What is Oral Myiasis? 

‘Oral’ means something related to the mouth, and it can be related to teeth, gums, tongue, and maxillary Sinus.

Maxillary Sinus is crucial in dentistry; it is located inside the skin in the facial bone below the eyes and front of the ear, and it’s an air cavity lined by cells.

It transfers infection from teeth and oral cavity towards the brain, nose, and vice versa. Sinuses have close relations with the upper 2nd Molars of each side. 

‘Myiasis’- It has 2 Greek words, ‘Myia’ means fly insects that fly and ‘as is’ means disease. Flies hatch their larvae (their eggs) on the dead tissue. The larva eats the dead tissue and gets it’s nourishment from it and turns into an adult insect and flies away.

So, Oral Myiasis is a rare disease caused by the Larvae of dipterans. It is reported mostly in developing countries. Myiasis can occur in various parts of our body, not only in the oral region. It can be in the skin, nose, ear, eyes.

History Of Oral Myiasis: 

In 1840 Frederick William Hope gave the term Myiasis. He referred it to diseases caused by Dipterans (order dipteral) are insects with two wings called true flies.

It is the largest of orders in an insect. Its numbers are more than 12500 species. Its example is Musca domestica (Housefly).

FW Hope described cases of Myiasis from Jamaica in which one was fetal and caused death. Such conditions have been from ancient times.

Ambroise Pare, the chief surgeon to King Charles and King Henry, observed these larvae in wounds.

Oral Myiasis was first described in 1909.

What Are The Causes Of Oral Myiasis?

It is caused by flies of order Dipterans, as previously said. Sarcophagidae, Calliphoridae, Oestridae, and Muscidae are genera from the order Dipterans. 

• Sarcophagidae – Flesh fly
• Calliphoridae – Blowfly
• Oestridae – Bot fly
• Muscidae – Housefly

Those were some examples of genera. Mostly, it is Chrysomya bezziana (Old Screwworm or Screwworm). It is an obligate parasite; it needs some dead tissue for its species survival, propagation, and reproduction. Its female lays eggs in open wounds, ulcers, scratches, or mucous membranes.

Suppose any injury or cut occurs and remains in direct contact with the air and external environment or not banded properly in its treatment. In that case, it serves as an open wound. Ulcers happen when stomach acid damages the lining of the digestive tract. The mucous membrane is the skin and gingival of the mouth.

This disease three modes of infestation:-

• Accidental: when larvae ingested along with food.
• Semi specific: larvae are laid on necrotic tissue.
• Obligatory: larvae affect intact skin.

Why It Occurs? 

It occurs because of poor oral hygiene (mostly)—facial trauma, extraction wounds, severe halitosis, alcoholism, senility, gingival disease.

Facial trauma occurred after an accident may lead to being infected by flies if not treated early. No proper hygiene of the patient is maintained. After any tooth extraction socket is cut and the body’s healing process begins, this site may be used by flies for their larva.

Severe halitosis is extreme bad breath. Senility is with old persons who can’t take care of their health and hygiene. 

To Whom Oral Myiasis Occurs Mostly?

Patients with mental retardation and psychiatric illness are most vulnerable if proper care of their health and hygiene is not taken correctly.

Moreover, persons with medical conditions like diabetes mellitus and mouth breathing habits are easy targets.

Infants who are breastfed by mothers can be infected.

Persons with anterior open bite i.e., absence of any vertical incisors overlap between upper and lower incisors. In these persons, the mouth remains open.

Symptoms Of Oral Myiasis:

Pain and swelling in mouth, teeth, lips, or palate. The patient can sense the sensation of larvae in the mouth. Extensive tissue destruction infection to other parts of the face and palatal perforation of these conditions are seen in the aftermath. The palate is bone, which is above the tongue. And yes, the larvae can be seen sometimes.

Treatment Of Oral Myiasis:

We highly recommend you take the patient to a concerned dental surgeon for treatment as soon as you observe symptoms. It will be good if treatment is done early to contain its infection.

However, the treatment is the surgical removal of larvae. And the result of the activities of larvae is treated after its removal. Turpentine solution help in the extraction of maggots.

How To Prevent Oral Myiasis:

Control of fly population i.e., to eradicate the adult flies before causing any damage, also called vector control. The second prevention is treating infected animals (yes, animals can be infected) or humans.

General cleanliness of dwelling areas, maintaining good oral health and personal hygiene, essential sanitization, and health education is prevention techniques.

Persons with senility and mental illness require special care and protection.

Does Oral Myiasis Has The Other Side? 

Yes, it is; these larvae have another side. Did you hear about maggot therapy?

Maggots i.e., larvae, are taking nutrition from dead tissue. Necrotic tissues (dead tissue), wounds are disinfected by live larvae, which eat the dead tissue and provide healing.

After its job is done, the larvae are taken out, and the area is cleaned and disinfected. 

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