Figure 5-11.Recurrent aphthous stomatiti (RAS).
are found in the vestibular and buccal mucosa, tongue,
soft palate, and in the floor of the mouth. The exact
cause of these lesions are not known, but studies show
that physical and emotional stress make them appear.
Also injuries from toothbrushing, eating harsh foods,
and allergies can start RAS. The healing time of the
ulcers is usually 7 to 10 days.
The viral infections of main concern that will be
explained are those caused by the herpes simplex virus
(HSV), and the human immunodeficiency virus, also
referred to as the HIV (causing AIDS) virus. Both are
extremely contagious to you and your other dental
patients through cross contamination of dental
instruments and dental equipment. Also the virus can
gain access via the skin, the eye, or mucous
membranes. If you treat a patient with one of these or
other viruses, ensure you follow the proper infection
control procedures outlined in chapter 10.
Herpes Simplex Viruses
The herpes simplex viruses are among the most
common infectious agents. There are two types:
Herpes simplex virusType 1 (HSV-1)
Herpes simplex virusType 2 (HSV-2) (genital
In oral pathology the most commonly diagnosed
sites for HSV-1 are the oral cavity, tongue (fig. 5-12),
lips, and the eyes. Direct contact with HSV-1 lesions is
probably the most common mode of spread.
Transmission through saliva is possible even if there
are no active lesions. Infection on the hands of
healthcare personnel from patients shedding HSV can
result in herpetic lesions.
Other lesions of the HSV-1 virus are acute herpetic
gingivostomatitis, characterized by red and swollen
gingiva. All of the oral mucosa is tender and eating is
painful. Vesicles form throughout the mouth and
rupture, leaving painful ulcers.