Clinical Characteristics of Oral Tuberculosis: A Scoping Review

Introduction: Oral tuberculosis (TB) is a rare manifestation of Mycobacterium tuberculosis infection, yet it may signal systemic disease. Because oral TB lesions often mimic traumatic ulcers, oral malignancy, or chronic infection, diagnosis is frequently delayed. Objective: To map the clinical characteristics of oral TB lesions, the oral sites most often involved, and the diagnostic approaches reported in recent literature. Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. PubMed and Scopus were searched for English- or Indonesian-language primary reports published between 2020 and 2025 that described oral manifestations of TB. Four reviewers independently screened records and extracted data; findings were synthesized narratively and mapped quantitatively by lesion pattern, anatomical site, and diagnostic pathway. Results: Of 58 records identified, 13 articles were included after deduplication and screening. Oral TB most often presented as chronic ulceration with poorly defined margins and erythematous or grayish-white surfaces, although nodules and tumor-like masses were also described. The tongue was the most frequent main site (5/13; 38.5%), followed by buccal and/or labial mucosa (4/13; 30.8%), palate (2/13; 15.4%), and, less commonly, gingiva or a post-extraction socket (1/13 each; 7.7%). Diagnosis typically combined clinical assessment, imaging when indicated, biopsy with histopathology, and, in several reports, molecular or culture confirmation. Clinical improvement after standard anti-TB therapy was described in the included cases. Conclusion: Across recent case-based reports, oral TB most commonly appears as chronic tongue or mucosal ulceration and requires multimodal confirmation. Greater familiarity with these patterns may help dentists recognize suspicious lesions earlier, particularly in TB-endemic settings.