By Dr Andre Clarke It is Valentine's Day and many Bahamians will use this opportunity to exchange gifts and to profess and confirm love. Even though this is a common practice in western society, it is still very important to be cautious about this practice. It is necessary to be cautious when considering what is given and to whom it is given. It is equally important to know from whom a gift comes. A simple gift such as a kiss can cause warm fuzzy feelings, but also can cause disease. Kissing is known to reduce stress; increase emotional bonding; and often times, can lead to sexual intercourse. It is even known for its metabolic boost. The more intense the kiss, the more kilojoules (energy) are used. Deep kissing also increases saliva flow, which helps to keep the mouth, teeth and gums, healthy. Regardless of the benefits associated with kissing, there are a small number of diseases that are spread by it. These diseases are caused by both bacteria and viruses. Kissing allows for the transfer of these microbes (small bugs), because kissing allows for the easy exchange of saliva and droplets between individuals. This type of direct contact can sometimes lead to diseases reaching endemic proportions. This endemic spread is also possible because infected droplets sometimes become airborne and can linger in the air and travel up to one meter before falling onto a surface. Four of the viral diseases that can be spread by kissing are colds; glandular fever; herpes (both type 1 and type 2); and chicken pox. The common cold affects the upper breathing tract and causes secretions (fluids and mucous) to be produced in excess in the nose and throat. Glandular fever is caused by the Epstein-Barr virus and is known as the kissing disease. It was given this name because it is primarily spread through saliva. Herpes is the virus that causes cold sores and is closely related to the virus that causes chicken pox. When kissing, direct contact with the herpes virus causes its spread. It is most easily spread when the blisters are forming or are present. Of note, when the blisters seem totally healed, they may still be shedding the virus. It is therefore necessary to be always cautious when kissing anyone who has cold sores. In a very similar fashion to the common cold, the chicken pox virus gets into the nose and throat by droplets and by direct contact. It is also known to become airborne. In a similar vein to viruses, bacteria use kisses to infect and to cause disease. The bacteria that causes tooth decay and those that cause meningococcal disease are of particular interest. Babies are not born with any tooth decay bacteria, but get them from infected saliva. The infected saliva comes from kisses and shared food; primarily between mothers and their children. Shared cutlery can also be another way for the infection to spread. Tooth decay bacteria, of course causes teeth to go bad. They use food debris that remains on teeth that are not adequately cleaned to produce acids that dissolve the enamel (hard tooth structure) of teeth and cause them to develop holes. Meningococcal disease is a potentially life threatening condition. The individual usually experiences symptoms that result from inflammation of the membranes that cover the brain and spinal cord. They also develop symptoms that result from large amounts of bacteria in the blood stream. Both of these are very serious symptoms. Meningococcal disease should not be taken lightly and neither should the way it is spread. Kissing should not be taken lightly. There is good news yet: meningococcal disease may only be spread by deep kissing. Now that we know a bit about kissing and some of its good points and bad points, let us keep it all in perspective. Although disease can be spread by a kiss, most of the bacteria and viruses shared will not cause disease and the risk of serious disease is small. Nevertheless, just to be on the safe side, avoid kissing when you or the other person is sick; and when you or the other person has cold sores or ulcers on or around the lips and mouth. It is also advisable to maintain generally good mouth health and to visit your mouth health care professional regularly. It is Valentine's Day. Enjoy it. Have a great time giving and receiving gifts. Protect your smile; you will need it tomorrow. Keep your smile alive.