The mouth is the beginning of the gastro-intestinal tract. Developmentally, the oral hard-tissue and soft-tissue structures derive from the ectoderm and mesoderm. It is innervated by both sensory and motor nerves through the trigeminal (V), facial (VII), glossopharyngeal (IX), vagus (X), spinal accessory (XI), and cranial nerves and with sympathetic and parasympathetic reticulation. Accordingly, it is a complex organ with multiple motor and sensory functions.
Mostly, the mouth is used for eating and drinking, respiration and deglutition, and phonation and speech. Yet there are many other functions for which the mouth is used, such as music making (whistling, singing, use of instruments), prehension, gripping, and sucking, as well as kissing and sexual activity.1-4
The many functions of the mouth allow the transmission of viruses through kissing and other social intercourse.5-19 Among these many functions, the oral cavity is used for for oro-genital contact, specifically for fellatio. A recently introduced device called a “Mouthy” covers the teeth and palate to augment the pleasurable sensation during fellatio (see the Figure).22 However, problems may arise from sexually transmitted diseases (STDs).
The Role of Diseases
STDs are contracted through sexual intercourse as well as through oro-genital contact.5 Viral and bacterial STDs are frequent, whereas protozoal diseases are rare.
Viral infections such as hepatitis, verruca vulgaris, Epstein-Barr virus, mononucleosis, and human immunodeficiency virus (HIV) are transmitted through close contact with or exchange of bodily fluids such as kissing.5,6 Human herpes viral infection is frequently found as a cofactor in aggressive forms of periodontitis.5
Men7 and women8 both harbor human papilloma viruses (HPVs). HPV has been strongly implicated as the cause of labial and oral papillomata.6 DNA typing suggests that oral and cervical cancers derive from distinct but transmissible HPV strains.5,8 A quadri-valent including HPV6/11/16/18-L1 particle virus-like particles is an effective vaccine against developing HPV associated cancers and mucosal warts.11 Gardasil is one commercially well-known HPV vaccine intended to develop immunity against HPV when administered to young women. Vaccines impart immunity in most recipients against HPV-induced neoplastic change.9-10
HIV once was considered rarely transmitted by saliva, but saliva is now acknowledged as a transmissible source of HIV infection.10-14 In addition to viruses, other infectious diseases like meningococcal infections may be contracted by ora-oral (kissing) or oro-genital contact.15 Also, intimate kissing (saviolum) is implicated in the transmission of Neisseria meningitides, the organism that causes meningitis mainly in young people.16
The public generally takes a healthy mouth for granted. Consequently, microbial transmission is prevalent, and transmission by viruses is common. Greater awareness of oro-genital contact as a source of infection should be noted and included in all sex education classes for adolescents and adults.18,19
At a recent workshop at of art-science collaborations at the London Science Gallery, Kuang-Yi Ku of Taiwan presented the Mouthy. He claims that it enhances the pleasure of fellatio.22
Those who use the Mouthy and other such devices should employ prosthetic and orthodontic hygiene practices to optimize the health of their periodontal and other oral structures and make these practices part of their personal hygiene. Sterilization and disinfection before and after the use of these devices would be indicated, much the same as that required for removable prostheses and orthodontic appliances, to eliminate the transmission of infections.21,25
To minimize transmission of infections, oro-genital contact such as fellatio and kissing should be reserved only for fully committed lifelong partners. Otherwise, it should be avoided. Also, HPV vaccination, as for all viral preventable disease, is desirable whenever possible for sexually active people of both genders.20
Dentistry may be regarded as cosmetic or aesthetic.23,24 However, dentistry for erotic satisfaction may be abuse of this expertise. Excellent dentistry complements the natural teeth, enhances appearance and general oral health, and permits full function including breathing, eating, talking, and communicating.
Techniques perfected for dentistry by healthcare professionals should always promote the health and the well-being of patients. However, using these techniques for erotic pleasure borders on exploitation for many, and some may regard such use as spurious.
Attitudes, knowledge, and skills are subject to value judgments, and personal discretion influences decisions. The exploitation of know-how and expertise perfected for dental therapy but manipulated for unintended purposes carries a substantial and severe risk of propagating infection. Taking advantage of the skill demanded from prosthodontics and orthodontics to intensify sexual pleasures remains spurious.
The authors thank the dental technicians F. Klingler, G. Willauer, and A. Blatter at zmk bern for the assistance provided during the construction of the device in the Figure.
- Meller SM, Waterman RE. Congenital craniofacial abnormalities. In: Shaw JH, Sweeney EA, Cappuccino CC, et al, eds. Textbook of Oral Biology. Philadelphia, PA: WB Saunders; 1978:863-896.
- Hamilton WJ. Prenatal growth and development. In: Cohen B, Kramer IRH, eds. Scientific Foundations of Dentistry. London, England: William Heinemann; 1976.
- Penfield WN, Rasmussen T. The Cerebral Cortex of Man: A Clinical Study of Localization of Function. New York, NY: Macmillan; 1950:109-134.
- Donovan B. Sexually transmissible infections other than HIV. Lancet. 2004;363:545-556.
- Contreras A, Slots J. Herpesviruses in human periodontal disease. J Periodontal Res. 2000;35:3-16.
- Nair S, Pillai MR. Human papillomavirus and disease mechanisms: relevance to oral and cervical cancers. Oral Dis. 2005;11:350-359.
- El-Mofty SK, Patil S. Human papillomavirus (HPV)-related oropharyngeal nonkeratinizing squamous cell carcinoma: characterization of a distinct phenotype. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:339-345.
- Crawford DH, Macsween KF, Higgins CD, et al. A cohort study among university students: identification of risk factors for Epstein-Barr virus seroconversion and infectious mononucleosis. Clin Infect Dis. 2006;43:276-282.
- Partridge JM, Koutsky LA. Genital human papillomavirus infection in men. Lancet Infect Dis. 2006;6:21-31.
- Hillemanns P, Wang X. Integration of HPV-16 and HPV-18 DNA in vulvar intraepithelial neoplasia. Gynecol Oncol. 2006;100:276-282.
- Joura EA, Leodolter S, Hernandez-Avila M, et al. Efficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, and 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials. 2007;369:1693-1702.
- Baron S, Poast J, Richardson CJ, et al. Oral transmission of human immunodeficiency virus by infected seminal fluid and milk: a novel mechanism. J Infect Dis. 2000;181:498-504.
- Schattenfroh S. HIV—transmission by kissing [in German]. Dtsch Med Wochenschr. 1997;122:A8.
- Kissing reported as possible cause of HIV transmission. J Can Dent Assoc. 1997;63:603.
- MacLennan J, Kafatos G, Neal K, et al. Social behavior and meningococcal carriage in British teenagers. Emerg Infect Dis. 2006;12:950-957.
- Touyz LZ. Kissing and HPV: honest popular visions, the human papilloma virus, and cancers. Curr Oncol. 2014;21:e515-e517.
- Touyz LZ. Human papilloma virus (HPV)—a biological and clinical appraisal: 2013. Science Postprint. 2013;1:e00001.
- Alexander M, Garda L, Kanade S, et al. Romance and sex: pre-marital partnership formation among young women and men, Pune district, India. Reprod Health Matters. 2006;14:144-155.
- Saranrittichai K, Sritanyarat W, Ayuwat D. Adolescent sexual health behavior in Thailand: implications for prevention of cervical cancer. Asian Pac J Cancer Prev. 2006;7:615-618.
- Touyz LZ. HPV vaccines? Still needed. Curr Oncol. 2016;23:e330-e331.
- Peixoto IT, Enoki C, Ito IY, et al. Evaluation of home disinfection protocols for acrylic baseplates of removable orthodontic appliances: a randomized clinical investigation. Am J Orthod Dentofacial Orthop. 2011;140:51-57.
- Swain F. Sex and dentistry: I made a fellatio prosthetic for my mouth. New Scientist. https://www.newscientist.com/article/2111538-sex-and-dentistry-i-made-a-fellatio-prosthetic-for-my-mouth/. Accessed March 5, 2017.
- Touyz LZ, Raviv E, Harel-Raviv M. Cosmetic or esthetic dentistry? Quintessence Int. 1999;30:227-233.
- Afrashtehfar KI, Assery MK. Five considerations in cosmetic and esthetic dentistry. J N J Dent Assoc. 2014;85:14-15.
- Nishi Y, Seto K, Kamashita Y, et al. Survival of microorganisms on complete dentures following ultrasonic cleaning combined with immersion in peroxide-based cleanser solution. Gerodontology. 2014;31:202-209.
Disclosure: The authors report no disclosures.