Wednesday, September 14, 2011

HPV and Oral disease




With all the recent dialogue about the HPV virus I felt it would be good to clarify why your dentist is concerned.

The Human Papilloma Virus (HPV) is a common sexually transmitted disease that has been associated with cervical cancers in woman. There are two vaccinations that are currently available for girls before they become sexually active. Although these vaccines appear safe the decision should be run by your doctor to determine whether they should be administered.

Evidence is growing that shows a strong correlation of cancer of the mouth and throat associated with HPV. The rate of increase is alarming and seems to be a result of the increase in oral sex. In fact there are more oral cancers detected every year than cervical cancer. Experts estimate over 34,000 cases of oral cancer detected every year. More than half of these are HPV related.

Your dental team should be performing a visual oral cancer exam on a regular basis. Beginning cancers usually are not detected by the individual who has it and it can be very difficult to spot in the back of the mouth. There are several diagnostic tests your dentist can perform to make this detection easier to accomplish.

If a warty bump appears your dentist may elect to observe it for a while to see if it will disappear on its own or recommend a biopsy. Although biopsy is the most definite way to confirm the nature of the bump we certainly do not want to biopsy everything we see in the mouth. Again, there are tests available help make this determination easier by “looking” under the primary layer of tissue with dyes and fluorescent lights.

Oral cancer exams are no longer performed on middle aged smokers and drinkers. They should be performed on young adults who have no history of smoking. In the future I expect an oral diagnostic test will be readily available for HPV.

Your dentist (me included) does not encounter HPV lesions very often in the general practice. The numbers will confirm that it is still not a very frequent occurrence. The alarming factor is the upward trend of HPV related STD’s and what it may mean in the future. As a precaution it is best to submit to a quick visual inspection of oral cancers by your dental team. Hopefully, the exam and test will be uneventful.

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