Dentists may soon be prying deeper in their patients' sex lives.
The human papillomavirus, or HPV, is now the most common sexually transmitted disease, and one researcher is urging dentists to get on board to warn patients about it.
But talking about HPV — and how it can be spread through oral sex — can be awkward.
"This is an emerging topic for dentists and not really one they ever expected to have to talk about," said Ellen Daley, the lead investigator of a recent study on this topic in the Journal of the American Dental Association. "It's controversial and uncomfortable. No one wants to talk about these sensitive topics."
HPV is the cause of 72 percent of oropharyngeal cancers, which can impact the base of the tongue, tonsils and walls of the pharynx, said Daley, who is also a professor studying women's health at the University of South Florida.
Younger patients, usually preteens and teens, are the most at risk for HPV. But the virus can also be dormant for years, which could impact older patients who won't necessarily experience symptoms for many years.
It's transmitted during vaginal, anal or oral sex with someone who has the virus.
Nearly 80 million people — or about one in four — are currently infected with HPV in the United States, according to the Centers for Disease Control and Prevention. About 14 million people become infected each year, and 30,700 of those cases cause cancer in men and women.
The HPV vaccine can prevent most of those cancers. An estimated 50,000 cases of oral type cancers will be diagnosed this year, according to the American Cancer Society.
HPV prevention methods are typically addressed by pediatricians, family medicine practitioners, obstetricians and gynecologists. But dentists and dental hygienists see nearly 85 percent of children and their parents in the U.S., making them an important group of health care providers who could address HPV prevention and detection, Daley said.
"Dentists are already seeing patients who are concerned about oral cancers or may be displaying symptoms. It's time for dentists to be prepared to start talking about prevention methods," she said.
The study says that some dentists don't talk to their patients about HPV prevention because they don't know enough about it or the proper prevention methods. Other dentists said they never anticipated that they'd have to talk about sexually transmitted diseases in their profession, which can be a sensitive subject when age is a factor.
Most don't want to embarrass older patients or have a tough conversation with the parents of a younger one.
"I know as a professional, you really should be able to talk like that. But for me, sometimes with patients the same age as my grandpa, I find it very uncomfortable to talk with him about anything related to HPV and their sexual activity," wrote one participating dentist in the study. "I guess I'm a little weirded out by that."
Dr. Scott Tomar, a dentist and professor at the University of Florida's College of Dentistry, sees routine teeth cleanings and examinations as the "opportune time" to broach this subject with regular patients.
"We live in a time where there is a vaccine for HPV, and dentists have a chance to reach adolescents at a young enough age where they can get the vaccine that could help prevent these kinds of cancers," he said. "This is an ideal setting."
As for it being uncomfortable, Tomar says dentists need to focus less on that and more on the educational importance of it.
"We can frame the conversation as education, and talk to them about STDs and what kind of potential side effects those can have on their oral health," Tomar said. "This is a tremendous role for dentists to play not just in oral health, but overall health."
