Herpes: Considerations for the Dentist
Did you know that herpes is so common that it probably infects 60-95% of adults? Though it isn’t talked about very much, there are some important facts to know about this viral disease.
There are two forms, HSV1 (oral) and HSV2 (genital). Both forms are caused by the herpes simplex virus and appear regularly in the mouth and lips.
According to the American Academy of Dermatology where there are several articles on herpes simplex, “oral herpes lesions appear as blisters appearing on the lips or around the mouth. Sometimes blisters form on the face or on the tongue. Although these are the most common places to find oral herpes, the sores can appear anywhere on the skin. It is important to know that these sores are contagious. If you have sores on your face:
- Do not kiss anyone.
- Do not have oral sex.
- Do not share items such as silverware, cups, towels, and lip balms.
If you have tingling, burning, itching, or tenderness where you had a herpes sore, keep that area of your body away from others.
You can prevent spreading the sores to other parts of your body by:
- Washing your hands after touching a cold sore.
- Using a cotton-tip swab to apply herpes medicine to a cold sore also helps.
The first infection from herpes can result in a larger, more painful infection. Symptoms include:
- Not able to chew or swallow
- Sores on the inside of the cheeks or gums
- Fever
- General discomfort, uneasiness, or ill feeling
- Very sore mouth with no desire to eat
- Halitosis (bad breath)
Besides the visible lesions on the lips, the dentist will detect ulcers commonly on the hard palate near the first molars where nerves enter the palate at the greater palatine foramen. It has been noticed that lesions for this disease are tissues covering hard surfaces rather than on the oral mucosa (loose tissue).”
What are treatments?
“There are common oral drugs: Acyclovir (Zovirax), Valacyclovir (Valtrex) and Famciclovir (Famvir). Also there are topical ointments for lip lesions: Acyclovir cream, and the only FDA approved over the counter non-prescripton ointment, docosanol (Abreva), among others. Early application seems to give the best chance of having the episode be of shorter duration. Without treatment the lesions will run their course in 2-21 days.”
Other concerns for a dentist
At one point in the history of dentistry we would not wear gloves. If a patient had an active herpes infection, one that is asymptomatic as most of them are, he could get herpes under his finger nails, he could develop herpetic whitlow, as lesion on this part of the body. A dentist’s ability to practice his art may well be compromised.
Dentists (or anyone) can get herpes on the eye. The result of this can be as severe as blindness.
So, herpes is common and can have some dire consequences.