Human Papillomavirus: A Narrative Review for Dental Providers in Prevention and Care
Abstract
1. Introduction
2. Methods
3. Results and Discussion
3.1. Human Papillomavirus
3.2. Importance to Oral Care
3.3. HPV Vaccine
- Administer intramuscularly.
- Vaccination initiation is recommended at age 11 or 12 years (can begin at age 9).
- Two doses of HPV vaccine are recommended for most persons starting the series before their 15th birthday.
- ◦
- The second dose of HPV vaccine should be given 6 to 12 months after the first dose.
- ◦
- Adolescents who receive two doses less than 5 months apart require a third dose of HPV vaccine.
- Three doses of HPV vaccine are recommended for ages 15 through 45 years, and for immunocompromised persons.
- ◦
- The recommended three-dose schedule is 0, 1–2, and 6 months.
- ◦
- Three doses are recommended for immunocompromised persons (including those with HIV infection) aged 9 through 26 years.
- Minor illnesses should not delay vaccination.
- Vaccination should be delayed in moderately or severely ill individuals until symptoms improve.
- Pregnant women should defer vaccination until they are no longer pregnant.
3.4. Patient Communication Tips
3.5. Role of the Dentist
4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Kombe Kombe, A.J.; Li, B.; Zahid, A.; Mengist, H.M.; Bounda, G.-A.; Zhou, Y.; Jin, T. Epidemiology and Burden of Human Papillomavirus and Related Diseases, Molecular Pathogenesis, and Vaccine Evaluation. Front. Public Health 2021, 8, 552028. [Google Scholar] [CrossRef] [PubMed]
- dos Santos, L.M.; de Souza, J.D.; Mbakwa, H.A.; Nobre, A.F.S.; Vieira, R.C.; Ferrari, S.F.; Rodrigues, A.R.; Ishikawa, E.A.Y.; Guerreiro, J.F.; de Sousa, M.S. High prevalence of sexual infection by human papillomavirus and Chlamydia trachomatis in sexually-active women from a large city in the Amazon region of Brazil. PLoS ONE 2022, 17, e0270874. [Google Scholar] [CrossRef] [PubMed]
- CDC. Sexually Transmitted Infections (STIs). 2024. Available online: https://www.cdc.gov/sti/about/about-genital-hpv-infection.html (accessed on 3 March 2025).
- Huber, J.; Mueller, A.; Sailer, M.; Regidor, P.-A. Human papillomavirus persistence or clearance after infection in reproductive age. What is the status? Review of the literature and new data of a vaginal gel containing silicate dioxide, citric acid, and selenite. Women’s Health 2021, 17, 17455065211020702. [Google Scholar] [CrossRef] [PubMed]
- Forman, D.; de Martel, C.; Lacey, C.J.; Soerjomataram, I.; Lortet-Tieulent, J.; Bruni, L.; Vignat, J.; Ferlay, J.; Bray, F.; Plummer, M.; et al. Global Burden of Human Papillomavirus and Related Diseases. Vaccine 2012, 30 (Suppl. S5), F12–F23. [Google Scholar] [CrossRef]
- Bruni, L.; Albero, G.; Rowley, J.; Alemany, L.; Arbyn, M.; Giuliano, A.R.; Markowitz, E.L.; Broutet, N.; Taylor, M. Global and regional estimates of genital human papillomavirus prevalence among men: A systematic review and meta-analysis. Lancet Glob. Heal. 2023, 11, e1345–e1362. [Google Scholar] [CrossRef]
- de Martel, C.; Plummer, M.; Vignat, J.; Franceschi, S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int. J. Cancer 2017, 141, 664–670. [Google Scholar] [CrossRef]
- Serrano, B.; Brotons, M.; Bosch, F.X.; Bruni, L. Epidemiology and burden of HPV-related disease. Best Pr. Res. Clin. Obstet. Gynaecol. 2018, 47, 14–26. [Google Scholar] [CrossRef]
- Senkomago, V. Human Papillomavirus–Attributable Cancers — United States, 2012–2016. MMWR Morb. Mortal Wkly. Rep. 2019, 68, 724–728. [Google Scholar] [CrossRef]
- CDC. Cancer. 2024. Available online: https://www.cdc.gov/cancer/research/cervical-cancer-rates-have-dropped-among-young-women.html (accessed on 3 March 2025).
- Dyne, E.A.V. Trends in Human Papillomavirus–Associated Cancers—United States, 1999–2015. MMWR Morb. Mortal Wkly. Rep. 2018, 67, 918–924. [Google Scholar] [CrossRef]
- DSouza, G.; Tewari, S.R.; Troy, T.; Waterboer, T.; Struijk, L.; Castillo, R.; Fakhry, C. Prevalence of oral and blood oncogenic HPV biomarkers among an enriched screening population: Baseline results of the MOUTH study. Cancer 2023, 129, 2373–2384. [Google Scholar] [CrossRef]
- Ahmed, H.G.; Bensumaidea, S.H.; Alshammari, F.D.; Alenazi, F.S.H.; Almutlaq, B.A.; Alturkstani, M.Z.; Aladani, I.A. Prevalence of Human Papillomavirus subtypes 16 and 18 among Yemeni Patients with Cervical Cancer. Asian Pac. J. Cancer Prev. 2017, 18, 1543–1548. [Google Scholar] [CrossRef] [PubMed]
- HPV and Cancer—NCI. 2019. Available online: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer (accessed on 3 March 2025).
- Moss, J.L.; Reiter, P.L.; Brewer, N.T. Correlates of human papillomavirus (HPV) vaccine coverage: A state-level analysis. Sex Transm. Dis. 2015, 42, 71–75. [Google Scholar] [CrossRef] [PubMed]
- Walker, K.K.; Jackson, R.D.; Sommariva, S.; Neelamegam, M.; Desch, J. USA dental health providers’ role in HPV vaccine communication and HPV-OPC protection: A systematic review. Hum. Vaccines Immunother. 2019, 15, 1863–1869. [Google Scholar] [CrossRef] [PubMed]
- Askelson, N. A Mixed-Methods Examination of Factors Related to HPV Vaccination Promotion in Private Dental Settings, Iowa, 2019. Prev Chronic Dis. 2021. Available online: https://www.cdc.gov/pcd/issues/2021/20_0553.htm (accessed on 3 March 2025).
- Kong, W.Y.; Bustamante, G.; Pallotto, I.K.; Margolis, M.A.; Carlson, R.; McRee, A.-L.; Gilkey, M.B. Disparities in Healthcare Providers’ Recommendation of HPV Vaccination for US. Adolescents: A Systematic Review. Cancer Epidemiol. Biomark. Prev. 2021, 30, 1981–1992. [Google Scholar] [CrossRef]
- Baumeister, R.F.; Leary, M.R. Writing Narrative Literature Reviews. Rev. Gen. Psychol. 1997, 1, 311–320. [Google Scholar] [CrossRef]
- Writing Narrative Style Literature Reviews: Medical Writing: Vol 24, No 4—Get Access. Available online: https://www.tandfonline.com/doi/full/10.1179/2047480615Z.000000000329 (accessed on 3 March 2025).
- Gregory, A.T.; Denniss, A.R. An Introduction to Writing Narrative and Systematic Reviews - Tasks, Tips and Traps for Aspiring Authors. Heart Lung Circ. 2018, 27, 893–898. [Google Scholar] [CrossRef]
- Green, B.N.; Johnson, C.D.; Adams, A. Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade. J. Chiropr. Med. 2006, 5, 101–117. [Google Scholar] [CrossRef]
- Greenhalgh, T.; Thorne, S.; Malterud, K. Time to challenge the spurious hierarchy of systematic over narrative reviews? Eur. J. Clin Invest. 2018, 48, e12931. [Google Scholar] [CrossRef]
- Baethge, C.; Goldbeck-Wood, S.; Mertens, S. SANRA—A scale for the quality assessment of narrative review articles. Res. Integr. Peer Rev. 2019, 4, 5. [Google Scholar] [CrossRef]
- Mühr, L.S.A.; Eklund, C.; Dillner, J. Towards quality and order in human papillomavirus research. Virology 2018, 519, 74–76. [Google Scholar] [CrossRef]
- Betz, S.J. HPV-Related Papillary Lesions of the Oral Mucosa: A Review. Head Neck Pathol. 2019, 13, 80–90. [Google Scholar] [CrossRef] [PubMed]
- Gillison, M.L.; Chaturvedi, A.K.; Anderson, W.F.; Fakhry, C. Epidemiology of Human Papillomavirus–Positive Head and Neck Squamous Cell Carcinoma. J. Clin. Oncol. 2015, 33, 3235–3242. [Google Scholar] [CrossRef] [PubMed]
- Stanley, M. HPV—immune response to infection and vaccination. Infect. Agents Cancer 2010, 5, 19. [Google Scholar] [CrossRef]
- D’souza, G.; Agrawal, Y.; Halpern, J.; Bodison, S.; Gillison, M.L. Oral Sexual Behaviors Associated with Prevalent Oral Human Papillomavirus Infection. J. Infect. Dis. 2009, 199, 1263–1269. [Google Scholar] [CrossRef] [PubMed]
- Kalinganire, N.; Uwineza, A.; Kyokunda, L.; Banura, C. Oral-genital HPV infection transmission, concordance of HPV genotypes and genital lesions among spouses/ partners of patients diagnosed with HPV-related head and neck squamous cell carcinoma (HNSCC): A scoping review. Infect. Agents Cancer 2023, 18, 63. [Google Scholar] [CrossRef]
- Wierzbicka, M.; Giorgi, M.R.M.S.; Dikkers, F.G. Transmission and clearance of human papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma—A review. Rev. Med. Virol. 2023, 33, e2337. [Google Scholar] [CrossRef]
- Quinlan, J.D. Human Papillomavirus: Screening, Testing, and Prevention. Am. Fam. Physician. 2021, 104, 152–159. [Google Scholar]
- Lam, J.U.H.; Rebolj, M.; Dugué, P.-A.; Bonde, J.; von Euler-Chelpin, M.; Lynge, E. Condom use in prevention of Human Papillomavirus infections and cervical neoplasia: Systematic review of longitudinal studies. J. Med. Screen. 2014, 21, 38–50. [Google Scholar] [CrossRef]
- Beder Ribeiro, C.M.; Ferrer, I.; Santos de Farias, A.B.; Fonseca, D.D.; Morais Silva, I.H.; Monteiro Gueiros, L.A.; Tavares Carvalho, A.; Ross Porter, S.; Carneiro Leao, J. Oral and genital HPV genotypic concordance between sexual partners. Clin. Oral. Investig. 2014, 18, 261–268. [Google Scholar] [CrossRef]
- Termine, N.; Giovannelli, L.; Matranga, D.; Caleca, M.P.; Bellavia, C.; Perino, A.; Campisi, G. Oral human papillomavirus infection in women with cervical HPV infection: New data from an Italian cohort and a metanalysis of the literature. Oral Oncol. 2011, 47, 244–250. [Google Scholar] [CrossRef]
- Shapiro, G.K. HPV Vaccination: An Underused Strategy for the Prevention of Cancer. Curr. Oncol. 2022, 29, 3780–3792. [Google Scholar] [CrossRef]
- D’souza, G.; Clemens, G.; Strickler, H.D.; Wiley, D.J.; Troy, T.; Struijk, L.; Gillison, M.; Fakhry, C. Long-term Persistence of Oral HPV Over 7 Years of Follow-up. JNCI Cancer Spectr. 2020, 4, pkaa047. [Google Scholar] [CrossRef] [PubMed]
- Antonsson, A.; de Souza, M.; Wood, Z.C.; Carroll, A.; Van, K.; Paterson, L.; Pandeya, N.; Whiteman, D.C. Natural history of oral HPV infection: Longitudinal analyses in prospective cohorts from Australia. Int. J. Cancer 2021, 148, 1964–1972. [Google Scholar] [CrossRef] [PubMed]
- D’Souza, G.; Dempsey, A. The role of HPV in head and neck cancer and review of the HPV vaccine. Prev. Med. 2011, 53, S5–S11. [Google Scholar] [CrossRef] [PubMed]
- Pierce Campbell, C.M.; Kreimer, A.R.; Lin, H.Y.; Fulp, W.; O’Keefe, M.T.; Ingles, D.J.; Abrahamsen, M.; Villa, L.L.; Lazcano-Ponce, E.; Giuliano, A.R. Long-term Persistence of Oral Human Papillomavirus Type 16: The HPV Infection in Men (HIM) Study. Cancer Prev. Research. 2015, 8, 190–196. [Google Scholar] [CrossRef]
- Wierzbicka, M.; Klussmann, J.P.; Giorgi, M.R.S.; Wuerdemann, N.; Dikkers, F.G. Oral and laryngeal HPV infection: Incidence, prevalence and risk factors, with special regard to concurrent infection in head, neck and genitals. Vaccine 2021, 39, 2344–2350. [Google Scholar] [CrossRef]
- Torre, D.D.; Burtscher, D.; Sölder, E.; Rasse, M.; Puelacher, W. The correlation between the quality of oral hygiene and oral HPV infection in adults: A prospective cross-sectional study. Clin. Oral Investig. 2019, 23, 179–185. [Google Scholar] [CrossRef]
- Gillison, M.L.; Broutian, T.; Pickard, R.K.L.; Tong, Z.-Y.; Xiao, W.; Kahle, L.; Graubard, B.I.; Chaturvedi, A.K. Prevalence of Oral HPV Infection in the United States, 2009-2010. JAMA 2012, 307, 693–703. [Google Scholar] [CrossRef]
- Doorbar, J.; Quint, W.; Banks, L.; Bravo, I.G.; Stoler, M.; Broker, T.R.; Stanley, M.A. The Biology and Life-Cycle of Human Papillomaviruses. Vaccine 2012, 30, F55–F70. [Google Scholar] [CrossRef]
- Darwish, G. Squamous Papilloma of the Soft Palate: A Case Report. Cureus 2023, 15, e37423. [Google Scholar] [CrossRef]
- Hochmann, J.; Millán, M.; Hernández, P.; Lafon-Hughes, L.; Aiuto, N.D.; Silva, A.; Llaguno, J.; Alonso, J.; Fernández, A.; Pereira-Prado, V.; et al. Contributions of viral oncogenes of HPV-18 and hypoxia to oxidative stress and genetic damage in human keratinocytes. Sci. Rep. 2023, 13, 17734. [Google Scholar] [CrossRef] [PubMed]
- Yeo-Teh, N.S.L.; Ito, Y.; Jha, S. High-Risk Human Papillomaviral Oncogenes E6 and E7 Target Key Cellular Pathways to Achieve Oncogenesis. Int. J. Mol. Sci. 2018, 19, 1706. [Google Scholar] [CrossRef] [PubMed]
- Fischer, M.; Uxa, S.; Stanko, C.; Magin, T.M.; Engeland, K. Human papilloma virus E7 oncoprotein abrogates the p53-p21-DREAM pathway. Sci. Rep. 2017, 7, 2603. [Google Scholar] [CrossRef]
- Szymonowicz, K.A.; Chen, J. Biological and clinical aspects of HPV-related cancers. Cancer Biol. Med. 2020, 17, 864–878. [Google Scholar] [CrossRef]
- Munger, K.; White, E.A. What are the essential determinants of human papillomavirus carcinogenesis? mBio 2024, 15, e00462-24. [Google Scholar] [CrossRef]
- Lechner, M.; Liu, J.; Masterson, L.; Fenton, T.R. HPV-associated oropharyngeal cancer: Epidemiology, molecular biology and clinical management. Nat. Rev. Clin. Oncol. 2022, 19, 306–327. [Google Scholar] [CrossRef]
- Sathish, N.; Wang, X.; Yuan, Y. Human Papillomavirus (HPV)-associated Oral Cancers and Treatment Strategies. J. Dent. Res. 2014, 93, 29S–36S. [Google Scholar] [CrossRef]
- McIlwain, W.R.; Sood, A.J.; Nguyen, S.A.; Day, T.A. Initial Symptoms in Patients With HPV-Positive and HPV-Negative Oropharyngeal Cancer. JAMA Otolaryngol. Head Neck Surg. 2014, 140, 441–447. [Google Scholar] [CrossRef]
- Marur, S.; D’Souza, G.; Westra, W.H.; Forastiere, A.A. HPV-associated head and neck cancer: A virus-related cancer epidemic. Lancet. Oncol. 2010, 11, 781–789. [Google Scholar] [CrossRef]
- D’souza, G.; Zhang, H.H.; D’souza, W.D.; Meyer, R.R.; Gillison, M.L. Moderate predictive value of demographic and behavioral characteristics for a diagnosis of HPV16-positive and HPV16-negative head and neck cancer. Oral Oncol. 2010, 46, 100–104. [Google Scholar] [CrossRef]
- Lingen, M.W.; Abt, E.; Agrawal, N.; Chaturvedi, A.K.; Cohen, E.; D’Souza, G.; Gurenlian, J.; Kalmar, R.J.; Kerr, A.R.; Lambert, P.M.; et al. Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity: A report of the American Dental Association. J. Am. Dent. Assoc. 2017, 148, 712–727.e10. [Google Scholar] [CrossRef] [PubMed]
- Al-Rawi, N.; Sultan, A.; Rajai, B.; Shuaeeb, H.; Alnajjar, M.; Alketbi, M.; Mohammad, Y.; Shetty, S.R.; Mashrah, M.A. The Effectiveness of Artificial Intelligence in Detection of Oral Cancer. Int. Dent. J. 2022, 72, 436–447. [Google Scholar] [CrossRef] [PubMed]
- Patel, S.; Kumar, D. Predictive identification of oral cancer using AI and machine learning. Oral Oncol. Rep. 2025, 13, 100697. [Google Scholar] [CrossRef]
- Tang, K.D.; Baeten, K.; Kenny, L.; Frazer, I.H.; Scheper, G.; Punyadeera, C. Unlocking the Potential of Saliva-Based Test to Detect HPV-16-Driven Oropharyngeal Cancer. Cancers 2019, 11, 473. [Google Scholar] [CrossRef]
- Schell, S.R. AHNS Prevention & Early Detection Committee AHNS Response to USPSTF Recommendation for|Policy Commons. Available online: https://policycommons.net/artifacts/1689543/ahns-prevention-early-detection-committee-ahns-response-to-uspstf-recommendation-for/2421204/ (accessed on 3 March 2025).
- Shin, D.; Vigneswaran, N.; Gillenwater, A.; Richards-Kortum, R. Advances in Fluorescence Imaging Techniques to Detect Oral Cancer and Its Precursors. Futur. Oncol. 2010, 6, 1143–1154. [Google Scholar] [CrossRef]
- Warnakulasuriya, S.; Kerr, A. Oral Cancer Screening: Past, Present, and Future. J. Dent. Res. 2021, 100, 1313–1320. [Google Scholar] [CrossRef]
- Moyer, V.A.; on behalf of the U.S. Preventive Services Task Force. Screening for Oral Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann. Intern. Med. 2014, 160, 55–60. [Google Scholar] [CrossRef]
- CDC. Human Papillomavirus (HPV). 2024. Available online: https://www.cdc.gov/hpv/hcp/vaccination-considerations/safety-and-effectiveness-data.html (accessed on 3 March 2025).
- HPV Vaccine|CDC. 2023. Available online: https://www.cdc.gov/vaccines/vpd/hpv/hcp/vaccines.html (accessed on 3 March 2025).
- Widdice, L.E.; Breland, D.J.; Jonte, J.; Farhat, S.; Ma, Y.; Leonard, A.C.; Moscicki, A.-B. Human Papillomavirus Concordance in Heterosexual Couples. J. Adolesc. Heal. 2010, 47, 151–159. [Google Scholar] [CrossRef]
- Ellingson, M.K.; Sheikha, H.; Nyhan, K.; Oliveira, C.R.; Niccolai, L.M. Human papillomavirus vaccine effectiveness by age at vaccination: A systematic review. Hum. Vaccines Immunother. 2023, 19, 2239085. [Google Scholar] [CrossRef]
- Schiller, J.T.; Castellsagué, X.; Garland, S.M. A Review of Clinical Trials of Human Papillomavirus Prophylactic Vaccines. Vaccines 2012, 30, F123–F138. [Google Scholar] [CrossRef]
- Sankaranarayanan, R.; Joshi, S.; Muwonge, R.; Esmy, P.O.; Basu, P.; Prabhu, P.; Bhatla, N.; Nene, B.M.; Shaw, J.; Poli, U.R.R.; et al. Can a single dose of human papillomavirus (HPV) vaccine prevent cervical cancer? Early findings from an Indian study. Vaccine 2018, 36, 4783–4791. [Google Scholar] [CrossRef] [PubMed]
- Joshi, S.; Anantharaman, D.; Muwonge, R.; Bhatla, N.; Panicker, G.; Butt, J.; Poli, U.R.R.; Malvi, S.G.; Esmy, P.O.; Lucas, E.; et al. Evaluation of immune response to single dose of quadrivalent HPV vaccine at 10-year post-vaccination. Vaccine 2023, 41, 236–245. [Google Scholar] [CrossRef] [PubMed]
- WHO Updates Recommendations on HPV Vaccination Schedule. Available online: https://www.who.int/news/item/20-12-2022-WHO-updates-recommendations-on-HPV-vaccination-schedule (accessed on 3 March 2025).
- Rosenblum, H.G. Declines in Prevalence of Human Papillomavirus Vaccine-Type Infection Among Females after Introduction of Vaccine—United States, 2003–2018. MMWR Morb. Mortal Wkly. Rep. 2021, 70, 415–420. [Google Scholar] [CrossRef] [PubMed]
- Herrero, R.; Quint, W.; Hildesheim, A.; Gonzalez, P.; Struijk, L.; Katki, H.A.; Porras, C.; Schiffman, M.; Rodriguez, A.C.; Solomon, D.; et al. Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica. PLoS ONE 2013, 8, e68329. [Google Scholar] [CrossRef]
- Hirth, J.M.; Chang, M.; Resto, V.A.; Guo, F.; Berenson, A.B. Prevalence of oral human papillomavirus by vaccination status among young adults (18–30 years old). Vaccine 2017, 35, 3446–3451. [Google Scholar] [CrossRef]
- Chaturvedi, A.K.; Graubard, B.I.; Broutian, T.; Pickard, R.K.L.; Tong, Z.-Y.; Xiao, W.; Kahle, L.; Gillison, M.L. Effect of Prophylactic Human Papillomavirus (HPV) Vaccination on Oral HPV Infections Among Young Adults in the United States. J. Clin. Oncol. 2018, 36, 262–267. [Google Scholar] [CrossRef]
- FDA Approves Merck’s GARDASIL 9 for the Prevention of Certain HPV-Related Head and Neck Cancers-Merck.com. Available online: https://www.merck.com/news/fda-approves-mercks-gardasil-9-for-the-prevention-of-certain-hpv-related-head-and-neck-cancers/ (accessed on 3 March 2025).
- Zhang, Y.; Fakhry, C.; D’souza, G. Projected Association of Human Papillomavirus Vaccination With Oropharynx Cancer Incidence in the US, 2020-2045. JAMA Oncol. 2021, 7, e212907. [Google Scholar] [CrossRef]
- HPV Vaccination Recommendations|CDC. 2023. Available online: https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html (accessed on 3 March 2025).
- Mayo Clinic. HPV Vaccine: Get the facts. Available online: https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292. (accessed on 3 March 2025).
- HPV Vaccination|Cancer Trends Progress Report. Available online: https://progressreport.cancer.gov/prevention/hpv_immunization (accessed on 3 March 2025).
- Increase the Proportion of Adolescents who Get Recommended Doses of the HPV Vaccine—IID-08-Healthy People 2030|odphp.health.gov. Available online: https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-proportion-adolescents-who-get-recommended-doses-hpv-vaccine-iid-08 (accessed on 3 March 2025).
- Pingali, C. National Vaccination Coverage Among Adolescents Aged 13–17 Years—National Immunization Survey-Teen, United States, 2023. MMWR Morb. Mortal Wkly. Rep. 2024, 73, 708–714. [Google Scholar] [CrossRef]
- Kornides, M.L.; Badlis, S.; Head, K.J.; Putt, M.; Cappella, J.; Gonzalez-Hernadez, G. Exploring content of misinformation about HPV vaccine on twitter. J. Behav. Med. 2023, 46, 239–252. [Google Scholar] [CrossRef]
- Taumberger, N.; Joura, E.A.; Arbyn, M.; Kyrgiou, M.; Sehouli, J.; Gultekin, M. Myths and fake messages about human papillomavirus (HPV) vaccination: Answers from the ESGO Prevention Committee. Int. J. Gynecol. Cancer 2022, 32, 1316–1320. [Google Scholar] [CrossRef]
- Casey, S.M.; Paiva, T.; Perkins, R.B.; Villa, A.; Murray, E.J. Could oral health care professionals help increase human papillomavirus vaccination rates by engaging patients in discussions? J. Am. Dent. Assoc. 2023, 154, 10–23.e17. [Google Scholar] [CrossRef] [PubMed]
- Griner, S.B.; Thompson, E.L.; Vamos, C.A.; Chaturvedi, A.K.; Vazquez-Otero, C.; Merrell, L.K.; Kline, N.S.; Daley, E.M. Dental opinion leaders’ perspectives on barriers and facilitators to HPV-related prevention. Hum. Vaccines Immunother. 2019, 15, 1856–1862. [Google Scholar] [CrossRef] [PubMed]
- Cartmell, K.B.; Mzik, C.R.; Sundstrom, B.L.; Luque, J.S.; White, A.; Young-Pierce, J. HPV Vaccination Communication Messages, Messengers, and Messaging Strategies. J. Cancer Educ. 2019, 34, 1014–1023. [Google Scholar] [CrossRef]
- Merrell, L.K.; Bishop, J.M.; Henry, D.S.; Walter, K.O.; Azariah, W.Y.; Loughlin, K.C. Exploring Young Adult Comfort with Oral Health Care Providers’ Discussions Related to HPV: A mixed methods study. Am. Dent. Hyg. Assoc. 2022, 96, 23–36. [Google Scholar]
- Qaderi, K.; Geranmayeh, M.; Farnam, F.; Hasani, S.S.; Mirmolaei, S.T. Understanding HPV-positive women’s needs and experiences in relation to patient-provider communication issues: A qualitative study. BMC Heal. Serv. Res. 2021, 21, 286. [Google Scholar] [CrossRef]
- Murciano-Gamborino, C.; Diez-Domingo, J.; Fons-Martinez, J. Healthcare Professionals’ Perspectives on HPV Recommendations: Themes of Interest to Different Population Groups and Strategies for Approaching Them. Vaccines 2024, 12, 748. [Google Scholar] [CrossRef]
- The HPV Vaccine: Why Parents Really Choose to Refuse. Available online: https://www.hopkinsmedicine.org/news/newsroom/news-releases/2018/10/the-hpv-vaccine-why-parents-really-choose-to-refuse (accessed on 3 March 2025).
- Pilkington, I.; Graziadei, V.; Furey, J.; Farrar, M. Breaking bad news: A clinical skill for postgraduate exams. Br. J. Hosp. Med. 2022, 83, 1–4. [Google Scholar] [CrossRef]
- Alsharif, M.T.; Alsahafi, E. Assessing the Knowledge of HPV-Associated Oropharyngeal Squamous Cell Carcinoma, HPV Vaccination, and Practice Scope among Saudi Dental Students in the Western Region. Healthcare 2024, 12, 905. [Google Scholar] [CrossRef]
- Naavaal, S.; Demopoulos, C.A.; Kelly, A.; Tranby, E.; Frantsve-Hawley, J. Perceptions about human papillomavirus vaccine and oropharyngeal cancers, and the role of dental care providers in human papillomavirus prevention among US adults. J. Am. Dent. Assoc. 2023, 154, 321–329. [Google Scholar] [CrossRef]
Site | % Linked to HPV |
---|---|
Anal | 90 |
Cervical | 90 |
Vaginal | 75 |
Vulvar | 70 |
Penile | 60 |
Average Annual Cases (2012–2016) | Number (%) Probably Caused by Any HPV Type | Number (%) Caused by HPV Subtypes 16 and 18 | Number (%) Caused by HPV Subtypes 31/33/45/52/58 |
---|---|---|---|
Total 16,479 | 11,600 (70%) | 9900 (60%) | 900 (6%) |
Female 3203 | 2000 (63%) | 1600 (51%) | 300 (10%) |
Male 13,276 | 9600 (72%) | 8400 (63%) | 300 (4%) |
Risk Factor | Description |
---|---|
Smoking | Linked to increased susceptibility to HPV infection and potential persistence. |
Oral sex | The primary mode of HPV transmission to the oral cavity. |
Number of sexual partners | A higher number of lifetime partners increases exposure risk. |
Younger age at first encounter | Early sexual debut is associated with a greater likelihood of acquiring HPV. |
HIV infection | Immunosuppression increases the risk of persistent HPV infection. |
Older age | HPV infections are more likely to persist with age due to immune system changes. |
Sexual behavior | Oral HPV incidence is higher in individuals with more oral sex partners, and transmission is observed in both heterosexual and MSM populations. |
Characteristic | HPV-Positive OPSCC | HPV-Negative OPSCC |
---|---|---|
Sexual risk factors | Oral Sex, increased number of partners | Not related |
Incidence | Increasing | Decreasing |
Prognosis | More favorable | Less favorable |
Location | Tonsil, base of tongue | All sites |
Common Presentation | Painless neck mass | Sore throat, dysphagia, and/or odynophagia |
Age | Younger cohorts | Older cohorts |
Smoking | Less strongly associated | More strongly associated |
Alcohol | Less strongly associated | More strongly associated |
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Lipsky, M.S.; Wolfe, G.; Radilla, B.A.; Hung, M. Human Papillomavirus: A Narrative Review for Dental Providers in Prevention and Care. Int. J. Environ. Res. Public Health 2025, 22, 439. https://doi.org/10.3390/ijerph22030439
Lipsky MS, Wolfe G, Radilla BA, Hung M. Human Papillomavirus: A Narrative Review for Dental Providers in Prevention and Care. International Journal of Environmental Research and Public Health. 2025; 22(3):439. https://doi.org/10.3390/ijerph22030439
Chicago/Turabian StyleLipsky, Martin S., Geo Wolfe, Brisa A. Radilla, and Man Hung. 2025. "Human Papillomavirus: A Narrative Review for Dental Providers in Prevention and Care" International Journal of Environmental Research and Public Health 22, no. 3: 439. https://doi.org/10.3390/ijerph22030439
APA StyleLipsky, M. S., Wolfe, G., Radilla, B. A., & Hung, M. (2025). Human Papillomavirus: A Narrative Review for Dental Providers in Prevention and Care. International Journal of Environmental Research and Public Health, 22(3), 439. https://doi.org/10.3390/ijerph22030439