Monkeypox Outbreak and Implications for Dental Practice

Dear Editor,

We wish to comment on the recent publication on “The Monkeypox Outbreak and Implications for Dental Practice” by Samaranayake and Anil in your journal.¹

They noted the infection to be a serious travel-related illness, and dental care professionals should be aware that the disease's premonitory symptoms typically manifest on the oral mucosa as macules and ulcers before the appearance of the characteristic skin lesions. They also rightly stated that during a local outbreak, contact and droplet infection control measures, patient isolation, and referral are crucial.¹ Also, they opined that the smallpox vaccination appears to be successful in preventing the disease, and a vaccine specifically for monkeypox is under development.¹

However, it is noteworthy that neither oral/skin lesions nor fever are seen in many cases, and some patients may present with neurologic and gastrointestinal problems.² With such atypical presentation, health professionals run the risk of missing the diagnosis on initial presentation. In such situations, the laboratory evaluation of clinical samples is typically the foundation of diagnostic inquiry. Of course, if the patient first presents with an oral sore, then the dentist is probably in a position to diagnose the disease.³

Therefore, atypical illness symptoms of monkeypox must be always borne in mind by dental practitioners, in disease-prevalent areas, while strictly adhering to standard contact and droplet precautions, in order to overcome this new public health issue.