Oral Lesions Arising from Oral Sexual Practices and Their Management: A Narrative Review

Author

Dr. Althaaf Khan


Abstract

 Objective: To review the oral lesions that arise from oral sexual practices, both infectious and traumatic, and to summarise their diagnosis, management and prevention with particular attention to the role of the dental practitioner.

Methods: A narrative review was undertaken. Biomedical literature, case reports, systematic reviews and the current World Health Organization and Centers for Disease Control and Prevention guidelines on sexually transmitted infections (STIs) were identified through web-based searches and critically summarised.

Results: Oral sexual practices may produce two broad groups of oral lesions. Traumatic lesions, chiefly erythema, petechiae and ecchymosis of the soft palate associated with fellatio, are asymptomatic and typically resolve spontaneously within one to two weeks. Infectious lesions include syphilitic chancres, mucous plaques and ulcers; oropharyngeal gonorrhoea and chlamydia, which are frequently asymptomatic; herpes simplex virus lesions; and human papillomavirus (HPV)-related papillomas and warts. Oral HPV infection, particularly HPV-16, is strongly associated with oropharyngeal cancer, and the risk rises with the number of lifetime oral sex partners. Management depends on the cause: reassurance and follow-up for trauma, and guideline-based antimicrobial or antiviral therapy, partner notification and referral for infections. HPV vaccination is associated with a marked reduction in vaccine-type oral HPV prevalence. Barrier methods lower but do not eliminate risk, and condoms appear less effective against extragenital gonorrhoea.

Conclusion: Dental practitioners are well placed to recognise these lesions. A sensitive sexual history, a careful oropharyngeal examination, appropriate testing or referral and preventive counselling allow timely diagnosis, avoid unnecessary investigation of benign traumatic lesions and help interrupt onward transmission of infection.



Keywords

oral sex; oral lesions; sexually transmitted infections; human papillomavirus; syphilis; palatal petechiae



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References


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