Human Papillomavirus (HPV) and Oral Cancer- Part One

Written by Heather Siler

Human Papillomavirus (HPV) is a group of nearly two hundred different strains of viruses with most being harmless and not cancer causing. It’s the most common sexually transmitted disease (STD), and it can be present for many years before transitioning into cancer. More difficult to detect than tobacco and alcohol-related oral cancers which usually occur in older patients, HPV related cancers affect young adults. Oral cancer caused by HPV is very serious, and most patients aren’t even diagnosed until they present with symptoms because the symptoms are often painless and subtle. Therefore, physicians are requesting the assistance of the dental profession with detecting and diagnosing HPV related oral cancer.

HPV is the leading cause of oropharyngeal (tonsils and base of the tongue) cancer. The location of these cancers makes the dental team invaluable, and their role is two-fold. First, it’s important to perform an oral cancer screening at each recall appointment. Second, it’s crucial to talk with the patient (if over 18 years of age) or parent to inquire if the three-dose HPV vaccination series has been administered. The vaccination series is recommended for patients ages nine to twenty-six, and The Food and Drug Administration (FDA) recommends that males and females receive the first injection of the series between the ages of eleven and twelve. This timing coincides with tetanus and meningitis vaccinations.

A less awkward way to begin the discussion of HPV related oral cancers is to ask the patient or parent if they see their doctor for regular exams and if they’re current on their vaccinations. Furthermore, ask if their vaccination series includes the HPV prevention injections. The conversation can be approached while performing an oral cancer exam. Explain that the exam is to look and feel for any lumps or lesions because HPV is the leading cause of oral cancer.

While there is a lot of information concerning HPV and the vaccine, some of it’s negative concerning the side effects, and this puts the likelihood of getting vaccinated in jeopardy. Direct the patient to legitimate websites such as the Centers for Disease Control (CDC). There are also reputable pamphlets that can be handed out to patients.

In part two of this blog, we’ll discuss the difficulty in diagnosis, symptoms, and treatments of HPV related oral cancer.