Human Papillomavirus (HPV) plays an independent role in the development of about one-third of all oral cancers. It is quite prevalent with 3 in every 4 sexually active men and women infected worldwide, most without symptoms. In a recent study published in 2019 in the journal BMC Public Health the authors aimed to “assess the knowledge held by practicing dental professionals as well as the lay public regarding HPV transmission through oral sex and subsequent oropharyngeal cancer development.”1
Information for this study was gathered through a forum discussion. The forum discussed several topics including incidence, morbidity, and risk factors for malignancy, current understanding regarding HPV, oral cancer, and oral sexual practices. The roles of health care professionals in educating patients on the transmission of HPV. Difficulties associated with patient education as sexual practices are not usually discussed in a dental setting. Lastly, screening programs available for oral malignancies.
The lay public portion of the survey included the following questions
- Frequency of oral sex activities for the past month
- Their perceived risk of transmission of HPV, HIV, and other STI’s through oral sex
- Their perceived risk of developing oral cancer through oral sex
- Number of different oral sex partners for the past month
- If they used any protective measures while engaging in oral sexual practices
- If they visited the dentists or physician over the past year
- If they have ever been asked about oral sexual practices by dentists or physician over the past year
The results showed more than 70% of all respondents in the lay public group believed oral sexual practices posed no risk in the development of oropharyngeal cancer. Additionally, 94.7% of respondents that visited a dentist in the past year reported they were never asked about oral sex practices. Lastly, 57.8% of respondents stated oral sex practices were no or low risk for transmission of HPV.
The authors acknowledge many dental professionals are aware of the connection between oral sex, HPV and oropharyngeal cancer. However, this study highlights the lack of skills to have a conversation to educate patients. In fact, one participant in the dental professional group stated, “we should consider how to better start the conversation around HPV with a patient without feeling awkward about sexual practices.”
The authors conclude by stating, “Discussions around HPV and head and neck cancers have mostly focused on the pathophysiology and treatment of such malignancies. Given that the transmission of HPV to the mouth likely occurs via sexual activities, there is an increased need to foster a dialogue between healthcare providers, especially dentists, and their patients about risk factors while leaving aside the embarrassment. This dialogue is still not happening, and participants remain unaware of the potential association between HPV infection and oral cancer.”
Do you talk to your patients about sexual practices and the prevention of HPV infections? Do you feel as if you need better education on the topic or better communication skills? Would you be willing to take a course that could help you better communicate the risk of HPV-related head and neck cancer?
- Brondani MA, Siqueira AB, Alves CMC. Exploring lay public and dental professional knowledge around HPV transmission via oral sex and oral cancer development. BMC Public Health. 2019 Nov 15;19(1):1529. doi: 10.1186/s12889-019-7923-6. PMID: 31729969; PMCID: PMC6858745.