One of the things I like to do in this blog is promote good oral health by talking about topics that relate to such. Another thing I like to sometimes do is perhaps teach you something you didn't know. That's not always possible when I talk about routine things like crowns, root canals and whiter teeth, but once in a while a good nugget of information pops into my head, allowing me to share something "common" in a way that not many are aware of.
Today's topic falls squarely into the "I've heard of this, but not in the manner you're talking about" category. And that topic today is gonorrhea. You've heard of it, right (probably in a giggly sixth-to eighth-grade health class)? Yup, that's right -- the age-old sexually transmitted disease (STD) gonorrhea, cast in a light that not many people are aware of. And that's orally.
Yes, you've heard of gonorrhea, but have you heard of oral gonorrhea? If not, it's about time you did.
As an NYC cosmetic dentist, I run into all manner of oral health issues and answer a lot of questions. A few weeks ago, I was asked by someone if it was possible to contract gonorrhea by without actually having sex. I told this person that yes, it was indeed possible. The questioner was surprised (and also somewhat relieved, if you can believe that... I suspect they realized their child was telling the truth about an encounter that left its mark).
So yes, oral gonorrhea is real, it happens, and it's something that we should all be aware of. Let's look at it a bit deeper.
To begin, gonorrhea is caused by the bacteria neisseria gonorrhoea, which targets cells of mucus membranes. That's why it's very much considered a "genital area" disease, often targeting organs and body parts where mucus membranes / bodily fluids are present, e.g., the penis, vagina and anus. And yes, the mouth, eyes and throat. (1)
Somehow, that last part gets left out in the cold. I honestly don't understand why (but even I just called it a "genital area disease." I suppose I could go back and edit that, but I'm going to leave it, as it somewhat proves my point). I think part of the reason is we use the term "sexually transmitted disease" to describe these types of afflictions, and then turn the focus on "safe sex" to keep from getting them ("safe sex" generally meaning "protected sex" with a condom). So, going by that, oral sex is safe sex, right? And, of course, kissing is VERY "safe sex", isn't it? One would think so, but in this case, having oral sex with (or perhaps kissing) someone with oral gonorrhea isn't safe at all. Not to mention the combination of mouths, fingers and genitals that often occurs. Yea, yikes!
Now, in my online research, I found a few sites (2) (3) that generally dismiss kissing as a transmitter. I'm sorry, but saying "kissing is not a very effective way to pass it on to someone else" or you cannot get it from "simple kissing" (err, just what is"simple" kissing?) do NOT make me feel better about catching gonorrhea. In my research, I can generally say that I am satisfied that kissing is not a "common" way to get it, but how does that make you feel? Not 100 percent, right? I'll leave it up to you to decide if kissing is a way to contract it or not, but I'll tell you, if it were me, I'd avoid "deep kissing" unless I was sure. Just my personal two cents here. I want to be clear -- the above is not meant to say "Dr. Connelly says that kissing definitely transmits Gonorrhea" -- it's simply saying I'm 100 percent sure oral gonorrhea is real, it's very clear that oral sex can transmit it, and yes, in my view, the jury is still out on kissing. Use your best judgment from that.
Okay, so what are the symptoms of oral gonorrhea? We all know the genital symptoms (burning sensations while urinating, increased vaginal discharge, maybe some pain, etc.), but oral gonorrhea can be a little trickier. Typical symptoms of oral gonorrhea include sore throat, difficulty swallowing, maybe some redness in the back of the throat... generally sounds like strep throat or something, right? Or even just a cold (which makes these symptoms easy to ignore).
But it gets even trickier -- in many cases, there are no symptoms at all (4), making it hard to detect. However, it's typical that in the case of frequent partners, if one has gonorrhea, then both will contract it. And one will usually have some kind of genital symptom. Thus, if a sexual partner of yours gets gonorrhea, go ahead and get yourself tested, even if you feel fine.
I hope this blog has opened your eyes to the fact that oral gonorrhea is real, and it's fairly easy to transmit. And yes, "safe sex" doesn't just mean a condom. Be smart, and be aware.
And until next time, keep smiling.
Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly