The Chair of Clinical Stomatology II of the Faculty of Dentistry of the UNR carries out prevention campaigns every year.
In recent years, cases of syphilis have increased in the country, a disease from the 15th century that many believed had been eradicated. Among the reasons are new practices in intimate relationships that are free of prejudices but leave health care aside, and on the other hand, the lack of campaigns to raise awareness about the correct use of barrier methods to avoid sexually transmitted infections.
The latest National Epidemiological Bulletin showed an upward curve of cases in 2023, at a rate of 88 per day, which means the highest number of infections in the last three decades. And in 2024 the trend continues in a similar way. In our city, around 1200 cases of syphilis are detected per year, a high number that affects all genders, ages and social conditions across the board.
In both public and private practices, dentists began to observe more frequently oral lesions compatible with this disease. To address this problem, the Chair of Clinical Stomatology II of the Faculty of Dentistry of the UNR carries out prevention and early diagnosis campaigns for sexually transmitted infections every year. These campaigns aim to disseminate information and control and are directed not only to professionals but to the whole society.
“Genital manifestations can also be seen in the mouth, which is considered a sexual organ,” says Mauricio Viccei, the chairperson of the Chair. When they detect lesions in the office, dentists request some blood tests and fluid from the sore. Then, they refer the patient to an infectious disease specialist for treatment. If the patient is very sore and the condition is characteristic, they refer the patient but with a dose of treatment.
In the event that the patient is a minor and the injury is due to an infection resulting from sexual abuse, the professional must report the situation to the forensic dentistry department following a protocol.
According to Associate Professor Fabiana Mardenlli, syphilis can increase the risk of contracting HIV and other sexually transmitted diseases, since the ulcers produced make it easier to transmit any disease of this type. She stresses that even though there is a treatment for HIV today, it is for life and there is still no cure.
Two years ago, the World Health Organization began issuing alerts: one epidemiological due to the high rates of syphilis infection and the other due to the rate of resistance to antimicrobials and drug treatment. Syphilis is treated and cured with penicillin. If the person has had it for less than a year, only one dose is necessary, but if it has been a longer period, they will need to receive a larger amount.
The cases that dentists see in their offices are both young and older adults. “Kids think they are Superman and Wonder Woman, that nothing will ever happen to them. On the other hand, many adults who get divorced, start establishing new relationships and believe that because of age or menopause, there is no need to protect themselves,” they say and advise: “People who do not have a stable partner should have a blood test every year for sexually transmitted infections.”
In her classes at the Faculty, Professor Merdenlli asks her students what they learned about Comprehensive Sexual Education at school and most of them answer: contraceptive methods. But “they don’t talk about the complications that can come from not taking care of oneself and that affect the life of each person.” For the teacher, in addition to providing guidance on how to take care of oneself, ESI should raise awareness about the danger of contracting sexually transmitted diseases.
One fact that shows the lack of care during sexual intercourse is the increasing use of the morning-after pill and PrEP (pre-exposure prophylaxis), a medication that reduces the chances of contracting HIV and is consumed especially in the male homosexual community but does not prevent all other sexually transmitted infections.
The only way to reduce the risk of contracting syphilis is through the correct and consistent use of condoms. Pregnant women should also undergo check-ups and treatment to prevent transmission to the baby. For professionals, “there is a lack of greater dissemination of information and sexual education to raise awareness.”
Syphilis is a sexually transmitted infection caused by a bacterium called Treponema pallidum that affects both men and women. It is transmitted through unprotected sexual intercourse (vaginal, anal or oral) with a person who has syphilis, through contact with skin or mucous membrane lesions, whether they are chancres or syphilids. It can also be transmitted from a pregnant person to a baby during pregnancy or through an infected blood transfusion.
Symptoms appear after contracting the bacteria and differ depending on the stage of the disease. Generally, without treatment, it has different clinical stages. In the primary phase, a small sore or ulcer called a chancre appears that can appear anywhere on the body where there was contact with the bacteria. The most common areas are the mouth, anus, vagina or penis. It is usually single and has raised edges. The sore or ulcer is not painful and, in addition to the fact that it can occur in places that cannot be seen (such as the vagina, rectum or throat), it can go unnoticed. The chancre disappears without any type of treatment after a few weeks.
In the secondary phase, a rash or hives may appear on the body some time after the sore has disappeared, especially on the trunk, palms and soles. Mouth lesions, fever, generalised enlargement of lymph nodes and hair loss may also appear. In the latent phase there are no symptoms and it may remain this way for many years. However, it can be detected by a laboratory test. The tertiary phase occurs after many years of having syphilis without having received treatment and can cause difficulty moving the arms and legs, paralysis, numbness, visual disturbances, heart disease, sterility or a dementia called neurosyphilis.
Journalist: Victoria Arrabal/Photographer: Camila Casero