DIAGNOSING TUBERCULOSIS DURING A DENTAL EXAM
Tuberculosis is one of the most ancient disease known to mankind. It has ruined many lives and continues to do so today. Long ago, in ancient Greece it was called “phthisis”, which translates as "exhaustion." Tuberculosis is caused by the tubercle bacillus (Mycobacterium tuberculosis) which is very resistant to environmental effects.
Tuberculosis infection occurs in two stages: the inactive stage (enters the body, some of the bacteria are inactivated by the immune system, and some are captured by immune cells forming tubercles, which do not affect the body in any way), and the active stage (when there’s a certain trigger, mycobacteria leave the tubercles, and affect the lungs, kidneys, etc.).
Diagnosing tuberculosis in the early stages provides a better chance for recovery without long-term effects and complications.
How dose tuberculosis manifest in its early stages, and how can a dentist diagnose the disease during a dental exam?
The main diagnostic sign of tuberculosis in the oral cavity is the so-called "lupoma" a particular lession in the form of a lump which is yellow in color and 1-3 mm in diameter. Lupomas form groups and have a tendency to merge. Another characteristic sign is a yellow plaque which covers the tops of the lesions.
The “apple jelly” sign
One of the methods used to diagnose tuberculosis, which can be easily carried out during a dental exam is pressing a sterile glass slide on the affected area. As a result, lupomas stand out against the pale background, and are visible as yellow nodules resembling the appearance of apple jelly.
The Pospelov phenomenon
A lupoma is probed with a special instrument, and the specific sign of a tuberculosis lesion is when the instrument sinks into the lupoma.
Indurated conglomerate of lymph nodes
Diagnosing tuberculosis in its early stages will not only help the patient receive professional advice and referral to a tuberculosis specialist, but will also protect the patient from long-term adverse effects.