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Tuberculosis (TB) is an airborne infection caused by Mycobacterium tuberculosis complex and is highly infectious. Therefore, precautionary measures should be implemented prior to dental treatment to reduce the risk of infection to staff and other patients. Dental history and examination have a role in identification of TB infection. Complex medical history poses a challenge to safe patient management in a dental setting, and close liaison between different disciplines in managing these patients is of paramount importance. This article explores the classical clinical features of pulmonary TB, its oral manifestations and the dental management of patients with active and latent TB.
CPD/Clinical Relevance: Clinicians should be aware of the clinical features and dental management of patients with active and latent TB.
Article
Tuberculosis (TB) is an airborne infection caused by Mycobacterium tuberculosis complex and can be described as active or latent.1Mycobacterium tuberculosis mainly affects the lungs, making pulmonary TB the most common presentation. Pulmonary TB is described as TB that affects the lung parenchyma and tracheobronchial tree.2 Although Mycobacterium tuberculosis is primarily a pulmonary pathogen, it also affects other organ systems such as the gastrointestinal, lymphoreticular, musculoskeletal and reproductive systems, as well as the skin.3
Globally, 1.5 million people died from TB in 2020, with TB being the 13th leading cause of death, and one of the leading infectious killers.4 The UK is a low incidence country, but higher rates are found in larger urban areas and are highest in people born outside the UK and in deprived populations, particularly in people with a history of imprisonment, drug and alcohol misuse, homelessness and asylum seekers. TB incidence in England was 7.8 per 100,000, which is below the World Health Organization (WHO) threshold for a low incidence country (less than or equal to 10 per 100,000 population).5 Data from the UK Health Security Agency (UKHSA) reveals that the number of notifications increased by 7% in the first half of 2023 compared with the first half of 2022. TB notification rates varied widely across the country, with the highest in London and the lowest in the north-east. Despite an overall downward trend in the number and rate of TB notifications in England over the past 10 years, the rate of decline is slowing.
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