Tuberculosis remains one of the most dangerous infectious diseases, with a high mortality rate in adults. Healthcare workers, including dentists, are at the forefront of combating this infectious epidemic and can make a significant contribution to its control. This is because oral lesions of tuberculosis are thought to account for 0.1–5% of all tuberculosis infections. Since these oral indications could emerge as a result of drug-resistant tuberculosis, acquired immunodeficiency syndrome (AIDS), and even HIV-associated opportunistic infections. As a result, the objective of this review is to improve understanding of the oral problems indicating tuberculosis as well as the role of a dentist in its detection.
Could oral issues indicate tuberculosis?
Yes, dental identification of M. tuberculosis has the potential to be a valuable tool in the first line of defense against this dangerous, and often fatal, disease. It is worth noting that oral tuberculosis (Oral TB) does occur, but it is uncommon. These lesions could be either primary or secondary in nature.
Primary lesions are rare and most commonly seen in younger patients with enlarged cervical lymph nodes. Secondary oral tuberculosis usually occurs in conjunction with pulmonary disease and can affect people of all ages. However, people in their forties and fifties are more susceptible. The most likely route of inoculation is for organisms to enter the sputum and reach the mucosal tissue through a small break in the surface. Furthermore, the organisms may enter the oral tissues via the bloodstream causing ulceration of the oral mucosa. Oral TB lesions can take many forms. These lesions specifically include ulcers, nodules, and periapical granulomas.
Which oral sites are usually affected by tuberculosis?
Oral tubercular lesions can affect any part of the oral mucosa. However, the tongue is the most commonly affected. Other sites include the palate, lips, buccal mucosa, gums, and floor of the mouth. The salivary glands, tonsils, and uvula are frequently involved. In contrast, the retromolar and lower arch alveolar mucosal regions are rarely involved.
Is it possible for a dentist to identify the condition?
Yes. Although rare, oral tuberculosis provides an early window for tuberculosis detection. Thus, by correlating the history, clinical, and radiological examinations, a dental expert can assist in identifying the condition. Despite the fact that microbial culture is considered absolute proof of disease, laboratory confirmation, and a thorough histopathological examination are required for a correct diagnosis. Furthermore, cultures, mycobacterial growth indicator tubes, and BACTEC are regarded as the most effective tools for TB detection. Thus, to avoid delays in treatment, it is the dentist’s responsibility to include tuberculosis (TB) in the differential diagnosis of suspicious oral lesions and refer the patient to a specialist.
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