Shingles is a skin rash than can be very painful. Shingles, is caused by the varicella-zoster virus, the same virus responsible for chicken pox. It can occur anywhere on the body but is most common to the torso and to the face. The shingles rash occasionally develops in the mouth. The virus usually affects only a small section of one side of the body. This unusual feature is due to the nerve-related aspect of this illness. After the initial chicken pox onset, the virus lies dormant in the nerve system. The shingles encore is believed to be activated by an episode which weakens the immune system either through illness, stress or age.
Signs and symptoms may include:
• Pain, burning, numbness or tingling
• Sensitivity to touch
• A red rash that begins a few days after the pain
• Fluid-filled blisters that break open and crust over
• Hearing problems
• Balance issues
• Facial muscle weakness
The rash develops blisters and can be extremely itchy once the blisters burst. The rash can take from between two and four weeks to heal.
The virus is contained in the blisters and is contagious, but only to people without immunity to chickenpox. Once infected, the person will develop chickenpox, not shingles. Pregnant women who have not had chicken pox, and babies and young children should avoid contact with the shingles patient.
If you experience any of the symptoms or you believe you have been exposed to the shingles virus, it is important to see your GP immediately as anti-viral medication is most effective if taken within 48 hours of the rash appearing. Early diagnosis and treatment can reduce the severity of pain and duration of the condition. Women who are pregnant, patients undergoing cancer treatment or people with compromised immune systems are at risk for more serious complications if they contract the disease.
Oral care Implications
• If currently experiencing a shingles episode let your dentist know before undergoing any kind of dental work as even a routine teeth cleaning with an ultrasonic device could disrupt the virus and increase the chances of it spreading to someone else.
• During the prodromal stage (i.e. the period between the appearance of initial symptoms and the full development of a rash or fever), the only presenting symptom may be mimicking severe toothpain. The sensory nerves impacted by shingles lead into the tooth pulp, which is filled with nerve endings and results in feelings associated with a severe toothache. Mysdiagnosis may lead to unnecessary extractions or fillings. The diagnosis must be properly established before final treatment.
• If the shingles rash develops in your mouth, it can be very painful and make it difficult to eat until it clears up. It can also change your sense of taste. You can help reduce discomfort caused by oral lesions by using soothing mouth rinses and/or topical anesthetics. Pain medications are often prescribed as well.