(1) Alice,

I'm a young gay man, and I'm concerned about oral sex and HIV. What are the risks, statistically and in your opinion, of receiving oral sex without a condom? Also, and this will sound kind of funny, I have braces, so I'm assuming giving head is dangerous.

(2) Dear Alice,

A couple of weeks ago, my girlfriend and I were having oral sex and... well, to make a long story short, my penis got "snagged" on her braces and I received a deep cut on the head. I put Neosporin on it every night for a week, but the cut doesn't seem to be healing very quickly. I don't want to go to Health Services because of the embarrassing nature of the problem.

Help me quickly, please, because it also is very painful to urinate, let alone have any sexual activity. I was also wondering if there was a risk in contracting any STDs from this occurrence. I would really appreciate any advice you can give me.

— Painful penis

Dear Reader and Painful penis,

While more research is needed on the subject of oral sex, braces, and the risk of contracting sexually transmitted infections (STIs), including HIV, braces may increase the risk of condom ripping and/or breaking the skin on the penis — both increasing the chance of STI transmission. Performing fellatio slowly and carefully or providing pleasure in other ways instead of oral sex could be options to consider when braces are involved. If an injury does occur, it may be helpful to go and see a health care provider, especially if it’s not healing and you’re in pain (they can also do STI testing if that’s a concern). While it’s completely normal to feel embarrassed, it’s good to remember that health care providers have seen and heard just about everything and are trained to be professional under every circumstance. If you're too uncomfortable to tell the whole story, that’s ok! You can start by saying you have a cut on your penis that is slow to heal. Period. If your provider needs more information, s/he will ask you.

So, what is known about the risks involved in oral sex with orthodontic devices? Unfortunately, there‘s been very little research conducted on this specific topic. While one recent study shows no correlation between STI infection (specifically oral HPV in the study) and oral sex with braces, many health care providers are of the informal opinion that braces do pose a risk. Why, you ask? Well, because braces could increase the chances of creating wounds in either the mouth of the giver or the genitals of the receiver. Even if using a condom, the braces may potentially rip a microscopic hole in it, thereby decreasing its ability to protect against HIV or STI transmission — even though the condom may look undamaged. In your case, Painful penis, the fact that your penis was lacerated during oral sex means STI transmission could be a possibility — although transmission is always a possibility during unprotected oral sex, even without braces.

What to do when braces have already caused damage? In your case, Painful penis, a visit to your health care provider will determine how to best treat the laceration so that it heals properly. S/he may use gauze to cover the cut and instruct you to apply antibiotics after it’s time for the gauze to be removed. Another benefit of going to your health care provider is that s/he may be able to treat the laceration in a way that helps your penis look as good as possible after it’s healed. It’s usually recommended not to have the penis erect until it is entirely healed, so your health care provider will provide you with the instructions you need. If you are concerned about STI transmission, you could also chat with her/him about your risk and testing options.

In order to prevent a braces mishap during oral sex in the future, take things slowly, gently, and cautiously. Avoid sudden movements. Communicating with each other is key — continually check-in with each other by asking "Is this okay?" (in your own words or phrases) throughout pleasuring, to keep the action going without pain. If you decide not to take your partner's penis into your mouth, your lips, tongue, saliva, and breath can be other wonderful sources of pleasure. For some ideas about ways to give and receive pleasure other than oral sex, check out What is outercourse? or browse Planned Parenthood’s list of sexual activities. Wishing you safe and pleasurable exploration ahead!


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