Syphilis is Infectious
Oral Manifestations of Syphilis
Syphilis is definitely contagious and will usually have lesions occurring in the mouth or oral region. Your dentist most likely will observe the oral lesions and referral to a physician is usually required since serologic testing is necessary. The test looks for the presence of antibodies which the patient creates to combat the disease. Large doses of penicillin or tetracycline will eliminate the disease completely. Syphilis was pretty much eliminated after 1943 when penicillin was developed, but the increase in AIDS has created a vacuum allowing the disease to begin increasing in numbers. It is now the fourth most common infectious disease in the United States. This is alarming. It is unusual since it was almost eliminated completely after WWII after being prevalent for centuries.
The oral manifestations of syphilis are various, and it is usually first noted in the mouth. However, almost always, all organs are involved and do not function properly. Yet sometimes, the only symptoms are the various lesions in the mouth. The oral lesions vary greatly in their appearance but most are found either on the lips, tongue or the palate. Most are ulcerated lesions on the lips. On the top of the tongue, the syphilitic lesion appears as an ulceration with a rolled border. On the palate it usually is simple redness with petechial or very minor bleeding. It is a must for your dentist or physician to give a thorough oral examination.
It is also quite interesting that humans are the only mammals which carry the spirochete (Treponema pallidum) which causes syphilis. No other mammal caries syphilis. It is transmitted by humans only, either by uterine transfer, or via sexual contact including oral-genital oral-anal, or by contaminated blood transfusion. It is very difficult to treat an AIDS patients due to frequent relapses and other complications. Syphilis is classified in two separate categories, congenital or acquired.
Congenital syphilis comes from the uterus of an infected mother after about 16 weeks of pregnancy. The fetus in the placenta is able to fight off this disease for the first four months, but less able to do so in the latter stages of pregnancy. Therefore the fetus becomes infected from its mother sometime during the fifth to ninth month of pregnancy.
Primary syphilis creates a sore or chancre at the site of inoculation within two weeks of exposure to someone who is infected. There is usually only one chancre which is painless and ulcerated. Primary and secondary syphilis occur one year or less after exposure. Latent syphilis is present for more than one year and regional lymph nodes are usually involved. Secondary syphilis is the systemic portion of the disease and the associated lymphadenopathy and comes on one to two months after the chancre. Sometimes a rash on the bottom of the feet or the palms of the hand. Compared to primary syphilis, secondary oral lesions are usually in multiples and are painful, causing fever and usually a sore throat.
Tertiary syphilis occurs one year after not being treated for the disease. The gumma or lesion forms usually on the palate, becomes non-infectious, but may invade the bone of the palate and destroy the cartilage of the nose. A white plaque, known as leukoplakia, usually forms on the tongue. Again, the tertiary stage is not infectious.
The disease of syphilis has various clinical manifestations and may affect all organs as well as compromise immune systems. It must be emphasized that oral evaluation is mandatory if any of these symptoms are present. The practice of unprotected oral sex may result in infection and ulcerated lesions on the lips is the most common oral manifestation of the disease.
Oral examinations are always a must, either by the dentist or a physician.
Life Member of American Dental Association, Emeritus Fellow of Academy of General Dentistry, American Association of Implant Dentists