Is oral sex actually safe? Bengaluru doctor shares what may actually increase your STI risk and how to maintain hygiene

Oral sex, often seen as safe, carries medical risks including STIs – while it may have lower transmission risk than penetrative sex, it is not risk-free.

While often perceived as a 'safe' alternative to penetrative intercourse, oral sex carries distinct medical risks that are frequently misunderstood by the public. To clarify these misconceptions, Dr Deepthi Ashwin, consultant, obstetrics and gynaecology, Aster Whitefield Hospital, Bengaluru, detailed the complexities of oral STI transmission and the necessary precautions for modern sexual health in an interview with HT Lifestyle.

Dr Deepthi Ashwin explains that oral sex is not entirely risk-free, with varying STI transmission risks. (Freepik)

Understanding the transmission spectrum

According to Dr Ashwin, the primary misconception is that oral sex is entirely risk-free – while the mechanics of transmission differ from other forms of intimacy, the biological pathways for infection remain open.

"Oral sex usually has a lower STI transmission risk than penetrative sex, like honestly it’s generally less likely, but it’s not a zero risk kind of thing," Dr Ashwin explained. "The actual risk isn’t the same for every infection; some are more easily passed around than others, depending on what kind of contact happens and whether symptoms are going on," she added.

The risk level fluctuates significantly based on the specific pathogen involved. Dr Ashwin categorised the risks as follows:

⦿ Higher transmission risk: Herpes, HPV, gonorrhoea, and syphilis

⦿ Moderate risk: Chlamydia

⦿ Low (but non-zero) risk: HIV

Regarding HIV, Dr Ashwin noted that while the baseline risk is low, 'that chance climbs a lot when there are oral sores, bleeding gums, or genital ulcers'.

Proactive prevention strategies

To mitigate these risks, Dr Ashwin highlighted a combination of physical barriers and lifestyle choices. She advocated for the normalisation of protection even during non-penetrative acts. "Use condoms during oral sex when it’s being done on a penis," Dr Ashwin advised, further suggesting that partners 'use dental dams (or cut condoms) during oral sex on a vulva or anus'.

Beyond physical barriers, the doctor highlighted the importance of clinical intervention and timing:

⦿ Regular screening: "Get regular STI screening, especially because oral infections can be silent for long periods."

⦿ Vaccination: "Consider HPV vaccination; it’s very effective against the strains most tied to oral and throat cancers."

⦿ Symptom awareness: "Don’t do oral sex when either partner has visible sores, ulcers, or an active outbreak."

The role of oral hygiene

Interestingly, Dr Ashwin pointed out that standard hygiene routines can occasionally backfire if timed incorrectly. While maintaining a clean mouth is vital, the physical act of cleaning can create microscopic vulnerabilities. "Keep up good oral hygiene, and avoid brushing or flossing right before oral sex," Dr Ashwin warned, 'since micro-abrasions can raise the risk, kind of subtly'.

By combining consistent testing with the use of barriers and being mindful of physical symptoms, individuals can significantly reduce their risk profile while maintaining a healthy sex life, the doctor concluded.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.