Symptoms of measles may appear in oral cavity before other manifestations of disease Dr. Flaitz described three main signs in the oral cavity indicative of measles: Koplik spots; atypical gingivitis with pustules and necrosis; and operculitis. “Some of these signs and symptoms are subtle,” she said. “So it’s very important to do a thorough soft tissue examination along with the dental examination. Lots of times, a number of these oral lesions are the first indication that a person has either an infectious disease or an underlying systemic disease. Sometimes this is the very first sign besides maybe more nondescript findings, such as a fever.” Other signs and symptoms can help dentists recognize patients with undiagnosed measles. More here: http://www.ada.org/en/publications/ada-news/2015-archive/march/symptoms-of-measles-may-appear-in-oral-cavity