Viruses of Relevance To Dentistry: Human Papillomavirus

Viruses of relevance to dentistry
DNAviruses
Papovaviruses
These DNA viruses infect both humans and animals; however, human disease is
infrequent.
Human papillomavirus
Human papillomavirus (HPV) mainly causes skin warts , it is also associated with a
number of lesions including oral papillomas, oral verrucous carcinomas and focal
epithelial hyperplasia.
Oral infections with HPV

Over 40% of healthy individuals have HPV in the normal oral mucosa, suggesting that
this is a reservoir of the virus.
Adenoviruses
These DNA viruses induce latent infections of the tonsils, adenoids and other
lymphoid tissues of humans. However, most infections caused by adenoviruses are
acute and self-limiting.
Herpesviruses
There are a range of different human herpesviruses (HSVs), currently
numbered 1–8 All of them are structurally similar (enveloped,
icosahedral with double-stranded DNA) and infect both humans and
animals. They are the most common causes of human viral infections.
All have the important property of remaining latent, with the ability to
re-infect the host a variable period after the primary infection.
Important human pathogens include herpes simplex virus types 1 and 2

(HSV-1 and HSV-2), varicella-zoster virus (VZV), Epstein–Barr virus
(EBV) and cytomegalovirus .Students of dentistry should be
thoroughly conversant with the herpes group of viruses as the majority
of them either cause oral infection or are intimately associated with
orofacial tissues and saliva.
HSV (human herpesviruses 1 and 2)

There are two types of HSV: human herpesvirus type 1 (HSV-1) and type 2
(HSV-2). They can be differentiated by serotyping, by DNA homology and, to
some extent, by clinical disease pattern
• Clinical disease
• Disease due to HSV can be either a primary infection, due to first
encounter with the virus, or a reactivation or recurrent infection,
due to activation of the latent virus.
• Recurrent infections
• Recurrence or reactivation of HSV entails activation of the non-
infectious form of the latent virus residing in the neurons of either
the trigeminal ganglion or the sacral ganglia. Reactivation is
provoked by stress, sunlight (possibly ultraviolet rays), local trauma,
etc.; the lesions tend to recur at the site of the primary lesion.
• Treatment
• The course of primary infection can be altered significantly with
drugs that interfere with viral DNA synthesis, such as aciclovir and
vidarabine, but these should be administered in the early prodromal
phase of the disease for best results
• Varicella-zoster virus (human herpesvirus 3)

• This organism causes both varicella (chickenpox) and herpes
zoster (shingles): two different diseases due to an identical
organism. Chickenpox is the primary infection, and herpes zoster is
the reactivation of illness.
•
• Clinical disease
• Varicella
• A common childhood fever, varicella is mild and self-limiting. The
disease is more severe if contracted in adulthood.
•
•
• Zoster (shingles)
• Occurs primarily as a reactivation of the virus in dorsal root or
cranial nerve (usually trigeminal) ganglia. The disease usually
affects adults, and the virus is reactivated despite circulating
antibodies. Zoster is triggered by trauma, drugs, neoplastic disease
or immunosuppression.
• Treatment
• Chickenpox is self-limiting and requires symptomatic
treatment, if any. Disseminated zoster in
immunocompromised patients requires antiviral drugs
(e.g., aciclovir, vidarabine), which interfere with
herpesvirus DNA replication.
• VZV is less sensitive to aciclovir than is HSV, and

hence, a higher dosage is required; therapy should start
within 72 h of onset. Systemic acyclovir may reduce
the duration of the early infective phase and the
associated pain. In addition, it may reduce the
prevalence of post-herpetic neuralgia.
•
• RNAviruses
• Orthomyxoviridae
• These RNA viruses cause worldwide epidemics of influenza. They are
subdivided into types A, B and C. variations are due to structural changes
in the surface spike glycoproteins: haemagglutinin (H antigen) and
neuraminidase (N antigen). The nomenclature of influenza viruses is
based on the H and N antigens. Influenza epidemics are due to the
emergence of a new virus strain containing a haemagglutinin that differs
from that of previously circulating viruses, so that the population has no
(herd) immunity to the new haemagglutinin. Antigenic variation may occur
due to:
• ■ antigenic drift, as a result of minor changes in the amino acid sequence

of the haemagglutinin. These viruses survive because they are less
susceptible to the antibodies most common in the population at the time
• ■ antigenic shift, which constitutes the appearance of a new antigenic type
unrelated or only distantly related to earlier types because of genetic
reassortment. It occurs infrequently and has only been identified in
influenza A
• These antigenic shifts are critically important in the
production of vaccines for influenza: the vaccine used
in previous years may have little or no effect because of
these phenomena.
• Paramyxoviridae
• The paramyxoviruses are enveloped, RNA viruses with
an unsegmented genome, which cause major diseases
of infancy and childhood. There are four groups of
paramyxoviruses:
• 1. parainfluenza virus
• 2. mumps virus
• 3. measles virus
• 4. respiratory syncytial virus (RSV).
• Picornaviridae
• Picornaviridae are non-enveloped, RNA viruses with an unsegmented
genome. Four members of this family cause significant human disease:
polioviruses, coxsackieviruses, echoviruses and rhinoviruses.
•
• Togaviridae
•
• Rubella
• The agent of rubella (German measles) is a togavirus. Rubella is a
childhood fever resembling measles, except that it has a milder clinical
course and shorter duration. If rubella is contracted in early pregnancy, the
virus can cause severe congenital abnormalities and may cause the death of
the foetus.
• POSSIBLE TRANSMISSION ROUTES OF COVID 19 IN DENTAL
CLINICS
• It was reported that live viruses were present in the saliva of infected
individuals by viral culture method. Furthermore, it has been confirmed that
COVID 19 enters the cell in the same path as SARS coronavirus, that is,
through the ACE2 cell receptor. ACE2+ epithelial cells of salivary gland ducts
were demonstrated to be a class early targets of SARS- CoV 1 infection, and
SARS-CoV 2 is likely to be the same situation, although no research has been
reported so far.
•
• Dental patients and professionals can be exposed to pathogenic
microorganisms, including viruses and bacteria that infect the oral cavity and
respiratory tract. Dental care settings invariably carry the risk of COVID 19
infection due to the specificity of its procedures, which involves face-to-
face communication with patients, and frequent exposure to saliva, blood,
and other body fluids, and the handling of sharp instruments
•The pathogenic microorganisms can be transmitted in

dental settings through inhalation of airborne
microorganisms that can remain suspended in the air for long
periods, direct contact with blood, oral fluids, or other patient
materials, contact of conjunctival, nasal, or oral mucosa with
droplets and aerosols containing microorganisms generated
from an infected individual and propelled a short distance by
coughing and talking without a mask , and indirect contact
with contaminated instruments and/or environmental
surfaces.
•Infections could be present through any of these conditions

involved in an infected individual in dental clinics and
hospitals, especially during the outbreak of COVID 19

Viruses of Relevance To Dentistry: Human Papillomavirus

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Viruses of relevance to dentistry

Oral infections with HPV

Important human pathogens include herpes simplex virus types 1 and 2

HSV (human herpesviruses 1 and 2)

• Varicella-zoster virus (human herpesvirus 3)

• VZV is less sensitive to aciclovir than is HSV, and

• ■ antigenic drift, as a result of minor changes in the amino acid sequence

•The pathogenic microorganisms can be transmitted in

•Infections could be present through any of these conditions

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