What is HPV and How is it Transmitted in the Oral Cavity?

What is the HPV Virus?

The Human Papillomavirus (HPV) is an extremely common virus with nearly 200 strains. HPV strains are categorized into high-risk and low-risk types based on the clinical prognosis of associated lesions and their carcinogenic potential. High-risk types, such as 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 66, are recognized by the International Agency for Research on Cancer (IARC), while low-risk types include 11, 42, 44, 53, 54, and 62.

How is HPV Transmitted?

HPV is easily transmitted through micro-injuries, primarily during sexual contact, including oral-genital interactions. The virus may also be transmitted from the mother to the infant during childbirth or through close contact in early childhood. Additionally, after infancy, it can spread through autoinoculation from infected areas. HPV typically does not show immediate signs or symptoms, and pinpointing the exact time of infection can be challenging.

The primary mode of transmission in adults is thought to be oral-genital contact. Condom use does not fully protect against HPV transmission, with protection rates ranging from 0% to 80%. Many individuals mistakenly believe that oral-genital contact is safe, leading to a higher likelihood of transmission. Although transmission through kissing cannot be entirely ruled out, indirect transmission may also occur among individuals sharing substances like marijuana through smoking.

What Oral Lesions are Associated with HPV?

HPV is linked to benign lesions such as papillomas, condylomas, and warts, as well as precancerous lesions like leukoplakia and erythroplakia. Additionally, there is a correlation with a percentage of squamous cell carcinomas in the oral cavity.

How is HPV Related to Cancer Development in the Oral Cavity?

High-risk HPV strains are associated with cancers of the cervix, oropharynx, penis, and anus. In the oropharyngeal area, HPV-related cancers primarily develop in the tonsils, peritonsillar region, and the posterior third of the tongue, though they can occur in the oral cavity as well. The presence of HPV does not automatically indicate cancer development; this depends on whether the infection is persistent and the individual’s immune response. Individuals with multiple sexual partners and weakened immune systems (such as those who are HIV-positive, immunocompromised, or transplant recipients) are at greater risk.

Are There Other Factors Related to Cancer Development in the Oral Cavity Besides HPV?

Yes, other contributing factors include smoking, alcohol consumption, exposure to radiation and sunlight, and genetic predispositions.

How Can I Find Out if I Have HPV in My Mouth?

The primary method for detection is a clinical examination by a specialist in oral medicine, accompanied by a patient history. This examination allows for the identification of benign, precancerous, and malignant lesions associated with HPV. If deemed necessary, a biopsy of the lesion may be performed and sent for histological analysis to check for the presence of the virus and its associated strains. Typically, HPV is not detected in a healthy mouth, as it is difficult to determine whether the infection is persistent and potentially harmful. Regular follow-up examinations are often recommended.

Article and Guidance by the Oral Surgeon at the ODONTIATRICO KENTRO ATHINON Clinic.