As dental professionals, we often find ourselves in a position of having to talk to our patients about difficult and often personal oral health issues. We will discuss the dangers of tobacco, and especially smokeless tobacco products, as significant factors in the development of oral cancer. But, can we talk about sex? If not, we need to get more comfortable.
It has become clear in recent years that sexual behavior is a contributing factor in the development of oropharyngeal cancer. Years ago, the classic head and neck cancer patient was easy to identify – an older male with a long history of tobacco and alcohol abuse. Now it is estimated that 60 -70 percent of head and neck cancers may be associated with the human papillomavirus (HPV), and it is no longer a club for men only.
While there are a couple hundred HPV varieties, only a few have oncogenic potential. Because oral HPV infections typically affect the folds of the tonsils or the throat at the base of the tongue, they are difficult to detect. Most oral HPV infections resolve on their own, but for a select few, and in the right individual, they can progress to oropharyngeal cancer up to decades later.
With that in mind, wouldn’t it be better to focus our attention on prevention rather than detection? We are fortunate that there is a vaccine against a number of HPV types including the oncogenic HPV16 and 18. As with all things sexual, there are stigmas attached. People are uncomfortable with discussions regarding the treatment or prevention of sexually transmitted diseases.
As dentists, we are in a unique position to reframe the discussion and advocate, not for a STD vaccine, but one that has the ultimate purpose of preventing oropharyngeal cancer.
For more information, visit www.ada.org or www.cdc.gov.
