Cunnilingus followed by Coated Tongue / Other risks?

[AZTraveler]

Doctors,

Thank you for all that you do.

I am a hetero male in the U.S.  In the last year or so, total of 7 incidents with CSWs:

5 incidents of condom-protected vaginal intercourse with 5 different massage girls.

No symptoms, no issues ever occurred after those 5 encounters... so I stupidly allowed the next 2 to escalate to Unprotected oral sex in both directions:

2 incidents of condom-protected vaginal intercourse + plus + UNprotected oral sex in BOTH directions with 2 different escorts.

First incident of [condom-protected vaginal and UNprotected oral in both directions] was about 5 months ago; second incident was about one month ago.

If it matters, I tend to get a lot of build up of fluid in my mouth when I am performing cunnilingus on a female.  Whether this is my own saliva manifesting itself or vaginal fluid is not really known, but I'm sure some of it unfortunately gets swallowed.

2 weeks ago (and two weeks after the last exposure), I noticed small white coating on my tongue - mostly in the back- and the ability to scrape it with my fingernail and see white residue.  I honestly don't know if it's been there 2 weeks or 2 years.  Went to the doctor last week.  She thinks it's oral yeast; gave me ciprofloxacin and fluconazole, but swabbed my tongue for Gon and Chlam, only after I explained my std concerns.  Awaiting results...  

Could you please let me know your thoughts?
to be specific:
1.  Could the coated tongue be related to the cunnilingus?
2.  If so, which STDs?
3.  Are yeast infections easily transmitted this way?
4.  I asked her if it would clear up on its own and she said 'No.'  Looking back, I don't really know if she was talking about oral yeast or the other possibilities (Gonn, Clym).  I thought Gonn/Clym would clear up on their own?  Maybe she meant the yeast?
4.  Do any of my specific activities (or the sum of all my activities) in your opinion warrant any testing for HIV?

Thank you so much

[Edward W Hook, MD]

I see no need for tesitng  EWH

[AZTraveler]

Thank you, sir.  Appreciate the information.

Regarding question 5 (HIV risk of the 7 events I described), I will not seek testing at this time for HIV unless you advise otherwise.

[Edward W Hook, MD]

Welcome back to the Forum.  I'll go directly to your questions:

1.  Oral Candida or "thrush" is a common problem in the mouth. Most people have the Candida yeast present in the throat and from time to time situations occur in which the yeast can overgrow.  One such situation is when people take antibiotics. Other times the process can occur without an obvious predisposing factor.  Finally, while it is rare, thrush can be "acquired" through cunnilingus although it is not considered a classical STD.
2.  Other than thrush there are no STDs to be concerned about.  Coated tongues can occur in heavy smokers or in persons with other, non-STD viral infections as well.  In some people guilt and anxiety also cause them to notice the normal coating of the tongue that most people get from time to time.
3.  See above, not particularly easily.
4.  I suspect she was talking about the yeast.  When we see thrush, we treat it.
5.  No, protected sex is safe sex and as for HIV transmission by oral sex, the quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.

hope this helps. EWH