Abstract
Oral sex is commonly practiced by sexually active male-female and same-gender couples of various ages, including adolescents. The various type of oral sex practices are fellatio, cunnilingus and analingus. Oral sex is infrequently examined in research on adolescents; oral sex can transmit oral, respiratory, and genital pathogens.Oral health has a direct impact on the transmission of infection; a cut in your mouth, bleeding gums, lip sores or broken skin increases chances of infection.
Although oral sex is considered a low risk activity, it is important to use protection and safer sex precautions,
There are various methods of preventing infection during oral sex such as physical barriers, health and medical issues, ethical issues and oral hygiene and dental issues. The lesions or unhealthy periodontal status of oral cavity accelerates the phenomenon of transmission of infections into the circulation. Thus consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.
INTRODUCTION
Oral
sex refers to sexual activities involving the stimulation of the
genitalia by the use of the mouth, tongue, teeth or throat. Oral sex is
now very common in both heterosexual and homosexual couples. People may
involve in oral sex as part of foreplay before sexual intercourse, or
during or following intercourse. Oral sex may be practiced by people of
all sexual orientations. A significant proportion of adolescents are
engaging in noncoital sexual activities, including oral sex.tudies indicate that between 14% and 50% of adolescents have had oral sex before their first experience with sexual intercourse hat more adolescents have had oral sex than vaginal sex nd that few adolescents who engage in oral sex use barrier protection.
The various types of oral sex performed are:
- Cunnilingus (Oral Vaginal Contact): Oral stimulation of a woman's vagina and/or vulva, especially her clitoris, by her partner's lips and tongue
- Fellatio (Oral Penile Contact): Stimulation of a man's penis by his partner's mouth-usually by licking or sucking.
- Analingus (Oral Anal Contact): Stimulation of the partner's anus with tongue or lips
ORAL HEALTH PROFILE
The
Surgeon General's report on oral health highlights the relationship
between oral and overall health, emphasizing that oral health involves
more than dentitionMouth acts as a window to lot of systemic diseases and serves as a port
of entry of the various infections that can alter and affect the immune
status of the person. The oral cavity has the potential to harbor at
least 600 different bacterial species, and in any given patient, more
than 150 species may be present, surfaces of tooth can have as many as
billion bacteria in its attached bacterial plaque and oral care may not
only reduce the microbial load of the mouth but the risk for pain and
oral infections as well.Good oral hygiene is the fundamental for oral integrity as it greatly
affects the quality of life. Lesions of the oral cavity have an immense
impact on the quality of life of patients with complex advanced
diseases;
they cause considerable morbidity and diminish patients physical and
psychological well being. The consequences of unhealthy or painful oral
cavity are significant and oral health should be given paramount
importance for the practice of oral sex. The good oral health permits in
building up defense against the various viruses and organisms by
obstructing their entry into body and circulation.
ORAL HEALTH IN ORAL SEX
Although oral sex is infrequently examined in research on adolescents, oral sex can transmit oral, respiratory, and genital pathogens. Oral-genital contact can transmit a number of sexually transmitted infections (STIs) including herpes, gonorrhea, and the human immunodeficiency virus (HIV) In various acts of oral sex there is a risk of infection since saliva, pre-cum, semen, vaginal secretions, and menstrual blood can get into the mouth. The practice of oral sex is also highly prevalent among young people, regardless of whether they have previously engaged in penetrative intercourse and more of these body fluids you are exposed to, the greater the risk of infection there would be. The various channels in oral cavity that serve as a gateway of entry of infection from oral cavity to blood stream includes any open sores, cuts, abrasions, or bleeding gum disease (gingivitis, periodontitis) in the mouth, the virus can get into the systemic circulation,SALIVA, TEETH AND HIV
The
potential for transmission of HIV by saliva is low, probably due to the
low levels of infectious virus and potential HIV inactivating agent(s)
in saliva.
The unique combination of a thick epithelial layer, reduced numbers of
CD4-bearing target cells, antiviral antibodies and several endogenous
inhibitors (including SLPI) make the oral cavity a particularly
resistant site for HIV transmission. Nonetheless, antiviral mechanisms
are not impermeable, particularly if HIV is delivered as a bolus (as in
receptive oral sex) or the integrity of the mucosal surface is breached
(as with tears, lesions or periodontal disease.
The intact mucosal membrane constitutes a formidable barrier to
infection by pathogenic microorganisms, including viruses. In addition
to lubricating mucosal surfaces; saliva dilutes the microbial burden and
flushes microorganisms into the gastrointestinal tract for inactivation
and destruction.
Dentinal carious lesions may serve as a reservoir for Candida organisms
in both HIV-positive and HIV-negative people, but they are more common
in HIV infected people and may participate in recurrent or recalcitrant
oral Candidiasis in immunosuppressed or immunocompromised patients. The
eradication of dentinal carious lesions with tooth restoration or
extraction, when indicated, may eliminate potential fungal reservoirs
responsible for recurrent or recalcitrant clinical oral candidiasis.
Current evidence suggests that the risk of HIV transmission from
exposure to saliva is considerably smaller than the risk from exposure
to semen.
INFECTION PROGRESSION AND PREGNANCY
The
biologic risk for transmission or acquisition of HIV from oral sexual
contact is not known, but the risk is likely to be related to a number
of factors. These include the presence or absence of virus at sexual
sites (oral, vaginal, anal and penile), the titer of virus (if present),
the integrity and mechanical properties of the sexual mucosa, mucosal
immunity, local inhibitory factors, and the presence or absence of
cofactors that may facilitate transmission. Finally, the frequency and
nature of exposure (e.g., the relative effect of a large number of lower
risk events compared with a small number of higher risk events) and the
underlying epidemiologic features of HIV dynamics in the community may
have an impact on the frequency of HIV transmission from oral
intercourse. The presence of chronic conditions, the occurrence of chronic
ulcerating lesions (candidiasis, herpes simplex virus infection, apthous
ulceration, ulcers secondary to crack cocaine use), and the presence of
many oral pathogens may provide an opportunity for facilitation of HIV
transmission similar to that which occurs with sexually transmitted
diseases. Similarly, the proportional importance of oral sex to HIV
transmission will be a complex result of the relative frequency of oral
sex compared with other activities, infectivity of oral secretions and
its modification by oral pathology, resistance to infection by
inhibitory substances in saliva, the HIV prevalence in the community in
which such activity takes place, the maturity of the epidemic in the
community (given recent observations on differential infectivity by
stage of infection, the role of high activity antiretroviral therapy,
and the extent to which personal prophylaxis is adopted).
Oral
sex with ejaculation was perceived as more risky than oral sex without
ejaculation, across scenarios, receptive anal intercourse was judged to
be riskier than insertive anal intercourse, which was perceived as
riskier than oral sex.
The evidence suggests that HIV transmission can take place through
oro-genital sex from penis to mouth and vagina to mouth. Case reports
describe apparent transmission from mouth to penis although this appears
less likely. The risk of oro-genital transmission of HIV is
substantially less than from vaginal and anal intercourse. Receptive
oro-genital sex carries a small risk of human papillomavirus infection
and possibly hepatitis C, while insertive oro-genital contact is an
important risk factor for acquisition of HSV 1. Oro-anal transmission
can occur with hepatitis A and B. The transmission of other viruses may
occur but ha not yet been proved. The relative importance of oral sex as
a route for the transmission of viruses is likely to increase as other,
higher risk sexual practices are avoided for fear of acquiring HIV
infection.
Thus, unprotected oral-genital contact was the most commonly reported
sexual activity in patients who developed primary HIV infection.
Increasing attention to the risks of oral-genital contact as an
important means of HIV acquisition appears to be warranted; although it is true that oral sex negates the risk of pregnancy
STI is an issue. There is no pathway or scope for sperm from the penis
to enter the uterus and fallopian tubes to fertilize an egg. In humans,
there is no connection between the gastrointestinal system and the
reproductive tract. Ingested sperm is killed and broken down by acid in
the stomach and proteins in the small intestine. The breakdown products
will be absorbed as a negligible quantity of nutrients. Despite this,
oral sex does carry a possible risk of pregnancy if semen from the man
comes in contact with the vaginal area circuitously. This can occur if
the semen in the ejaculate is carried on the fingers, hands, or other
body parts; and comes in contact with the vaginal area. It is therefore
still essential to exercise awareness when having oral sex to avoid
pregnancy.
PREVENTION AND BARRIER TECHNIQUES
To avoid risks during oral sex it is advisable to keep semen and vaginal fluids out of mouth as earliest. The oral cavity should free from any potential bleeding tendencies or pathology. Due to disease risks, many medical professionals advise the use of condoms or dental dams when performing or receiving oral sex with a partner whose STD status is unknown. A makeshift dental dam can be made out of a condom. Using a real dental dam is preferable, because real dental dams are larger and the makeshift version may be accidentally poked with the scissors during the cutting procedure. Plastic wrap may also be used as a barrier during oral sex, but many find that the thickness of the plastic dulls sensation.CONCLUSIONS
The practice of oral sex is also highly prevalent among young people, regardless of whether they have previously engaged in penetrative intercourse. Oral sex involves giving or receiving oral stimulation (i.e. sucking or licking) to the penis, the vagina, and/or the anus. However, although the risk of STD transmission is far greater during vaginal and anal sex than during oral sex, the increasing practice of oral sex, low rates of barrier method use and the finding that first oral sex often occurs prior to first vaginal or anal sex will help increase the relative importance of oral sex as a mode of transmission for genital pathogens. HIV, other STDs can be transmitted through oral sex with an infected partner examples of these STDs include HIV, herpes, syphilis, gonorrhea, genital warts (HPV), intestinal parasites and hepatitis. There are several ways to reduce the risks of oral sex. Generally, the use of a physical barrier during oral sex can reduce the risk of transmission of HIV and other STDs. To reduce the risk of infection during unprotected oral sex, limit exposure to sexual fluids and ensure that no cuts or lesions are present in mouth or on genitals. A good oral health, free from bleeding gums, lip sores, cuts, broken skin and oral epithelium enormously reduces the chances of transmission of infection among the partners indulge in oral sex. A periodic oral health check up is mandatory among the people frequently involved in oral sex and thus good oral hygiene is the fundamental for oral integrity as it greatly affects the quality of life.TO BE CONTINUE ,,,,....READ MORE
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