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Spokane, Washington  Est. May 19, 1883

Dr. Zorba Paster: A potentially simple solution to stopping spread of an STD

By Dr. Zorba Paster For The Spokesman-Review

When was the last time you read Teen Vogue? I doubt if many readers of my column have this magazine on their to-do reading list – unless, of course, you’re looking for a Neiman Marcus top for a tidy sum of $1,150.

I don’t know if many kids in my small town read this or buy the stuff it advertises, but when I found it in the waiting room recently, I was intrigued enough to read it. It was more interesting than one of those dry medical journals that usually make up my lunchtime fare.

As I was chewing on my tuna salad sub – on whole wheat bread, without cheese, but with lots of veggies and hot peppers – I nearly choked when I came to the article discussing how to use mouthwash to prevent gonorrhea infections from oral sex. I nearly fell off the chair.

Who would have thought a story on the art of oral sex would be found next to the latest fashion statement? But, then again, the ad on the page was for Creatures of the Wind pants, a mere $895, not including tax. I was intrigued – by the article, not so much the pants.

Oral sex is common among teens. According to the Centers for Disease Control and Prevention, about 50 percent of teenage boys and girls age 15 to 19 have had oral sex. This is often the prelude to sexual intercourse. Therefore keeping your mouth free of dangerous bugs that can cause serious disease is a public health concern worth noting.

Viruses such as HPV, which causes cervical cancer, and HIV, which causes AIDS, along with the old standbys of syphilis, chlamydia and gonorrhea, can all be spread orally. Reduce the reservoir of sexually transmitted diseases in the mouth and you’ll cut down on STDs in the population overall. Simple math, isn’t it? This is especially important for gay boys and men, who have booming rates of STDs due in part to their sinking rate of safe sex condom use.

A recently published British Medical Journal study looked at Listerine, that old standby mouthwash found in any grocery store, as an option for STD prevention. Back in 1879, the maker of Listerine claimed that it cured gonorrhea in the mouth, but then again he claimed that it cured heart disease and cancer. Ah … those were the pre-Food and Drug Administration days where snake-oil salesmen could claim anything they wanted with impunity.

In 1977, the Federal Trade Commission told the maker of Listerine to stop saying it killed the germs that caused colds because there was no proof of that. And about 10 years ago they made them stop saying that it was as good as flossing (I wish) to get rid of plaque. So there’s a long history of claiming that mouthwash is good for more than just curing halitosis, I’ll let you be the judge on that score.

But the gonorrhea claim may have some truth to it. Before the advent of penicillin, getting rid of this awful infection was a big deal. When antibiotics knocked it dead, gonorrhea was thought to be a thing of the past – until more and more cases of antibiotic-resistant GC came knocking on the doctor’s door.

That GC has been a nasty creature, mutating away. Every time we find a new, stronger, better drug to cure it, this smart bug manages to weasel out of it. The researchers from the BMJ study thought maybe Listerine might help play a role.

In their first experiment, scientists took Listerine Cool Mint and Listerine Total Care mouthwash, applying them to GC cultures to see if the mouthwash stopped them dead. Lo and behold, a solution of one part Listerine to four parts water did the trick.

Then they looked at 200 gay and bisexual men who had previously tested positive for GC in their mouth. These men had received antibiotics but still tested positive for GC. They were placed into two treatment groups.

The first group gargled with salt water, and the second group gargled with Listerine. When tested a few minutes later, the men in the Listerine group were much less likely to have GC infecting their mouth than those in the salt-water gargle group.

Now, this doesn’t mean Listerine will actually work in a real-world situation, but it is promising. It could prove to be a simple solution to a potentially devastating problem. Use of a regular mouthwash might help cut down on STDs – and you don’t need a doctor’s prescription to get it. Wow.

Talking about sex and disease is still taboo in some circles. When I went to UW-Madison in the 1960s it was against the law to say the word “condom” in public. If you did, you could go to jail. How dumb was that? But, then again, did we really believe that Ozzie and Harriet slept in separate beds? And if they did then where did Ricky and David come from?

My spin: STDs are no laughing matter. And reaching the group most likely to get them, teenagers, is a great way to spread the word and cut down on the disease. Stay well.

Dr. Zorba Paster is a family physician, professor at University of Wisconsin School of Medicine and Public Health, and host of the public radio program “ZorbaPaster on Your Health,” which airs at noon Wednesdays on 91.1 FM, and noon Sundays on 91.9 FM. His column appears twice a month in The Spokesman-Review. He can be reached at askzorba@doctorzorba.com.