Primary tuberculosis of the oral cavity

Two cases of primary tuberculosis of the mouth are reported. Painless ulceration of long duration and enlargement of the regional lymph nodes that did not respond to conservative and antibiotic therapy were the main manifestations of the disease in both cases. In the first case the tubercle ulcer was located in the lower buccogingival sulcus of a 17-year-old girl. In the second case the lesion occurred as a chronic periodontal inflammation around the gingiva of the left lower second molar tooth. When the tooth was extracted, a painless ulceration appeared around the socket, which was filled by granulation tissue. Histopathologic examination; bacteriologic, serologic, and blood tests; and chest x-ray film confirmed the diagnosis. Predisposing factors that might favor primary inoculation of tubercle bacilli into oral mucosa are also discussed. Finally we emphasize that in such cases it is essential to attempt to locate a possible primary site elsewhere in the body before oral tuberculosis is considered the primary disease.