Lecture 6

Question 1

Why study STIs in dentistry?

Answer 1

Oral manifestations are present.

Question 2

What is required for medical treatment of STIs in dentistry?

Answer 2

Require referral for medical treatment.

Question 3

How may STIs be transmitted in a dental setting?

Answer 3

May be transmitted by direct contact with lesions, blood, or saliva.

Question 4

What should health care providers assume about patients?

Answer 4

Health care providers should assume all patients are potentially infectious.

Question 5

What precautions must be adhered to in dentistry?

Answer 5

Must adhere to standard precautions.

Question 6

What is the causative agent of Gonorrhea?

Answer 6

Neisseria gonorrhoeae

Question 7

What is the second most common STI?

Answer 7

Gonorrhea, after Chlamydia

Question 8

How is Gonorrhea transmitted?

Answer 8

Through sexual contact

Question 9

What is the primary medical management for Gonorrhea?

Answer 9

Antibiotics

Question 10

What is the first-line antibiotic for Gonorrhea treatment?

Answer 10

Ceftriaxone IM

Question 11

What are alternative antibiotics for Gonorrhea?

Answer 11

Cefixime and oral Azithromycin

Question 12

What should be used for gonorrhea patients with a Cephalosporin allergy?

Answer 12

Gemifloxacin and Azithromycin

Question 13

When can dental care be provided for Gonorrhea patients?

Answer 13

After beginning antibiotic treatment

Question 14

What precautions should be taken during dental management of Gonorrhea?

Answer 14

Use standard precautions

Question 15

What is the transmission risk once antibiotics for Gonorrhea have begun?

Answer 15

Limited transmission risk

Question 16

What are the oral manifestations + symptoms of Gonorrhea?

Answer 16

Pharyngitis (sore throat), erythematous throat with small pustules, enlarged palatine tonsils with possible exudate, cervical lymphadenopathy

Question 17

What is the etiology of syphilis?

Answer 17

Treponema pallidum

Question 18

How is syphilis transmitted?

Answer 18

Through sexual contact and in utero to a fetus

Question 19

What are the stages of syphilis?

Answer 19

Primary, Secondary, Latent, Tertiary, Congenital

Question 20

What is the medical management for syphilis?

Answer 20

Antibiotics: Parenteral injection of penicillin

Question 21

What is the alternative treatment for syphillis for penicillin allergy?

Answer 21

Oral doxycycline

Question 22

What precautions should be taken for dental management of syphilis?

Answer 22

Use standard precautions for all patients unless oral lesions are present.

Question 23

When should a patient with syphilis be referred to a physician?

Answer 23

Refer to physician for undeterminable lesions.

Question 24

How infectious are skin and mucous membranes in syphilis?

Answer 24

Skin and mucous membranes are highly infectious.

Question 25

What are the oral manifestations of primary syphilis?

Answer 25

Oral chancres on the lips, tongue, oropharynx; possible lymphadenopathy.

Question 26

What are the oral manifestations of secondary syphilis?

Answer 26

Mucous (red or grayish-white) lesions, linear erosions, ulcerations, pharyngitis.

Question 27

Can secondary syphilis be asymptomatic?

Answer 27

Yes, it may be asymptomatic.

Question 28

What is a rare oral manifestation of tertiary syphilis?

Answer 28

Oral gumma.

Question 29

What are the characteristics of lesions in the tongue and palate in tertiary syphilis?

Answer 29

Exophytic, indurated, ulcerated lesions; may erode bone and perforate into nasal cavity.

Question 30

What are congenital manifestations of syphilis?

Answer 30

Hutchinson's incisor, mulberry molars, high narrow palate, skin fissures around the mouth.

Question 31

What is the etiology of genital herpes simplex virus?

Answer 31

One virus in a family of 8.

Question 32

Where does HSV-I occur?

Answer 32

Above the waist; oral, nose, eyes, brain, skin.

Question 33

Where does HSV-2 occur?

Answer 33

Involves the genital area.

Question 34

How is HSV-I transmitted?

Answer 34

Through close contact and infected saliva (kissing).

Question 35

How is HSV-2 transmitted?

Answer 35

Transmitted through sexual contact.

Question 36

What is the treatment for genital herpes?

Answer 36

Oral anti-viral meds: acyclovir, famciclovir, valacyclovir.

Question 37

What should be disclosed on medical history regarding herpes simplex virus?

Answer 37

HSV infection may be disclosed on medical history.

Question 38

What precautions should be taken for asymptomatic HSV infection?

Answer 38

Standard precautions.

Question 39

During which stages are HSV lesions infectious?

Answer 39

Lesions are infectious during papular, vesicular, and ulcerative stages.

Question 40

When should dental treatment be deferred for HSV lesions?

Answer 40

Defer treatment until healed.

Question 41

When is it safe to treat a patient with HSV lesions?

Answer 41

When dried & crusted, safe to treat because considered non-infectious.

Question 42

What can happen if fingers come into contact with HSV lesions?

Answer 42

Contact fingers → herpetic whitlow.

Question 43

What can happen if eyes come into contact with HSV lesions?

Answer 43

Contact eyes → ocular herpes.

Question 44

What is the etiology of infectious mononucleosis?

Answer 44

Epstein Barr virus 90%.

Question 45

What is the most common population affected by infectious mononucleosis?

Answer 45

Children, adolescents, young adults.

Question 46

How is infectious mononucleosis transmitted?

Answer 46

Intimate personal contact (infected saliva, oropharyngeal secretions).

Question 47

What is the medical management for infectious mononucleosis?

Answer 47

Treat symptoms (bedrest, fluids, pain management, gargling).

Question 48

What is the dental management for infectious mononucleosis?

Answer 48

Defer treatment symptomatic. Reschedule for ~4 weeks.

Question 49

What are the oral manifestations of infectious mononucleosis?

Answer 49

Palatal petechiae, enlarged tonsils, pharyngitis with exudate, lymphadenopathy.

Question 50

What is the etiology of genital warts?

Answer 50

Human papilloma virus.

Question 51

How is genital warts transmitted?

Answer 51

Through sexual contact and passed to fetus through infected birth canal.

Question 52

What are the medical management options for genital warts?

Answer 52

Surgical ablation, immunomodulatory agents, electrosurgery, chemical destruction, topical agents.

Question 53

What is the medical management for cancer related to HPV?

Answer 53

Surgery plus radiation or chemotherapy.

Question 54

What is the prevention method for HPV?

Answer 54

HPV vaccine (Gardasil 9).

Question 55

What is the dental management for genital warts?

Answer 55

Present minimal risk to oral healthcare providers; use standard precautions.

Question 56

What are the oral manifestations of genital warts?

Answer 56

Lesions on the tongue, gingiva, labial mucosa, palate; oral condylomata acuminatum.

Question 57

What is the appearance of oral condylomata acuminatum?

Answer 57

Single lesions or multiple lesions in a cluster on ventral tongue, gingivae, labial mucosae, palate.