Sexually transmitted infections (STIs) can affect more than just the genital area. Oral STIs, which manifest in the mouth and throat, are common. Understanding these infections and their signs is important for better sexual health and timely medical attention.
Common STDs Affecting the Mouth
Herpes Simplex Virus (HSV), specifically HSV-1, commonly causes oral herpes, appearing as fluid-filled blisters or cold sores on or around the lips. These sores can also emerge inside the mouth, on the gums, tongue, or roof of the mouth, sometimes accompanied by fever, swollen lymph nodes, or a sore throat during a primary infection.
Syphilis, caused by the bacterium Treponema pallidum, can manifest in the mouth through direct contact with a sore. Oral syphilis often presents as a firm, round, usually painless sore, known as a chancre, on the lips, tongue, or other areas inside the mouth. In later stages, syphilis can cause mucous patches, which are raised grey or white lesions, or a widespread rash that may include the mouth.
Gonorrhea (Neisseria gonorrhoeae) can infect the throat, often resulting from oral sex. Many individuals with oral gonorrhea experience no symptoms, but some may notice a sore throat, redness in the throat, swollen lymph nodes, or a fever. Chlamydia (Chlamydia trachomatis) can also affect the throat, frequently without noticeable symptoms. If symptoms do occur, they might include a sore throat, mouth sores, swollen tonsils, swollen lymph nodes, or a mild fever.
Human Papillomavirus (HPV) can cause infections in the mouth and throat, though oral HPV often presents without symptoms. When symptoms are present, they may include small, firm bumps or growths, and certain high-risk HPV types are linked to oropharyngeal cancers. Human Immunodeficiency Virus (HIV) is a systemic infection that can lead to various oral manifestations, such as thrush (a white, creamy coating), oral hairy leukoplakia (white, non-removable lesions on the tongue), or Kaposi’s sarcoma (purple or reddish-brown lesions).
How Oral STDs Spread
Oral STIs primarily transmit through direct contact with infected bodily fluids or skin during sexual activity. Oral sex, which involves using the mouth to stimulate the genitals or anus, is a common route. This contact can transfer bacteria or viruses from an infected partner’s genitals, anus, or mouth to the mouth or throat.
Sores, lesions, or cuts in the mouth or on the genitals can increase transmission likelihood. Even tiny, unnoticeable breaks in the skin, such as those from aggressive brushing or flossing, can serve as entry points for pathogens. Bodily fluids like semen, pre-ejaculate, vaginal fluids, and saliva contain infectious agents, and their exchange during oral sex contributes to STI spread. It is also possible to acquire an STI on the genitals or other areas if receiving oral sex from a partner with an oral infection.
Identifying and Testing for Oral STDs
Recognizing oral STIs often begins with noticing unusual symptoms, though many are asymptomatic. If oral changes like sores, lesions, persistent sore throats, or unusual bumps are observed, seeking medical attention is important. A healthcare provider can conduct a visual examination of the mouth and throat for infection indicators.
To confirm a diagnosis, various testing methods are available. Swab tests collect samples directly from lesions, sores, or the throat for laboratory analysis. Blood tests identify antibodies or antigens related to certain STIs, such as syphilis or herpes, indicating past or current infection. Self-diagnosis is unreliable due to often subtle or absent symptoms, emphasizing the need for professional medical evaluation and testing.
Preventing Oral STDs
Reducing the risk of acquiring or transmitting oral STIs involves specific preventive measures during sexual activity. Consistent use of barrier methods is a primary strategy. Condoms can be used for oral sex on a penis, while dental dams offer a barrier during oral-vaginal or oral-anal contact. These barriers limit direct contact with potentially infectious bodily fluids and skin.
Open communication with partners about STI status and sexual history contributes to informed sexual health decisions. Regular STI testing, particularly for individuals with multiple or new partners, helps identify infections early, enabling prompt treatment and preventing further transmission. Avoiding oral sex when visible sores, rashes, or lesions are present in the mouth or genital area is an additional protective step, as these indicate a higher transmission risk. Vaccination against certain STIs, such as the HPV vaccine, can provide protection against high-risk HPV types that cause oral infections and associated cancers.