Kiss is probably the most frequently used gesture of affection between lovers, but how many of us know that we can become sick by kissing? The oral cavity can be the means of contacting infections through several mechanisms: micro-organisms that are transmitted through saliva, pathological changes manifested by oral flora, microorganisms that can be transmited through small wounds or simply by touching the skin or lips (such as human papilloma virus or mouth herpes).
1. Oral Herpes
Oral herpes is an infection caused by the herpes simplex virus. The virus causes painful sores on your lips, gums, tongue, roof of your mouth, and inside your cheeks. It also can cause symptoms such as fever and muscle aches.
The herpes simplex virus affects only humans. Mouth sores most commonly occur in children aged 1-2 years, but they can affect people at any age and any time of the year.
People contract herpes by touching infected saliva, mucous membranes, or skin. Because the virus is highly contagious, most people have been infected by at least 1 herpes subtype before adulthood.
Herpes simplex is a DNA virus that causes sores in and around your mouth. Two herpes subtypes may cause these sores.
Herpes simplex virus, type 1 or herpes-1, which causes 80% of cases of oral herpes infections
Herpes simplex virus, type 2 or herpes-2, which causes the rest.
2. Oral candidiasis
Oral or oropharyngeal candidiasis is an infection caused by fungi that grow in the mouth. The most common fungus is Candida Albicans. They grow in the mouth, pharynx and esophagus in certain conditions. In the absence of other known causes of immune suppression, oral thrush in an adult is highly suggestive of HIV infection. Three clinical presentations are common in people with HIV: pseudomembranous, erythematous, and angular cheilitis. As HIV disease progresses, candida infection may invade the esophagus causing dysphagia or odynophagia.
Oral infections by Candida species usually appear as thick white or cream-coloured deposits on mucosal membranes. The infected mucosa of the mouth may appear inflamed (red and possibly slightly raised). In babies the condition is termed thrush. Adults may experience discomfort or burning sensation.
Patients presenting oral candidiasis may be totally asymptomatic, so it is important to inspect the oral cavity thoroughly. Lesions can occur anywhere on the hard and soft palates, under the tongue, on the buccal mucosa or gums, or extending back into the posterior pharynx.
Pseudomembranous candidiasis appears as creamy white curd-like plaques on the buccal mucosa, tongue, and other mucosal surfaces that will wipe away, leaving a red or bleeding underlying surface. Lesions may be as small as 1-2 mm. in size, or extensive plaques covering the entire hard palate.
Erythematous candidiasis presents as a flat red, subtle lesion or lesions either on the dorsal surface of the tongue and/or the hard/soft palates. The tongue may have depapillated red mucosal areas on its dorsal surface.
Angular cheilitis presents with fissuring and redness at either one or both corners of the mouth, and may appear alone or in conjunction with another form of oral candida infection.
3. HPV – human papilloma virus
Research shows that the mouth is, at the cellular level, very similar to the vagina and cervix. Both have the same type of epithelial cells that human papilloma virus types 16 and 18 target. Hpv in mouth tissue is similar to the hpv that causes vaginal dysplasia or condyloma as is the epithelial cells they target. The human papilloma virus affects the skin and mucosal areas of the body. Recent studies have linked human papilloma virus with certain types of oral cancer. 25% of those diagnoses with oral cancer were non-smokers and 75% had used tobacco on some form at some point in their lives. Hpv in mouth tissue is similar to the hpv that causes vaginal dysplasia or condyloma as is the epithelial cells they target.
4. HIV and other STDs
The infections can be transmitted in the oral cavity if there is any wound bleeding (eg bleeding gums).The virus can penetrate these small lesions. It is true that the risk of contacting HIV infection by kiss is lower than by vaginal or anal sex, but not inexistent.
5. Hepatitis
Hepatitis may be transmitted by kissing especially when young people present bleeding mouth lesions such as bleeding gums. HBV (hepatitis B) or HCV (hepatitis C) are very dangerous, because they have the dendecy to evolve in chronic diseases.Is believed that approximately 25% of population has immunity to HBV but 75% may develop chronic hepatitis, cirrhosis and even liver cancer.
6. Mononucleosis
Famous disease called “kissing disease”, mononucleosis, is typically transmitted by kissing. It is caused by the Epstein-Barr virus (EBV) which is found in the saliva of the carrier. In exceptional circumstances mononucleosis can also be transmitted by coughing or sneezing. The disease presents symptoms similar to flu, but can and splenic enlargement could be observed.
