Published on June 13, 2016

Your dentist can alert you to oral and oro-pharyngeal cancerYour dentist can alert you to oral and oro-pharyngeal cancer

Team Maureen

L-R: Michael Fishbein, MD; Eileen Duffy-Lind, RN MSN CPNP; Alessandro Villa, DDS, PhD MPH

At future dental appointments, don’t be surprised if the conversation turns to a discussion about the Human Papilloma virus (HPV).

Although, this can be a touchy subject for some, because it is a sexually transmitted disease, HPV is a link to oral and oropharyngeal cancers. The importance of a thorough oral exam during your dental visit and dialogue about the subject can save lives.

“According to the CDC, there are 79 million people infected with HPV in the United States and there are 14 million new cases every year,” said Alessandro Villa, DDS, PhD MPH, an associate surgeon at Brigham and Women’s Hospital and Dana-Farber Cancer Institute. “HPV-associated cancers are a concern for all providers, and dental health care may play a major role in diagnosing oral cancer.”

Dr. Villa spoke during a dental presentation at the Coonamessett Inn in Falmouth last month. The event, sponsored by Cape Cod Healthcare and Team Maureen, was attended by more than 50 area dentists, oral surgeons and dental hygienists. Team Maureen, is a Falmouth-based non-profit that promotes education, public awareness and supports innovative treatment and research of HPV/cervical cancer.

“Although, HPV is more commonly connected with cervical cancer, it was also found to be associated with about 70 percent of oro-pharyngeal cancers,” said Dr. Villa. Oro-pharyngeal cancers associated with HPV are on the rise, he added.

Although, HPV infections generally do not produce symptoms, the following are symptoms that can indicate oropharyngeal cancers according to Dr. Villa:

  • A sore throat that doesn’t go away
  • Trouble swallowing
  • Difficulty opening the mouth fully
  • Ear problems, pain (can be related to tonsillar cancer)
  • Changes in voice
  • Coughing up blood
  • Sudden weight loss

Approximately 48,250 people in the United States will be diagnosed with oral cancer this year and that translates into 132 new cases of oral cancer every day, according to the Oral Cancer Foundation.

The foundation also notes that even though tobacco and smoking are the major risk factors, the fastest growing group of oro-pharyngeal cancer is in young, healthy, non-smoking individuals, due to the HPV virus.

The Link Between Sex and Oral Cancer

The HPV virus is transmitted through skin-to-skin contact during anal or oral sex.

“Studies show that a large number of sexual partners or any high number of oral sex partners cause HPV infection and HPV-related diseases,” said Dr. Villa.

When HPV settles into the lining of the mouth, and lives there for a long time, it can cause oral cancer, according to Dr. Villa. If the body is able to “clear” the infection, which usually takes about a median time of 7 months, then the body is rid of it and the infection does not progress to cancer, he explained.

In cases where the infection does not clear, it can develop into cancer.

Dr. Villa stressed the importance of dentists and hygienists looking for any changes or lesions in all areas of the mouth including the back of throat and most importantly under the tongue during exams.

The Conversation

Beginning the conversation about the link between HPV and oral cancer is important for the oral health community, Eileen Duffey-Lind, RN, MSN, CPNP, founder of Team Maureen told the gathering. She and her team have developed “Tips for Talking about HPV at the Dentist,” to help dentists educate their patients.

When the dentist or hygienist speaks with a patient, Team Maureen has also provided  pre-printed prescription reminder that states, “Call your doctor to make an appointment for the cancer prevention vaccine.”

The focus of the conversation is not about sex but about prevention, Duffy-Lind emphasized. Even though parents don’t like to think their children will be sexually active, some day they will be, she said.

All boys and girls, ages 11-12 years should be vaccinated against the HPV virus, or at least before the age of 14, as this is the time their immune systems have the greatest immune response, said Duffey-Lind.

Males can get caught up with the vaccine through 21 and females, through age 26 if they did not receive the vaccine when they were younger, according to the Centers for Disease Control and Prevention (CDC).

More information is available by going to the Team Maureen website.