As you apparently have seen, oral sex can be considered safe sex, with low risk for all STDs (much lower than unprotected vaginal or anal sex) and virtually zero risk for some. Among oral sex practices, the highest risk is for oral infection in persons who perform fellatio, i.e. oral sex on men. Oral to penile STD transmission is very safe and so is cunnilingus, for both the vaginal and oral partner. This is a bit controversial, and recent research suggests that gonorrhea and perhaps chlamydia may be more frequently transmitted by cunnilingus than previously described, but still a lot less so than by vaginal or anal sex. HIV is very low risk:  to my knowledge, no cientifically validated cases of HIV transmission by cunnilingus have been reported in the medical literature, so if it happens, it's rare. (Fingering is even lower risk, zero for practical purposes, so no further comments about that part of your exposure history.)

So the main STDs of potential risk via cunnilingus in your situation are syphilis, herpes, and human papillomavirus (HPV). Syphilis is very rare in most heterosexual settings in the US, not a significant worry. If your massage partner(s) have HSV2, you could get an oral herpes infection. But HSV2 doesn't take well to oral tissues, and oral herpes due to HSV2 is very rare (almost all oral herpes is due to HSV1, acquired by kissing or other saliva exposure). Finally, although oral HPV infections are not rare, they rarely cause symptoms or disease and generally are cleared by the immune system, so this too is not a serious worry. Going back to gonorrhea, chlamydia and HIV, the risks may not be zero, but they are very low.

Those comments partly address your specific questions, but to be explicit:

1,3) From a medical or risk standpoint, no syphilis or HIV testing is necessary. However, anxious persons often are more reassured by negative tests than by expert opinion based on probability and statistics. You certainly could be tested from time to time (e.g. once a year as long as these sexual practices continue) if the negative results would help reduce your worries about it. But not because of this particular event or the risks associated with it.

2) Similar advice. Can't say the risk is zero, but it's very low. A throat swab is the only way to know for sure. You don't ask about chlamydia, but it's rare in the throat and not known to be transmitted by cunnilingus. Oral chlamydia is always without symptoms, as far as we know, and probably not transmitted to partners. But ongoing research could change this assessment. For now, throat swab testing for chlamydia is not recommended.

4) If somehow I were in your situation, I would continue regular unprotected sex with my wife, and might also be tested once a year (gonorrhea throat culture, blood tests for HIV and syphilis). I would not pursue testing after any particular exposure, only routine testing yearly while I continued sex at home. Yes, that implies a small risk of being infected and putting your partner at risk between annual tests. But extremely low risk, in my view worth taking. If not willing to take at least some risk along these lines, your only realistic choice is to stop having the sorts of sexual exposures described.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

After the latest act, I decided that I am going to stop with these behaviors. I prefer no risk activities, which is why I always received handjobs, and even if the risk is minuscule, which I gauge from your previous responses and response to my question, I'd rather not take those chances, however small they might be. 

I have my annual checkup in February. In summary, are you confident I can hold off on any testing until then and continue along with my normal life? My main risks as of now, regardless of how small they might be would present symptoms (I assume?) such has herpes or Syphillis, so absent of those I can really rest easy until my annual checkup? 

Thanks for all of the work you do!

While it is not possible to guarantee you haven't been infected through the cunnlingus events described, the risk is extremely low. If I were in your situation, I would continue sex with my wife without worry, pending my annual check-up in a coupel of months.