Common infections and oral health

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  Posted by: The Probe      23rd February 2020

Common sexually transmitted infections (STI) have health consequences within the oral cavity and beyond. These infections can be transferred non-sexually, which underscores the need for thorough decontamination and sterilization protocols.

Chlamydia

Chlamydia is the most common bacterial STI in existence. When present in the pharynx, it can cause pharyngitis or lymphadenitis, but in the majority of cases it is asymptomatic (only 14% of men experience symptoms).[1] Chlamydia trachomatis has been recorded within the epithelial lining of periodontal pockets and within the gingival sulcus of patients with periodontitis.[2]

Research has found that C. trachomatis can occupy other biofilms, such as those produced by Candida albicans (a fungal yeast which can cause infections of the mouth, throat and esophagus).[3] Biofilms containing these bacteria can develop in the oral cavity, and on inorganic surfaces such as medical devices. Biofilms can harbour C. trachomatis, allowing it to remain infectious for up to 72 hours following exposure, and serve as a reservoir for the pathogen, leading to reinfection. C. trachomatis is capable of replicating within epithelial cells, and can infect them following release from biofilm.[4]

HPV

The human papilloma virus (HPV) is the most common sexually transmitted virus, though it can be spread in other ways, including on improperly sterilized surgical instruments and other objects.[5] Approximately 20% of oral cancers and 60-80% of oropharyngeal cancer cases are believed to be attributable to HPV infection.[6],[7] HPV is well established as the leading cause of cervical cancer, which has lead to widespread immunisation of young women in the UK against the most carcinogenic strains. This programme has recently been expanded to cover men and teenage boys. However, because the programme, in some cases, requires men to request inoculation at a GUM clinic, coverage will almost certainly be less thorough than the programme for girls which occurs during compulsory education.[8]  This is changing as similar inoculation programmes are being set up in secondary schools.

Preventing cross-contamination

Following disinfection and sterilization protocols carefully and thoroughly prevents the spread of harmful microbial agents between patients, and protects your staff in the instance of sharps injuries.

With integrated traceability, the new Lisa vacuum B sterilizer from W&H can be used to handle your practice’s sterilization needs reliably and with great efficiency. W&H can also provide ECPD training, helping clinicians obtain a thorough understanding of the theory and practice of handpiece maintenance and decontamination, and ensuring they are confident in reprocessing handpieces in accordance with HTM 01-05.

The oral cavity is never going to be a perfectly sterile environment, and every mouth harbours countless species of bacteria, fungi and viruses. While patients are not unlikely to become infected with diseases such as chlamydia and HPV at some point during their lives, minimising the risk of contamination between patients is a critical duty of care and can help prevent both major and minor health repercussions.

 

To find out more visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com

                                                                                                                        

[1] Chan P., Robinette A., Montgomery M., Almonte A., Cu-Uvin S., Lonks J., Chapin K., Kojic E., Hardy E. Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature.  Infectious Diseases in Obstetrics and Gynecology. 2016; 5758387. https://www.hindawi.com/journals/idog/2016/5758387/ April 4, 2019.

[2] Reed S., Lopatin D., Foxman B., Burt B. Oral chlamydia trachomatis in patients with established periodontitis. Clinical Oral Investigations. 2000; 4(4): 226-232. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760468/ April 4, 2019.

[3] Filardo S., Di Pietro M., Tranquilli G., Sessa R. Biofilm in gential ecosystem: a potential risk factor for chlamydia trachomatis infection. Canadian Journal of Infectious Diseases and Medical Microbiology. 2019; 1672109. https://www.hindawi.com/journals/cjidmm/2019/1672109/ April 4, 2019.

[4] Filardo S., Di Pietro M., Tranquilli G., Sessa R. Biofilm in gential ecosystem: a potential risk factor for chlamydia trachomatis infection. Canadian Journal of Infectious Diseases and Medical Microbiology. 2019; 1672109. https://www.hindawi.com/journals/cjidmm/2019/1672109/ April 4, 2019.

[5] Sabeena S., Bhat P., Kamath V., Arunkumar G. Possible non-sexual modes of transmission of human papilloma virus. Journal of Obstetrics and Gynaecology Research. 2017; 43(3).  https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.13248 April 4, 2019.

[6] Kim S. Human papilloma virus in oral cancer. Journal of The Korean Association of Oral and Maxillofacial Surgeons. 2016; 42(6): 327-336. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206237/ April 4, 2019.

[7] Poelman M., Brand H., Forouzanfar T., Daley E., Jager D. Prevention of HPV-related oral cancer by dentists: assessing the opinion of Dutch dental students. Journal of Cancer Education. 2018; 33(6): 1347-1354. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280774/ April 4, 2019.

[8] NHS. Who should have the HPV vaccine? NHS. 2017. https://www.nhs.uk/conditions/vaccinations/who-should-have-hpv-cervical-cancer-cervarix-gardasil-vaccine/ April 4, 2019.


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