This article discusses the symptoms, diagnosis, and treatment for oral syphilis.
Syphilis Symptoms
Oral syphilis occurs when someone contracts the infection orally. When this happens, the initial symptom is one or multiple sores, known as chancres. As the disease progresses, it can go through other stages, including secondary, latency, and tertiary.
During secondary oral syphilis, lesions that appear as white patches can develop on the inner lips and tongue. These white patches could also develop into sores or ulcers within the mouth.
The latency stage of syphilis presents with no symptoms at all, but if it progresses to the tertiary stage, lesions of dead skin cells can present on the roof of the mouth. While the bumps that develop in genital syphilis are typically painless, in more than 91% of oral cases, pain is present.
Causes
The main cause of oral syphilis is oral sexual activity with a person that has an active syphilis infection.
Fever Fatigue Weight loss Hair loss Swollen lymph nodes Muscles aches and pains
The syphilis bacteria, known as Treponema pallidum, enters the body through open cuts or sores, and when it does, it causes infection. If that bacteria enters through a cut within the mouth, oral syphilis will develop.
Diagnosis
The diagnostic process for oral syphilis is similar to that of other types of syphilis infection. However, dentists are usually the first to notice or examine the lesions.
In some cases, a dentist will perform a biopsy to determine if an infection is present, but other tests and a health history collection will be needed.
If syphilis is suspected after examination, a blood test known as a rapid plasma regain (RPR) will be performed to check for syphilis-specific antibodies, which are specialized proteins designed to help fight off syphilis infections.
If the test comes back positive, treatment may begin, or more tests may be ordered to help confirm the diagnosis. Other tests include blood tests that look for specific signs of the infection within the blood or a specialized lab test that looks for the syphilis bacteria.
Treatment
Syphilis is curable with the use of antibiotics. The length of time a person has had the infection and the stage of disease will play a role in how long their treatment will last:
Under two years/primary and secondary stages: Oral antibiotics may be taken for 10 to 14 days, or one single injection of penicillin may be administered. Over two years/latency and tertiary stages: Oral antibiotics will be taken for 28 days, or three injections will be given once a week for three weeks.
Possible Side Effects
Oral syphilis can lead to some of the same side effects as other types of syphilis if it is left untreated. During the later stages, especially the tertiary stage, untreated oral syphilis can affect the health of the brain, heart, and other organ systems. The side effects can include:
Neurological decline, including dementia, mental changes, and issues with cognition Issues with the heart’s functionality that compromise proper blood flow Hearing loss Blindness Lesions that develop in various areas of the body, such as the skin, bones, and organs Death
How to Prevent Syphilis in the Mouth
The best way to prevent oral syphilis is to avoid sexual contact with a person who has an active infection. Using protection while participating in oral sexual activities can also help prevent contracting a bacterial infection from another person.
If you are sexually active and have multiple partners, practicing safe sex and participating in regular screenings can avoid any long-term complications that may arise if you do contract oral syphilis.
Summary
Oral syphilis is a type of syphilis that occurs within the mouth. When the bacterial infection is contracted in the mouth, the first sign of infection is typically one or more sores on the inside of the mouth. Secondary oral syphilis presents with worsened mouth lesions that can appear as white patches, sores, and ulcers. Other symptoms of syphilis can also be present, such as fever, headache, muscle aches and pains, and hair and weight loss.
People who are HIV positivePeople who engage in oral sexual activity with partners that have syphilis or who engage in condomless oral sexual activityMen who have condomless oral sex with other men
Oral syphilis may originally be noticed by a dentist examining the mouth. Otherwise, diagnosing and treating oral syphilis is essentially the same as other types of syphilis and involves the use of a physical examination and blood tests. The only treatment is antibiotics.
While some people are at an increased risk of contracting oral syphilis, anyone that engages in condomless oral sex with a person who has an active infection can contract the infection. The best way to protect yourself against oral syphilis is to engage in safer-sex practices and get regular screenings.
A Word From Verywell
Oral syphilis can be challenging to diagnose, so be sure to visit your healthcare provider if you develop any mouth sore. Treatment is available for oral syphilis; the faster you get treatment, the better it will be for your overall health.
