Oral sex and oral health: An enigma in itself.

Oral sex is commonly practiced by sexually active couples of various age groups, including male-female and same-gender adolescents. The various type of oral sex practices are fellatio, cunnilingus, and analingus. Oral sex can transmit oral, respiratory, and genital infections from one site in body to the other. Oral health has a direct correlation on the transmission of infection; a cut in the mouth, bleeding gums, lip sores or broken skin increases chances of life-threatening infections. Although oral sex is considered a low risk activity, it is important to use protection such as physical barriers, health and medical issues, ethical issues, and oral hygiene and dental issues. The ulcerations or unhealthy periodontium in mouth accelerates the phenomenon of transmission of infections into the circulation. Thus, consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.

INTRODUCTION

A significant proportion of adolescents are engaging in noncoital sexual activities which includes oral sex commonly. Oral sex refers to sexual activities involving the stimulation of the genitalia by the use of the mouth, tongue, teeth or throat.[1] It is now very common in both heterosexual and homosexual couples among people of all sexual orientations. They may practice it as part of foreplay before, during or following sexual intercourse. Studies indicate that adolescents have had oral sex before their first experience with sexual intercourse[23456] that more adolescents have had oral sex than vaginal sex[34567] and that few adolescents who engage in oral sex use barrier protection.[8]

The various types of oral sex performed are:[1]

Cunnilingus (Oral Vaginal Contact): Oral stimulation of a woman's vagina and/or vulva, especially her clitoris, by her partner's lips and tongue

Fellatio (Oral Penile Contact): Stimulation of a man's penis by his partner's mouth-usually by licking or sucking

Analingus (Oral Anal Contact): Stimulation of the partner's anus with tongue or lips.

While the youth consider oral sex much “safer” than vaginal sex, this is a perilous fallacy. Although pregnancy is not an outcome of oral sex but may lead to sexually transmitted infections (STIs). Adults involved in oral sex need to know that it is associated with several STIs including syphilis,[9] gonorrhea,[1011] herpes,[12] HIV,[13] chlamydia,[14] and HPV[11] can also be transmitted through oral sex.

ORAL CAVITY IN HEALTH

Good oral hygiene is the fundamental for good quality of life. Mouth acts as a window to lot of systemic diseases and serves as a port of entry of the various infections that can alter and affect the immune status of the person. The oral cavity has the potential to harbor about 600 different bacterial species of which more than 150 species may be present as commensal. Tooth surface can have as many as billion bacteria in its attached bacterial plaque and oral care may not only reduce the microbial load of the mouth, but the risk for pain and oral infections as well. Lesions of the oral cavity have an immense impact on the quality of life of patients with complex advanced diseases;[15] they cause considerable morbidity and diminish patients physical and psychological well-being. The consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex. The good oral health permits in building up a defense against the various viruses and organisms by obstructing their entry into the body and circulation.

ORAL HEALTH AND ORAL SEX

Although very less research is available on the oral sex and oral health status but oral sex can transmit oral, respiratory, and genital pathogens [Table 1].[16] Oral-genital contact can transmit a number of STIs. Contact of body fluids such as saliva, precum, semen, vaginal secretions, and menstrual blood develop the risk of infection that can be transmitted through orogenital route. The practice of oral sex is highly prevalent among young people, regardless of whether they have previously engaged in penetrative intercourse and more of these body fluids you are exposed to the greater risk of infection there would be[17] open sores, cuts, abrasions, and periodontal disease are the various channels in oral cavity that serve as a gateway of entry of infection from oral cavity to blood stream. The clinical presentation of the various venereal diseases and infections spread through oral sex along with the possible channel of passage are mentioned below:

Table 1

Different infections and presenting features

PREVENTION

To avoid risks of infections during oral sex, it is advisable to keep body fluids (semen and vaginal fluids) out of the mouth as earliest [Table 2]. The oral cavity should be free from any potential bleeding disease. Due to disease risks, many medical professionals advise the use of condoms or dental dams when performing or receiving oral sex with a partner whose STD status is unknown. A makeshift dental dam can be made out of a condom. Using a real dental dam is preferable, because real dental dams are larger and the makeshift version may be accidentally poked with the scissors during the cutting procedure. Plastic wrap may also be used as a barrier during oral sex, but many find that the thickness of the plastic dulls sensation. Details of various methods and technique are illustrated as follows:

Table 2

Methods of prevention

CONCLUSION

The practice of oral sex is also highly prevalent among young people, regardless of whether they have previously engaged in penetrative intercourse. Oral sex involves giving or receiving oral stimulation (i.e., sucking or licking) to the penis, the vagina, and/or the anus. However, although the risk of STD transmission is far greater during vaginal and anal sex than during oral sex, the increasing practice of oral sex, low rates of barrier method use, and the finding that first oral sex often occurs prior to first vaginal or anal sex will help increase the relative importance of oral sex as a mode of transmission for genital pathogens. HIV, other STDs can be transmitted through oral sex with an infected partner examples of these STDs include HIV, herpes, syphilis, gonorrhea, genital warts (HPV), intestinal parasites, and hepatitis. There are several ways to reduce the risks of oral sex. In general, the use of a physical barrier during oral sex can reduce the risk of transmission of HIV and other STDs. To reduce the risk of infection during unprotected oral sex, limit exposure to sexual fluids and ensure that no cuts or lesions are present in the mouth or on genitals. A good oral health, free from bleeding gums, lip sores, cuts, broken skin, and oral epithelium enormously reduces the chances of transmission of infection among the partners indulge in oral sex. A periodic oral health check-up is mandatory among the people frequently involved in oral sex and thus good oral hygiene is the fundamental for oral integrity as it greatly affects the quality of life.[18]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.