The human papilomavirus (HPV) vaccine, known as Gardasil or Cervarix has been incredibly effective in preventing women from contracting cervical cancer. The man behind the vaccine, Professor Ian Grazer quickly became a household name after discovering the link between HPV and cervical cancer. This discovery, and the subsequent development of the vaccine, meant he was awarded the Queenslander of the Year and Australian of the Year awards, the Florey Medal for medical research in 2007 and the 2008 Prime Minister’s Prize for Science.
When you consider that this vaccine was the first vaccine to ever be created to specifically prevent the contraction of a cancer, a cancer that was incredibly deadly, it’s no surprise that Professor Grazer quickly became the name on everyone’s lips.
What is HPV?
HPV is the name of a contagious virus that usually affects moist membranes in your body, such as the mouth, throat and cervix. It is incredibly prevalent, with over three quarters of sexually active women acquiring it at some point in their lifetime. Sexual intercourse, including oral sex, is the most common way that the virus is transferred from person to person. HPV causes changes to tissue growth, which contributes to cervical cancer, but its most common symptom is found in the appearance of genital warts.
Connection between HPV and Dentistry
Soon after its implementation, it was discovered that the vaccine was also incredibly effective in preventing other forms of cancer that were previously thought to be unrelated to HPV. The American Dental Association reported that the scientific world had gradually come to realise there was a link between HPV and squamous cell cancers of the oropharynx and more specifically cancers of the tonsils and at the base of the tongue.
Previously, mouth cancers were associated with smoking and heavy alcohol consumption, although these cancers were typically found at the front of the mouth. As smoking levels decreased so did the prevalence of front of mouth cancers, but during the same time oropharynx, or back of the mouth cancers increased. The ADA places the level of increase at 224% between 1988 and 2004. In light of this finding, recommendations were made for boys to receive the HPV vaccine as a way to slow down this increase in back of mouth cancers.
HPV 16 was found to be the dominant cause of back of mouth cancers and the increase in popularity of oral sex amongst the general population was described as the contributing factor behind the rise in this type of cancer. The good new is, back of mouth cancers have much better survival rates than the front of mouth cancers caused by smoking and heavy drinking. It is hoped that when the cohort of people who have received the vaccine reach maturity the rates of this cancer will drop sharply.
The Role of Dentists
Dr Aldritt, Chair of the Oral Health Committee of the Australian Dental Association, sees dentists as playing a crucial role in ensuring that these types of cancers are recognised early. Firstly, he notes, dentists have to shed their aversion of asking patients question about topics such as oral sex and they have to be willing to present people with the facts about risky behaviour. He sees this as similar to the process that dentists had to go through when encouraging people to quit smoking. Some dentists felt uncomfortable in doing this and felt that it wasn’t their job but ultimately, as a medical professional it was their job to inform patients that smoking and heavy drinking were contributing factors to the development of deadly, front of mouth cancers.
Dr Aldritt recommends that dentists go about an examination in a general manner. He encourages dentists to start by looking for lumps on the outside of the face, the neck and the jaw line. Then they should examine the mouth and explain that they are looking for lumps, red patches or ulcers. While conducting the examination they should mention that smoking, heavy alcohol consumption and oral sex are risk factors for the contraction of back of mouth cancers. By doing this, the dentists doesn’t have to directly ask the patient any questions – instead, they are just looking for any signs of possible cancer and providing education about risky behaviours.
To put the importance of conducting this examination into context, six people are diagnosed with oral cancers every day and one person dies everyday as a result of oral cancer. As mentioned, back of mouth cancers do have high survival rates but the earlier the cancer is noticed and the earlier the patient is referred the greater the chance is of treatment being successful. Out of all the professions, dentists spend the most time examining the areas that are affected by oral cancers so dentists need to be the first line of defence against oral cancers.
If you would like more information about oral cancers or would like to book for a dental check up you can: