Oral Tuberculosis Diagnosis and Management
Summary
Oral tuberculosis represents a rare form of extrapulmonary tuberculosis, typically manifesting as chronic ulcers, swellings of salivary glands or bony lesions of the jaw. Clinical presentation often mimics neoplasms or chronic ulcerative conditions, leading to misdiagnosis and unnecessary surgery. A high index of suspicion is essential, particularly in endemic regions or immunocompromised patients. Diagnosis integrates clinical examination with microbiological and histopathological methods. Smear microscopy and culture remain gold standards, though molecular tools such as the GeneXpert assay enable rapid detection and rifampicin-resistance profiling. Fine-needle aspiration cytology and biopsy deliver cytological or histological confirmation, revealing characteristic epithelioid cell granulomas with Langhans giant cells. Imaging modalities, including ultrasound, CT and MRI, assist in delineating lesion extent and guiding sampling. Management follows a standard antitubercular therapy regimen, typically comprising isoniazid, rifampicin, pyrazinamide and ethambutol for an initial intensive phase, followed by a continuation phase. Surgical intervention is reserved for diagnostic biopsy or complications such as osteomyelitis or abscess formation. Interdisciplinary collaboration between dental surgeons, otolaryngologists, radiologists and infectious-disease specialists ensures prompt diagnosis, optimised therapy and prevention of dissemination. Recent advances in point-of-care molecular diagnostics and targeted imaging have improved detection of paucibacillary oral lesions, underscoring the global importance of recognising oral manifestations within tuberculosis control strategies.
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Oral Tuberculosis Diagnosis and Management publication trend
The graph below shows the total number of articles in oral tuberculosis diagnosis and management across all publications each year (not limited to Nature Index journals).
Technical terms
Extrapulmonary tuberculosis: TB infection occurring in organs other than the lungs, including the oral cavity.
Granuloma: Organised collection of immune cells formed in response to persistent pathogens or foreign material.
Fine-needle aspiration cytology (FNAC): Minimally invasive technique using a thin needle to sample cells for microscopic examination.
GeneXpert assay: Rapid molecular diagnostic test that detects Mycobacterium tuberculosis DNA and rifampicin resistance.
Antitubercular therapy (ATT): Standard multidrug pharmacological regimen used to treat tuberculosis infection.
References
- Primary Mandibular Tuberculous Osteomyelitis Mimicking Ameloblastoma: A Case Report and Literature Review of Mandibular Tuberculous Osteomyelitis. Archives of Plastic Surgery (2024).
- Primary Tuberculosis of Buccal and Labial Mucosa: Literature Review and a Rare Case Report of a Public Health Menace. Case Reports in Dentistry (2023).
- A Giant Nodule of the Soft Palate Mimicking a Tumor: A Case of Oropharyngeal Tuberculosis. Cureus (2022).
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