Prostituting Prosthodontics: Use or Abuse of Dentistry?

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 Mouthy

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.

Final Remarks

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.

Acknowledgments

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.

References

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Dr. Touyz is an associate professor and former director of the department of periodontics at McGill Faculty of Dentistry in Montreal, Canada. He is a Fellow of the Academy of Dentistry International, International College of Dentistry, Pierre Fouchard Academy, and American College of Dentists. His degrees include a DDS, a master’s in dental science, and a master’s in dentistry in periodontics and oral medicine, obtained at the University of the Witwatersrand Oral & Dental Hospital in Johannesburg, South Africa. He is a referee for many professional journals including the Archives of Oral Biology and The European Journal Oral Biology Dental Association of South Africa. He has more than 120 publications, and he can be reached at touyzlouis@gmail.com.

Dr. Afrashtehfar obtained his master of science degree at the Division of Prosthodontics and Restorative Dentistry at McGill Faculty of Dentistry in Montreal, Canada. He is a Fellow of both the International Academy for Dental Facial Esthetics and the Academy of Dentistry International. He has authored more than 100 publications, and he is the youngest editorial board review member of The Journal of Prosthetic Dentistry. Dr. Afrashtehfar actively works in the field of evidence-based dentistry and has contributed to the launch of ebhnow.com, which is a website that provides free immediate access to clinically relevant information to aid dentists in considering a treatment accordingly to the patient’s specific scenario. He is currently an Implant Fellow at the University of Bern School of Dental Medicine in Bern, Switzerland, under the supervision and mentorship of Profs. Brägger, Belser and Buser. He can be reached at kelvin.afrashtehfar@zmk.unibe.ch.

Disclosure: The authors report no disclosures.

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