22nd April 2024

Viral and Bacterial Infections of the Mouth

Herpes Simplex Virus (HSV) infections are caused by two types of viruses: HSV-1 and HSV-2. HSV-1 primarily causes oral infections, while HSV-2 is associated with genital infections, although both viruses can infect either location. HSV-1 infections can be transmitted through direct contact with oral secretions. HSV infections in the mouth habitually present as painful fluid-filled blisters or ulcers on the lips, tongue, gums, or inside the cheeks. These lesions are often accompanied by local inflammation, discomfort, and mild systemic symptoms, such as fever and malaise. The primary infection can be severe, with multiple lesions and more systemic symptoms, while recurrent infections tend to be milder. Diagnosis of oral HSV infections is based on clinical presentation and can be confirmed through viral culture, polymerase chain reaction testing, or serological assays. Management focuses on symptomatic relief and includes antiviral medications, such as acyclovir, which help to reduce the duration and severity of outbreaks. Coxsackievirus infections can also lead to various oral manifestations, including herpangina and hand, foot, and mouth disease (HFMD). Herpangina presents as small, painful ulcers on the back of the throat, while HFMD results in ulcers on the tongue, gums, and inner cheeks.

Bacterial infections in the oral cavity, particularly dental abscesses, are common and can lead to significant oral health issues. Dental abscesses are localised collections of pus that form within the teeth or surrounding tissues. These infections, if left untreated, can result in severe pain, swelling, and potentially systemic complications such as infective endocarditis. Dental abscesses typically originate from dental caries (tooth decay) or periodontal disease. Streptococcus mutans, a common bacterium found in dental plaque, is frequently associated with the initiation and progression of dental caries. As caries progress, bacteria can penetrate the tooth structure and infect the dental pulp, leading to the formation of an abscess. Diagnostic imaging techniques, such as dental X-rays or orthopantomogramme may be employed to assess the extent of the infection and identify any underlying dental pathology. Antibiotics are commonly prescribed to control the infection.