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Ambivalent information on risk via open mouth kissing

Nov 27, 2010

Hi Dr. Frascino,

I hope you are well.

I just want to note the numerous, ambivalent and highly confusing information available via the internet to the common populace, earnestly seeking out said information to assess their individual risks from kissing. Further, is not immune to this phenomenon.

For example, you frequently convey open mouth kissing is not a risk for HIV transmission ( is your most recent example). However, the "Can HIV be transmitted by kissing?" section of's HIV Transmission page does stipulate the existence of a risk through open mouth kissing, when blood transfer is involved (blood being present in the mouth is not as rare as one may imagine, given that many people bite their cheeks/tongues when eating; frequently bleed due to bad gums or vigorously brushing their teeth, whereby gum trauma occurs). Are we to believe you or's HIV transmission page?

Further, you sometimes tell people in this forum that kissing is not a significant risk of HIV transmission, which contradicts your other posts of "no risk". Doing this further agonizes the anxiety held by those frequenting this forum to find answers and contributes to the wealth of conflicting information on the internet.

So, is open mouth kissing a risk or not? It's virtually impossible to ascertain a true definitive answer, given the conflicting information many of us are exposed to. To top it all off, it appears the medical community cannot agree on one answer either.


A Concerned Visitor

Response from Dr. Frascino

Hello Concerned Visitor,

I always strive to make my responses as definitive and consistent as possible. Responding to your specific question, "is open mouth kissing a risk or not?" the answer is that kissing is not a risk for HIV transmission. You implied a related question: is blood in the mouth a risk for HIV transmission? That's an entirely different question and has a different answer. Fresh HIV-tainted blood in the mouth (or on any mucous membrane) is a potential risk for HIV transmission.

An analogy would be to ask if it's safe to go outside in the rain. The answer would be yes. But if you ask if it's safe to carry a metal umbrella in a severe electrical rainstorm, the answer would change, not because of the rain (equivalent to the kiss), but because you are carrying a metal object in an electrical storm and there is the very rare possibility that you could get zapped dead by an errant lightening bolt. Likewise, with minimal bleeding from aggressive toothbrushing or gingivitis, there would be an extremely remote possibility of HIV transmission (about the same as being zapped by that lightening bolt).

It would not be feasible for me to detail every potential extenuating circumstance or confounding variable when responding to literally thousands of questions on this site. If you read my responses carefully, they take into account all the information given in question.

Hope that helps.

Dr. Bob

Last night encounter
The Finger, PEP and at 3 days from exposure...

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