Sir, I read with interest the article 'Case series of extra pulmonary tuberculosis presenting as facial swelling' by E. Carter et al. (Br Dent J 2015 May 8; 218: 519–522) about maxillofacial manifestations of tuberculosis.

Oral tuberculosis lesions, whilst uncommon, have been observed in both primary and secondary stages of the disease but have largely become a forgotten diagnosis in oral lesions. They are found in 0.05–5.00% of tuberculosis cases. Primary oral tuberculosis is more common in younger patients.1,2

The tissues of the oral cavity frequently reflect the condition of a person's general health and often may indicate the presence of an infectious disease, since many infection diseases occur primarily within the oral cavity.3 Presence of atypical oral ulcerations should raise suspicion of underlying sexually transmitted infections especially in high risk group patients.4 Dentists can play a key part in the diagnosis and management of patients and have an exceptional opportunity to become familiar with and to interpret changes in oral tissues. Health professionals must be prepared to recognise oral and maxillofacial manifestations of sexually transmitted infections and consider them in the differential diagnosis of these lesions.