Tuberculosis of the oral cavity: a systematic review.

The recent increase in the incidence of tuberculosis, combined with an emerging global resistance to antituberculous drugs, warrants an increased awareness of the involvement of Mycobacterium tuberculosis in persistent or atypical lesions in the oral cavity. We sought to review the published reports of mycobacterial infection of the oral cavity found in the literature in otherwise uncompromised patients, from 1950 to the present day, and analyzed the documented manifestations. M. tuberculosis infects all parts of the mouth (soft and hard palate, uvula, buccal mucosa, gingivae, lips, tongue, maxilla, and mandible) more often in men than in women, appearing predominantly in the form of ulcerative lesions. It was found as a secondary infection in 58% (54% pulmonary, 4% extrapulmonary) of patients and as a primary infection in 42% of patients. Carcinomas are found to co-exist in the same lesion site in 3% of patients. In approximately 50% of patients, an oral manifestation of TB has led to the diagnosis of a previously unknown systemic infection, which resulted in a timely and effective treatment. The investigation for tuberculosis should therefore be actively pursued in the dental surgery. Diagnostic work-up for systemic involvement and control of healthcare-associated spread is important, while therapeutic options are still considered adequate.

Tuberculosis: a re-emerging problem for health care workers.

The current upward trend in the incidence of tuberculosis, particularly in the USA, and the problems of treating multiply drug resistant strains of Mycobacterium tuberculosis have caused a resurgence of interest in this infection. This review describes the microbiology, routes of transmission and epidemiology of Mycobacterium tuberculosis infections. The emergence and problems of treating multiply drug resistant strains are outlined. The significant potential for occupationally acquired infection among health care workers is discussed, together with a summary of the available infection control measures currently being examined. The true level of occupational risk to dental personnel remains uncertain.