Tuberculosis is a chronic infectious disease that affects multiple organs, including the lungs. Tuberculosis is caused by Mycobacterium tuberculosis. TB disease has a major manifestation of occurrence in the lungs, and TB disease is also in other organs including in the oral cavity. In the oral cavity, clinical manifestation of TB can be oral tuberculosis ulcer, tongue fissure, tuberculoma and enlargement of the gingiva.
Oral tuberculosis ulcers have a clinical appearance similar to those of ulcerated lesions caused by trauma or traumatic ulcers, ulcerated lesions caused by syphilis or syphilis ulcer lession , aphthous ulcers , actinomycosis and Wegener’s granuloma. Oral tuberculosis ulcers have a non-specific clinical appearance and can be misdiagnosed for other ulcerated lesions of the oral cavity, especially if these lesions present before systemic symptoms appear.
The research was conducted from July to November 2017 at the tuberculosis outpatient installation at Dr. Soetomo Hospital, to determine the prevalence of oral tuberculosis ulcers. From the 23 tuberculosis patients, there were no oral tuberculosis ulcers. The incidence of oral ulcer tuberculosis is low due to non-specific clinical features making it difficult to diagnose. Furthermore, oral defense mechanisms such as the antibacterial components of saliva (sIgA and defensin), the presence of good bacteria, muscle immunity, and a protective layer of the epithelium protect the oral mucosa from infection of Mycobacterium tuberculosis.
The low manifestations of oral ulcer tuberculosis are also associated with the use of anti-tuberculosis drugs (OAT). OAT is bactericidal, which inhibits the growth of Mycobacterium tuberculosis in the lungs so that Mycobacterium tuberculosis in the sputum and infections outside the lungs such as the oral cavity will also decrease. Therefore, tuberculosis patients who undergo OAT treatment have a small possibility to be infected by Mycobacterium tuberculosis.
This study concluded that not all tuberculosis patients had manifestations of oral ulcer tuberculosis. It is important for dentists to know the clinical picture of oral tuberculosis ulcers as well as a differential diagnosis of the disorder to prevent transmission between dentists, health workers and patients.
Author: Prof. Dr. Diah Savitri Ernwati, drg., M.Si., SppM(K)
Details of research can be accessed on: D.S.Ernawati, A.E.Parmadiati, B.Soebadi, P.Hadi, N.F.Ayuningtyas, N.D.Maharanidan E.E.Lebang.Prevalence Of Oral Tuberculosis Ulcer In Dots PolyclinicOf Dr. Soetomo General Hospital Surabaya. Biochem. Cell. Arch.2020; 20(Supp 1): 2845-2848.
http://www.connectjournals.com/toc2.php?abstract=3181100H_2845A.pdf&&bookmark=CJ-033216&&issue_id=Supp-01%20&&yaer=2020
