Lecture 6 Flashcards
Why study STIs in dentistry?
Oral manifestations are present.
What is required for medical treatment of STIs in dentistry?
Require referral for medical treatment.
How may STIs be transmitted in a dental setting?
May be transmitted by direct contact with lesions, blood, or saliva.
What should health care providers assume about patients?
Health care providers should assume all patients are potentially infectious.
What precautions must be adhered to in dentistry?
Must adhere to standard precautions.
What is the causative agent of Gonorrhea?
Neisseria gonorrhoeae
What is the second most common STI?
Gonorrhea, after Chlamydia
How is Gonorrhea transmitted?
Through sexual contact
What is the primary medical management for Gonorrhea?
Antibiotics
What is the first-line antibiotic for Gonorrhea treatment?
Ceftriaxone IM
What are alternative antibiotics for Gonorrhea?
Cefixime and oral Azithromycin
What should be used for gonorrhea patients with a Cephalosporin allergy?
Gemifloxacin and Azithromycin
When can dental care be provided for Gonorrhea patients?
After beginning antibiotic treatment
What precautions should be taken during dental management of Gonorrhea?
Use standard precautions
What is the transmission risk once antibiotics for Gonorrhea have begun?
Limited transmission risk
What are the oral manifestations + symptoms of Gonorrhea?
Pharyngitis (sore throat), erythematous throat with small pustules, enlarged palatine tonsils with possible exudate, cervical lymphadenopathy
What is the etiology of syphilis?
Treponema pallidum
How is syphilis transmitted?
Through sexual contact and in utero to a fetus
What are the stages of syphilis?
Primary, Secondary, Latent, Tertiary, Congenital
What is the medical management for syphilis?
Antibiotics: Parenteral injection of penicillin
What is the alternative treatment for syphillis for penicillin allergy?
Oral doxycycline
What precautions should be taken for dental management of syphilis?
Use standard precautions for all patients unless oral lesions are present.
When should a patient with syphilis be referred to a physician?
Refer to physician for undeterminable lesions.
How infectious are skin and mucous membranes in syphilis?
Skin and mucous membranes are highly infectious.
What are the oral manifestations of primary syphilis?
Oral chancres on the lips, tongue, oropharynx; possible lymphadenopathy.
What are the oral manifestations of secondary syphilis?
Mucous (red or grayish-white) lesions, linear erosions, ulcerations, pharyngitis.
Can secondary syphilis be asymptomatic?
Yes, it may be asymptomatic.
What is a rare oral manifestation of tertiary syphilis?
Oral gumma.
What are the characteristics of lesions in the tongue and palate in tertiary syphilis?
Exophytic, indurated, ulcerated lesions; may erode bone and perforate into nasal cavity.
What are congenital manifestations of syphilis?
Hutchinson’s incisor, mulberry molars, high narrow palate, skin fissures around the mouth.
What is the etiology of genital herpes simplex virus?
One virus in a family of 8.
Where does HSV-I occur?
Above the waist; oral, nose, eyes, brain, skin.
Where does HSV-2 occur?
Involves the genital area.
How is HSV-I transmitted?
Through close contact and infected saliva (kissing).
How is HSV-2 transmitted?
Transmitted through sexual contact.
What is the treatment for genital herpes?
Oral anti-viral meds: acyclovir, famciclovir, valacyclovir.
What should be disclosed on medical history regarding herpes simplex virus?
HSV infection may be disclosed on medical history.
What precautions should be taken for asymptomatic HSV infection?
Standard precautions.
During which stages are HSV lesions infectious?
Lesions are infectious during papular, vesicular, and ulcerative stages.
When should dental treatment be deferred for HSV lesions?
Defer treatment until healed.
When is it safe to treat a patient with HSV lesions?
When dried & crusted, safe to treat because considered non-infectious.
What can happen if fingers come into contact with HSV lesions?
Contact fingers → herpetic whitlow.
What can happen if eyes come into contact with HSV lesions?
Contact eyes → ocular herpes.
What is the etiology of infectious mononucleosis?
Epstein Barr virus 90%.
What is the most common population affected by infectious mononucleosis?
Children, adolescents, young adults.
How is infectious mononucleosis transmitted?
Intimate personal contact (infected saliva, oropharyngeal secretions).
What is the medical management for infectious mononucleosis?
Treat symptoms (bedrest, fluids, pain management, gargling).
What is the dental management for infectious mononucleosis?
Defer treatment symptomatic. Reschedule for ~4 weeks.
What are the oral manifestations of infectious mononucleosis?
Palatal petechiae, enlarged tonsils, pharyngitis with exudate, lymphadenopathy.
What is the etiology of genital warts?
Human papilloma virus.
How is genital warts transmitted?
Through sexual contact and passed to fetus through infected birth canal.
What are the medical management options for genital warts?
Surgical ablation, immunomodulatory agents, electrosurgery, chemical destruction, topical agents.
What is the medical management for cancer related to HPV?
Surgery plus radiation or chemotherapy.
What is the prevention method for HPV?
HPV vaccine (Gardasil 9).
What is the dental management for genital warts?
Present minimal risk to oral healthcare providers; use standard precautions.
What are the oral manifestations of genital warts?
Lesions on the tongue, gingiva, labial mucosa, palate; oral condylomata acuminatum.
What is the appearance of oral condylomata acuminatum?
Single lesions or multiple lesions in a cluster on ventral tongue, gingivae, labial mucosae, palate.
