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 there isn’t a whole lot of research on oral sex and braces, it can be a good to be careful when giving oral sex if you do have braces to avoid any cuts or injuries. Generally speaking, human immunodeficiency virus (HIV) isn’t commonly spread through oral sex. However, other sexually transmitted infections (STIs) may be transmitted through this activity. The risk of transmission increases if either partner has open sores or cuts, bleeding gums, contact with menstrual blood, exposure to ejaculate, or has an STI outbreak such as with herpes. If you’re concerned about contracting or transmitting STIs, you might explore other ways of providing pleasure to your partner. If an injury does occur, it’s best to talk with your health care provider to ensure you’re able to receive treatment in a timely manner.

You both mentioned braces, and they do seem to pose some potential risks as it relates to oral sex. Namely, if the person giving oral sex has braces, they can either unintentionally cut their partner or they can have open sores from the braces. Both of these situations increase the chance of STI transmission during oral sex. Even if you’re practicing safer sex and wearing a condom or using a dental dam, it’s possible for your hardware to rip a microscopic hole in it, thereby decreasing its ability to protect against HIV or STI transmission — even though the condom may look undamaged.

Painful penis — it sounds like you’ve already encountered some of the hazards associated with receiving oral sex with braces. Because the penis has a rich supply of blood, any cuts to the area are likely to cause heavy bleeding. That blood supply is also what helps it heal quickly. If you’ve been caring for the wound and it hasn’t healed after three or four days, it might be good to talk with your health care provider. Other more serious symptoms that are best addressed by a medical professional include pain upon urination, urethral (opening where urine exits the body) injury, swelling of the genitals, continued pain even after medication, or blood in the urine or penis opening. While it’s completely normal to feel embarrassed, it’s good to remember that health care providers are trained to be professional under such circumstances. If you feel uncomfortable telling the whole story, that’s okay! You can start by saying you have a cut on your penis that’s slow to heal. If your provider needs more information, they will ask you. They’ll also likely be able to advise you on the best course of treatment and be able to assess your risk for STIs and testing options.

In order to prevent a braces mishap during oral sex in the future, it’s a good idea to take things slowly, gently, cautiously, and 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 the experience, to keep the action going without pain. You and your partner can also brainstorm other possibilities, sexual or otherwise, to keep the spice alive. Wishing you safe and pleasurable exploration ahead!

Alice!

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