Sexual Health and the Mouth

Sexual Health And The Mouth

• Oral sex involves stimulating a partner's genitals with the mouth, lips, or tongue.
• Fellatio involves sucking or moving the tongue across the penis to give pleasure.
• Cunnilingus involves moving the tongue across the female sex organs to give pleasure.
• Anilingus involves moving the tongue across the anus to give pleasure.
• STIs spread between people during sexual activity, including unprotected vaginal, anal, or oral sex, and sharing sex toys.
• Undiagnosed STIs can lead to Pelvic Inflammatory Disease (PID), infertility, miscarriage, ectopic pregnancy, epididymo-orchitis, cancers, and further spread of infection.
• In 2019, there was a 26% increase in gonorrhea and a 10% increase in syphilis.
• Between 2018-2019, 15-17 year old girls had a 23% decrease in HPV, while heterosexual boys had an 11% decrease in HPV.
• HPV is the most common STI in the UK.
• High-risk groups for STIs include heterosexual 15-24 year olds, men who have sex with men (MSM), and Black ethnic minorities.
• Oral assessment involves screening, educating, directing, and normalizing discussions around sexual health.

Common STIs

• Herpes is highly contagious and caused by HSV1 and HSV2 and can cause blisters; barrier methods may not be sufficient.
• Herpes may not always result in an outbreak, and initial infection can cause those affected to feel unwell; it is not curable but manageable.
• Gonorrhea is caused by Neisseria gonorrhoeae and is highly contagious, with flu-like symptoms, including sore throat, swollen lymph nodes, and fever.
• Gonorrhea can cause pain in the eyes or light sensitivity and requires antibiotics; oropharyngeal gonorrhea is often asymptomatic.
• Syphilis is caused by Treponema pallidum, increases the risk of HIV, and is treated with IM or oral antibiotics.
• Early diagnosis of syphilis is crucial as it is on the rise in the UK, especially in men.
• Primary syphilis occurs 2-3 weeks after initial infection.
• Secondary syphilis occurs 2-6 months after initial infection.
• Late latent and tertiary syphilis both occur 2 years after initial infection.
• HPV (Human Papilloma Virus) is the most common STI, with over 100 different types including HPV16.
• HPV often has no symptoms and no treatment, but there is a vaccination program to prevent it.
• It can mutate into cancer, and the number of oral sex partners and oral sex intensity increases the risk.

Red Flag Signs and Advice

• Red flag signs of possible oral cancer include:
  • Trouble swallowing
  • Constant earaches
  • Unexplained weight loss
  • Enlarged lymph nodes
  • Constant sore throats
  • Lumps on the cheeks
  • Growths or lumps on the neck
  • Hoarseness
• Less frequent STIs that can affect the mouth include Chlamydia, HIV, Hepatitis A, B, and C, and pubic lice.
• Advice includes:
  • Encourage discussion
  • Educate patients
  • Screen for STIs
  • Provide dental treatment
  • Normalize the conversation around STIs