TB is most commonly caused by Mycobacterium tuberculosis. It may infect different organs, but only pulmonary and laryngeal TB are of concern to dental providers, as the pathogen is transmitted by inhalation through aerosol.
It is important to establish the time of diagnosis to know when the patient’s treatment was initiated, as well as if the patient is compliant with the therapy.
Noncompliance may result in multidrug-resistant TB (MDRTB), which is associated with a high degree of morbidity and mortality.
Treatment of TB usually lasts for several months. A noninfectious status may be present in as soon as 2-3 weeks after beginning treatment. However, the vast majority of patients are noninfectious only after 3-6 months of therapy.
Individuals having been exposed to or treated for TB may be in a nonactive (noninfectious) state, defined as three consecutive negative sputum samples.
Active (infectious) TB is associated with weight loss, fatigue, fever, night sweats, chest pain, cough, cough with blood in the sputum, and production of mucopurulent sputum.
A positive purified protein derived (PPD) tuberculin skin test (TST), also called Mantoux TST, indicates exposure to TB but does not determine infectivity.
For individuals who have previously received the TB vaccine Bacille Calmette-Guerin (BCG) a TB blood test - interferon-gamma release assay or IGRA - is preferred.
The more common medications for TB include isoniazid (INH), pyrazinamide, ethambutol, streptomycin, and rifampin.
Rifampin speeds up the metabolism of drugs given concomitantly, which may result in reduced efficacy of these medications.
- Oral Health Care Considerations
- Tuberculosis. MedlinePlus. U.S. National Library of Medicine. May 21, 2021.
- Latent TB Infection and TB Disease. Centers for Disease Control and Prevention. December 11, 2020.
- Testing for TB Infection. Centers for Disease Control and Prevention. March 8, 2021.
- BCG Vaccine. Centers for Disease Control and Prevention. May 4, 2016.
- Drug-Resistant TB. Centers for Disease Control and Prevention. January 17, 2017.