ABSTRACT:
Background and

OBJECTIVES:
While syphilis is well-recognized as a systemic sexually transmitted infection, oral syphilis remains underdiagnosed despite its significant contribution to disease transmission and oral health burden. The objective of this study was to conduct a scoping review of oral syphilis to assess its prevalence, clinical presentation, diagnostic challenges, and public health implications.

METHODS:
We systematically searched PubMed, Scopus, and Web of Science for articles published between 2000 and 2025 using the terms “oral syphilis,” “secondary syphilis,” “Treponema pallidum,” and “oral lesions.” A total of 147 publications were screened, with 52 meeting the inclusion criteria. Data were charted and synthesized to identify trends in epidemiology, oral manifestations, and approaches to diagnosis and management.

RESULTS:
Oral syphilis most commonly presented as mucous patches, ulcers, or leukoplakia-like lesions, often mimicking oral cancers or fungal infections. Delays in diagnosis were frequent due to clinical overlap with other oral diseases and low clinician awareness. Rising global syphilis incidence—particularly in high-risk populations such as men who have sex with men—has increased the likelihood of oral presentations. Only a minority of reviewed cases were initially identified in dental settings, highlighting missed opportunities for early detection.

CONCLUSIONS:
Oral syphilis represents a critical intersection between oral health and infectious disease control. Its misdiagnosis contributes to delayed treatment, ongoing transmission, and increased risk of systemic complications. Strengthening collaboration between dental and medical professionals, improving training in oral manifestations of sexually transmitted infections, and integrating oral syphilis screening into broader public health strategies could improve outcomes.