Primary Tuberculosis of Buccal and Labial Mucosa: Literature Review and a Rare Case Report of a Public Health Menace

Table 1

Differentiating features between primary and secondary tuberculosis [2, 14–16, 18, 28–30, 33, 34].

Variable	Primary oral tuberculosis	Secondary oral tuberculosis
Occurrence	Extremely rare, seen primarily in children	More frequently seen than the primary form, primarily in the middle-aged and elderly
Risk factors	(1) Systemic factors; (a) Lowered host resistance; (i) Primary & secondary immunodeficiency; (ii) Nutritional deficiencies; (b) Increased virulence of the mycobacteria; (2) Local factors: oral mucosal traumas (extraction sockets, jaw fracture), chronic inflammation (poor oral hygiene, tobacco habit, periodontitis, chronic pulpitis, dental abscess/cysts), hyperkeratotic disorders (leukoplakia); (3) General factors: overcrowding, poor ventilation and sunlight source, early marriage, and repeated pregnancies at small intervals
Clinical Manifestation	Ulcer: superficial or may be larger and deeper	Ulcer: with undermined, irregular edges, covered with Trélat granules
Oral site	Mostly gingiva	Mostly tongue
Pain/soreness	Lesion is painless	Pain
Lymph nodes	Enlarged and tender	Enlarged/not enlarged, and generally nontender
Management	Antitubercular therapy (ATT), topical application of anti-inflammatory gels, and mucosal protecting agents. Maintaining meticulous oral hygiene and removing of plausible traumatic factors