Dentists may not realise that there is an increase in the proportion of cases of genital herpes that are caused by herpes simplex virus type 1. In developed countries there is an increase in the proportion of adults who have not been exposed to herpes simplex virus type 1 during childhood but who contract it genitally in adulthood. The recurrence rate of genital herpes due to type 1 is apparently less frequent than with type 2. Conversely, there are several reports of primary herpetic gingivostomatitis and up to 4% of recurrent herpes labialis being caused by herpes simplex virus type 2. Dentists treating these patients should be aware of this developing trend and the availability of laboratory tests to aid them in their diagnosis.

Tests for sexually transmitted diseases have shortcomings such as the window period required before the test becomes positive. This is particularly important for dentists or their staff who sustain a needle-stick injury.

 

Further reading

Lafferty WE. The changing epidemiology of HSV-1 and HSV-2 and implications for serological testing. Herpes 2002;9:51-5.

Olin L, Wald A. Case report: symptomatic oral herpes simplex virus type 2 and asymptomatic genital shedding. Herpes 2006;13:25-6.

Lowhagen GB, Tunback P, Bergstrom T. Proportion of herpes simplex virus (HSV) type 1 and type 2 among genital and extragenital HSV isolates. Acta Derm Venereol 2002;82:118-20.



Dr M McCullough of the Australian Dental Association