterial (chlamydia, gonorrhoea, syphilis) or viral (herpes, hepatitis, HIV, HPV).
Many symptoms of STIs occur within the mouth and the most common are outlined the most common below.
Human papillomavirus (HPV)
According to the World Health Organisation, HPV is the most commonly transmitted STI and often someone will have it without realising, before clearing it from the body within two years.
HPV is a virus with over 100 types that cause different symptoms, notably genital warts and an increased risk of including cervical and oropharyngeal cancer development. We’ll be focusing on the oropharyngeal (OPSCC).
The oropharynx is made up of the soft part of the roof of the mouth, tonsils, back of the tongue and throat and an infection with HPV-16/18, which is spread through oral and sexual contact, has a strong association with cancer risk (other risk factors include smoking and alcohol).
OPSCC can present in many different ways and if you’re concerned about any of the following symptoms, please visit your dentist or GP:
- A persistent hoarse voice or sore throat
- Difficult or painful swallowing
- Swollen lymph nodes
Early detection is essential and the 5-year survival rate of OSPCC increases from 65 to 85% if done so, so pop in and visit your dentist regularly who is trained to check for red flag signs of OSPCC.
In the UK, we have a vaccine against HPV-16/18 that is available for free on the NHS for:
- Girls AND boys aged 12-13
- Those under 25 who missed the vaccine in school
- Men who have sex with men under the age of 45
Women can also have routine cervical screening between the ages of 25 and 64.
Herpes is another viral infection that someone can often have but be unaware of. Unlike HPV, it’s life-long and never fully cleared from the body.
It has two main forms; HSV-1 which affects the face, mouth and genitals and HSV-2, which affects only the genitals.
HSV-1 is most common in children and young adults and has a two-stage infection.
The initial infection is called Primary Herpetic Gingivostomatitis and symptoms include gum inflammation, mouth ulcers and a general unwell feeling. It’s managed with bedrest and painkillers and typically lasts between 7-14 days. Antiviral medication may be considered in severe cases.
Like HPV, it is spread through oral and sexual contact and also skin-skin contact and is highly contagious. So if you have a cold sore, sharing lip balm, kissing and oral sex are a no go. You'll have to show your love in a more creative way.
HIV is a unique virus that weakens the immune system. As a result, it’s associated with over 30 conditions in the mouth that show in up to 90% of positive patients, often before anywhere else.
These include ulcers, fungal infections, oral hairy leukoplakia (white patches on the tongue), gum disease and even other STIs.
Patients diagnosed with HIV should visit their dentist regularly for routine check-ups of these conditions.
Syphilis is a less common bacterial infection spread through sexual contact that can show in the mouth when reinfection occurs. Symptoms can vary and mimic other conditions and include patches of grey-white or red and ulcers that resemble snail-tracts. Treatment is with antibiotics.
What can I do to protect myself?
Practicing safe sex is the most effective way to prevent the spread of STIs and this can include:
- Knowing your partners full sexual history
- Using condoms or other barrier forms of protection
- Speaking to a sexual health professional following unprotected sex
You should also visit your dentist routinely and your dentist or GP with any concerns.
If you’d like to learn more about this or other oral health related topics or ask the author a question, you can reach them on Instagram (@Tillertalksteeth).