Dental practices have a role to play in combating the spread of monkeypox, a Lehigh Valley hospital network says.
Among symptoms of the viral illness that’s been declared a national public health emergency are oral lesions present in up to 70% of cases, St. Luke’s University Health Network said last week. Other symptoms can include fever, muscle aches, lymph node swelling and rash.
Dr. Jeffrey Jahre, the St. Luke’s senior vice president of medical and academic affairs and section chief emeritus of infectious diseases, said the network’s health-care providers have begun seeing oral monkeypox symptoms and called on the dental community to be alert.
“This disease is not as easily transmitted as COVID-19,” Jahre said in a statement. “Early recognition by all health-care providers including dentists can potentially bring the spread of this disease to a halt.”
Dental practices also need to take steps to keep employees and patients safe, similar to the challenges they’ve faced with the coronavirus over the past two and a half years.
Monkeypox is transmitted most commonly through direct contact with body fluids or lesions of the body of someone who has the disease, St. Luke’s said. Less commonly it can also spread through materials that have touched these skin lesions or sores. Close contact with respiratory droplet secretions may be another uncommon mode of spread, though the exact frequency is unknown.
The American Dental Association earlier this month also sought to spread the word among its members about monkeypox, which is in the same family as the virus that causes smallpox. Monkeypox symptoms are similar to smallpox but milder, and the disease has rarely proved fatal, the ADA said.
“Dentists have provided care using standard infection control precautions for several decades now, and the enhanced protocols implemented during the COVID-19 pandemic will continue to keep our patients and staff safe during this monkeypox emergency,” ADA Council on Scientific Affairs Chairwoman Ana Karina Mascarenhas said in a statement, driving home the need to wear personal protective equipment, or PPE, and take additional steps to limit infections.
“Use of appropriate PPE including masks and gloves, surface cleaning, and extra diligence when examining patients for symptoms and the characteristic facial rash and intraoral lesions to identify a patient early are imperative,” Mascarenhas continued.
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St. Luke’s advises dental-care practitioners to familiarize themselves with monkeypox facial and oral lesions, including through a search of Google images.
The facial lesions can vary in number and location including lips and can be papules, pustules, clear vesicles, or open sores with or without scab formation, according to St. Luke’s. The intraoral lesions are equally diverse and could be present anywhere in the mouth including gums, tongue, cheeks, palate and throat. These lesions can resemble other well-known conditions such as cold sores (herpes simplex), canker sores, lesions of hand-foot-mouth disease or trauma.
“It is very important at this time that oral care programs, such those that train dental hygienists and other dental professionals, are aware of and alert to oral monkeypox symptomology and understand how to handle cases,” stated Dr. Wayne Saunders, chief of oral and maxillofacial surgery at St. Luke’s.
St. Luke’s says it’s important to assess patients’ medical history to try and ascertain the causes of lesions that may be present. Currently, most monkeypox cases in the United States involve men who have sexual relations with men who have multiple sexual partners, according to the health network, which notes that the disease is expanding beyond this group, so symptoms in others cannot be ignored.
When suspicious lesions are present, the patient can be referred to primary care providers or urgent care centers for conclusive testing, which is now widely available, Saunders advised. This is the first step to treatment for these often-painful lesions, as well as to potentially protecting the patient’s contacts through the expanding supply of protective vaccinations.
There have been more than 39,000 cases reported in countries that have not historically seen monkeypox. The U.S. has the most infections of any country — more than 13,500. About 98% of U.S. cases are men and about 93% were men who reported recent sexual contact with other men.
The Associated Press contributed to this report.
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