Diagnosis of tuberculosis based on preliminary oral findings: multiple cases with variable oral manifestations and a brief review

Objective: Tuberculosis (TB) is a systemic disease with world wide distribution and its occurrence in the oral cavity is well documented in the literature. Oral TB is currently reemerging as an infectious disease and may be a diagnostic challenge for dental care providers. The aim of this study was to report all patients with primary manifestations of oral tuberculosis and to evaluate the clinical characteristics of oral tuberculosis lesions. All these patients were subsequently diagnosed with tuberculosis based on oral histological findings and referred for management and therapy. Material and methods: 10 patients with oral lesions were histologically diagnosed as having tuberculosis, who did not give any history of the disease, following surgical biopsy. Results: Oral TB was found in all 10 patients, 7 males and 3 females, with male to female ratio 7:3. Involved oral sites included the angle of the mandible (1 case), right mandibular molar region (2case), left mandibular molar region (4 cases), Gingiva (2 cases), buccal mucosa (1 case). Oral TB patients in this series ranged in age from 6 to 35 years. All the lesions were suggestive of primary tuberculosis. The appearance of the affected mucosa in oral TB was variable. The most common manifestation was ulceration and swelling of the mucosa. Conclusion: TB should be considered in patients with oral ulcerations and swellings. A biopsy specimen for histologic study, acid-fast stains and cultures should be obtained for confirmation and differential diagnosis with other conditions.