Tuberculosis Update

Dentistry Today

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Tuberculosis (TB) experienced decades of steady decline in the United States, but the disease has re-emerged in the last 5 years. Worldwide, 8 million people develop TB annually, and an estimated 30% to 60% of adults in developing countries are infected. According to an article by Yepes, Sullivan, and Pinto, healthcare personnel, including dentists, face a growing number of patients who have been exposed to TB or have acute infection. In New York, tuberculin testing indicates that there has been a 50% increase in Mycobacterium tuberculosis contacts among healthcare workers during the past 8 years. Only people with active TB are infectious, thus it is important to distinguish between people with active TB who are taking appropriate chemotherapy; those with active TB who are not being treated; and those infected with M tuberculosis but not with active disease (positive tuberculin test). People that are asymptomatic with a positive tuberculin skin test and no evidence of active pulmonary disease, and those with a positive tuberculin skin test and evidence of prior TB via chest radiograph do not pose a risk for transmission of TB, but they may be candidates for preventive therapy. Signs and symptoms of pulmonary TB include cough, sputum/blood production, and chest pain. Anorexia, fatigue, weight loss, fever, and night sweats are often associated with active TB. TB lesions of the oral mucosa vary widely, including ulceration, diffuse inflammatory lesions, granulomas, and fissures.


(Source: Oral Surg, Oral Med, Oral Pathol, Oral Radiol, and Endodontol, Vol. 98, No. 3, 2004)