Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of staph bacteria. It is resistant to many antibiotics used for standard staph infections, which can make it more difficult to manage. While frequently associated with skin infections, these bacteria can cause infections in various parts of the body. The oral cavity is one such location where MRSA can cause noticeable and uncomfortable symptoms.
Oral MRSA Manifestations and Symptoms
An MRSA infection inside the mouth often appears as distinct sores or abscesses. These lesions can develop on the gums, tongue, palate, or the inside of the cheeks. They resemble red, swollen boils or pimples that are often filled with pus or draining fluid. The area is also painful and tender to the touch.
The localized pain can cause discomfort while chewing or swallowing. In response to the infection, lymph nodes under the jaw may become swollen and tender. A person might also experience systemic symptoms like a low-grade fever and a general feeling of being unwell. Because these oral lesions can mimic other dental problems, professional evaluation is necessary for an accurate diagnosis.
Causes and Transmission Routes
Staphylococcus aureus can live harmlessly on the skin or in the nose but becomes an issue when it breaches the body’s protective barriers. For an oral infection to begin, the bacteria must enter the mouth’s mucosal tissues. Entry points can be created by minor breaks in the surface, such as cuts from dental procedures, irritation from braces, or sores from ill-fitting dentures.
The transmission of MRSA into the mouth can happen through several pathways. Direct person-to-person contact is a common route. Another pathway involves contaminated objects; touching an item like a shared towel or cup and then touching the mouth can introduce the bacteria. It is also possible to transfer the bacteria from a MRSA infection on another part of the body to the mouth.
Identifying High-Risk Individuals and Settings
Certain populations and environments are associated with a higher risk of acquiring MRSA infections. These risk factors include:
- A recent or prolonged stay in a healthcare facility, such as a hospital or nursing home.
- A weakened immune system from conditions like HIV/AIDS or treatments like chemotherapy.
- Recent oral surgery or extensive dental work.
- Living in crowded conditions like military barracks or college dormitories.
- Participation in high-contact sports.
Diagnosis and Medical Interventions
Attempting to self-treat a suspected oral MRSA lesion is strongly discouraged, as trying to drain a sore can worsen the infection and cause it to spread. The correct course of action is to seek an evaluation from a doctor or dentist. A healthcare professional will examine the affected area and may take a tissue sample or a swab of the pus. This sample is sent to a laboratory for a culture to confirm the presence of MRSA.
The primary treatment for a localized MRSA abscess is a procedure called incision and drainage. A provider will numb the area and use a sterile scalpel to open the sore, allowing the infected material to drain. In many cases, thorough drainage of the abscess may be sufficient treatment without the need for antibiotics.
If the infection is severe, has spread, or if the patient is in a high-risk group, antibiotics are necessary. Based on lab results, a doctor will prescribe effective oral antibiotics, such as clindamycin or doxycycline. More severe infections may require intravenous antibiotics like vancomycin in a hospital setting.
Prevention and Oral Hygiene Practices
Preventing the spread of MRSA involves general hygiene and specific oral care. Consistent handwashing with soap and water is one of the most effective measures. When soap and water are unavailable, use an alcohol-based hand sanitizer with at least 60% alcohol. Avoid sharing personal items that contact the mouth or skin, such as towels, razors, and eating utensils.
Maintaining excellent oral health helps protect against oral MRSA infections. A routine of brushing and flossing keeps the gums and oral mucosa healthy, reducing potential entry points for bacteria. Any injuries to the mouth, like cuts or sores, should be cared for promptly. Those who wear dentures or other dental appliances must ensure they are cleaned regularly to prevent bacterial buildup.