Oral manifestation of tuberculosis

1. Oral Pathology 1
Tuberculosis
Professor: Dr. Jay Hansel Tabije
subj/sec: DOP 221 / DDA
Name: Khafi Makoo , Noorallah

2. Infectious disease caused by Mycobacterium
Tuberculosis, which primarily affects the lungs
but is also capable of involving almost any site in
the body including the oral cavity.
TUBERCULOSIS

3. • Aerosolized droplets 1– 5 µm(microns ) in diameter.
 Spreads through the air when a person:
• Sneezes
• Coughs
• Speaks
• Talks
Transmission

4. Signs and Symptoms
• Weight loss, fatigue, productive cough,
fever and night sweats.
• Hemoptysis.
• Pleuritic pain.

5. • Chest x-rays Air appears black
in lungs (radiograph)
• Tuberculin skin test (TST or PPD)
Diagnosis

6. • In dentistry, the incidence of exposure to
an active TB patient is quite low.
• Oral lesions of TB are uncommon, with
most cases appearing as a chronic
painless ulcer.
• This does not mean that the dental health
care worker should not concern
themselves with good diagnostic and
preventive measures and realization that
patients and other HCWs may be infected
with TB.
Relationship of TB with
dentistry

7. • Patient Education
Should educate the patient regarding his/her severe health
condition and needs to make sure that the patient should cover
his/her mouth and nose while coughing or sneezing.
• Barriers
Dentist and dental nurse should wear gloves, eye glasses and mask
to prevent the possibility of microorganism from being transferred
during dental procedures.
Safety Measures By
Dentist

8. Oral manifestation
TB oral lesions are a relatively rare occurrence.
Studies vary, but the incidence has usually been
reported as less than 1% of the TB population. Saliva is
believed to have a protective effect, which may explain
the paucity of TB oral lesions, despite the large
numbers of bacilli contacting the oral cavity mucosa in
a typical case of pulmonary tuberculosis. Other factors
that attribute to relative resistance of oral cavity for TB
are presence of saprophytes, resistance of striated
muscles to bacterial invasion, and thickness of
protective epithelial covering.

9. Oral Tuberculous lesion of the dorsum of the tongue in
a patient with both TB disease and HIV infection.

10. Tuberculous ulcer on tongue

11. Oral manifestation
Oral TB lesions may be either primary or
secondary in occurrence. Primary lesions are
uncommon, seen in younger patients, and present
as single painless ulcer with regional lymph node
enlargement. The secondary lesions are common,
often associated with pulmonary disease, usually
present as single, indurated, irregular, painful
ulcer covered by inflammatory exudates in
patients of any age group but relatively more
common in middle-aged and elderly patients.

12. Ulcer in buccal vestibule

13. Oral manifestation
Oral TB may occur at any location on the oral mucous
membrane, but the tongue is most commonly affected.
Other sites include the palate, lips, buccal mucosa,
gingiva, palatine tonsil, and floor of the mouth.
Salivary glands, tonsils, and uvula are also frequently
involved. The retromolar region is rarely involved.
Secondary lesions of the mandibular ridge (alveolar
mucosa) are extremely rare. Primary oral TB can
present with painless ulceration of long duration and
enlargement of the regional lymph nodes.

14. Gingival enlargement

15. TB and Dentist
TB is a recognized occupational risk for dentists,
as we work in close proximity to the nasal and oral
cavities of patients, with generation of potentially
infectious sprays during routine operative
procedures. A history of TB should prompt the
clinician to distinguish whether the person is an
active case under treatment, active case without
treatment or previously infected but currently
disease free. The non treated active cases pose
maximum risk to the dental personnel.

17. Thank YOU