What Should Oral Health Clinicians Tell Their Patients About Oral HPV? A Brief Review
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 6
Abstract
In the United States, it is estimated that there are at least 20 million new cases of sexually transmitted infections (STIs) each year, with a prevalence of 110 million people infected, and costing the country 16 billion dollars. The Centers for Disease Control and Prevention (CDC) estimates just over 14 million new cases of HPV infection each year in the US, where half consist of young people between the ages of 15-24 [1]. Approximately 90% of HPV infections will clear within a few years without any symptoms. However, for the infections that do persist, serious health risks may be the outcome. HPV Natural History We actually are still in the infancy stages regarding the natural history of HPV. However, the information we do have on cervical cancer guides the model for oral cavity cancer (OCC) and oropharyngeal cancer (OPC). HPVs are categorized into low-risk (wart-causing) and high-risk (cancer-causing) types. Globally, HPVs type 16 and 18 cause approximately 70% of cervical cancers [2]. The other two most common HPV types are 6 and 11, which predominantly cause genital warts. The tissues within the oropharynx are comparable to the tissues of the cervix, thus it is not surprising that we see a similar paradigm occurring between the two regions regarding HPV infection. For example, HPV can be found in precancerous lesions of the oral cavity, which is the same case in cervical cancer [3]. HPV Risk Factors Internationally, over time, there have been changes in sexual behaviors with the age of sexual interaction beginning much younger; along with the increasing number of sexual partners one has [4-6]. As well, sexual practices have changed with oral sex being performed more by men and women within the 30-49 year age range compared with older adults [5,6]. As such, it is not surprising that HPV infection of the oral cavity is strongly associated with sexual behavior, but what is still perplexing is that it is twice as predominant in males as in females [7]. A multicenter study observed that the frequency of HPV detection in oral cancer biopsy specimens was higher among individuals who reported having more than one sexual partner or having oral sexual contact [8]. Furthermore, an increased risk of oral cancer has been reported both in women with cervical cancer and in spouses of women with cervical cancer [8,9]. These results may collectively suggest a common mode of HPV transmission between the oral and genital area, reinforcing the possibility of sexual transmission of the virus in the oral cavity. Potential reservoirs for the virus are proposed to be the tonsillar crypts [10,11] as well as periodontal pockets [12]. Also, an association between long-standing periodontitis and the risk of tongue cancers has been demonstrated [13]. A recent pilot study observed the oral health status of 223 patients and HPV infection [14]. Their results demonstrated a trend between oral HPV 16 infection and poor clinical oral health status. Thus, it is imperative that oral health practitioners continue to educate their patients on the connections between oral health status and acquiring other diseases.
Authors and Affiliations
Juliet Dang
Keywords
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- EP ID EP573879
- DOI 10.26717/BJSTR.2017.01.000506
- Views 156
- Downloads 0
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