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Root canal, oral sex, and canker sores.

Question: 

What is the risk of transmission for the following scenarios:

1.) Get root canal on upper back tooth (next to the wisdom tooth). Dentist comments that the gums have taken a beating and to not eat on that side for a while. When a tissue is pressed against the tooth, a little blood stain is there. Later that evening, kissed someone with unknown status. No deep kissing, but not completely closed mouth either. The regular type kissing where the mouth opens a little bit.

2.) Receive oral sex (male receiving oral from female). Later that night, notice small reddish stain on underwear (which was near the oral sex) about the size of a small paperclip, but can't tell if it's blood or lipstick/makeup.

3.) Receive oral sex. Don't notice blood, but the oral sex is very deep and done passionately.

4.) Have two big canker sores inside mouth under the tongue. Deep kiss with someone with lots of tongue involved. Usually canker sores may be consider negligible risk, but what if they are two bigger ones?

Thank you.

Answer: 

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV transmission for the following scenarios:

1.) Get root canal on upper back tooth (next to the wisdom tooth). Dentist comments that the gums have taken a beating and to not eat on that side for a while. When a tissue is pressed against the tooth, a little blood stain is there. Later that evening, kissed someone with unknown status. No deep kissing, but not completely closed mouth either. The regular type kissing where the mouth opens a little bit.

This scenario is determined to be Negligible Risk (There are no evidence or no documented cases of transmission). In this case, there appears to be no direct exchange of blood from your partner to yourself. Because you described there to be no deep kissing, we determine this to be of negligible risk.

2.) Receive oral sex (male receiving oral from female). Later that night, notice small reddish stain on underwear (which was near the oral sex) about the size of a small paperclip, but can't tell if it's blood or lipstick/makeup.

3.) Receive oral sex. Don't notice blood, but the oral sex is very deep and done passionately.

Both of these scenarios are determined to be of Negligible Risk: (There are no evidence or no documented cases of transmission. However, there is a theoretical possibility). Even with the possible presence of blood in your partners mouth, each of these scenarios pose the same amount of risk of HIV transmission to you, which is again, negligible. Being the recipient of unprotected oral sex is considered a negligible risk activity, while, performing unprotected oral sex is considered to be a Low Risk activity (Evidence of transmission occurs through these activities when certain conditions are met)

4.) Have two big canker sores inside mouth under the tongue. Deep kiss with someone with lots of tongue involved. Usually canker sores may be consider negligible risk, but what if they are two bigger ones?

This scenario is determined to be a Negligible Risk( There are no evidence or no documented cases of transmission. However, there is a theoretical possibility). Canker sores may be a source of transmission, due to the possibility of blood exchange with direct access to the blood stream during deep kissing. Saliva alone is not considered to be a method of transmission, and if there was no blood exchange, then the activity is of negligible risk. Larger canker sores may increase the risk of blood being present in the mouth, but do not greatly increase the risk of HIV acquisition in this scenario.

Recommendation: There are no evidence or no documented cases of transmission refer to Physician for more personalized answers.

All the best,

AIDS Vancouver Helpline/Online, Cody & Chelsea