to expand traditional patient education topics (i.e., tobacco and alcohol) to include information on HPV (Taberna, et al., 2017). Given the association between HPV and oral cancer, dental professionals will need to understand the fundamentals of HPV and to develop communication skills appropriate for responding to patient inquiries and concerns as part of a comprehensive approach to preventive oral health care (Kline et al., 2018). It is not clear whether, or how, health professionals are providing HPV-associated disease information or responding to patient questions about the efficacy of the HPV vaccine in preventing HPV-associated disease (Constable, et al., 2022). Previous research assessing HPV-related knowledge and attitudes of practicing dentists and dental hygienists has revealed their need for specific information about HPV and oral cancer (Kline, et al., 2018; Tillman, 2019). There is also reluctance among some dental professionals to discuss HPV with patients because it is a sexually transmitted disease (Rehan, 2017; Wagner and Villa 2017). However, the increasing prevalence of HPV in the population makes it important for all healthcare professionals, especially dental professionals, to understand HPV and its association with oral cancer and be able to communicate this information in a professional manner (Hakeem & Catalanotto, 2019). This intermediate-level course is designed to address the concerns of dentists, dental hygienists, and dental assistants by providing them with general information about HPV, evidence of the association between oral HPV and oral cancer, and effective ways to further communicate this information to patients. This course provides dental professionals with information that will enable them to effectively meet the challenges they face as the link between HPV and oral health continues to emerge. which can adversely impact health outcomes. Addressing implicit bias in healthcare is crucial for achieving equity in medical treatment. Strategies to combat these biases involve education and awareness programs for healthcare professionals. These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
HPV is most commonly known for causing cervical and other cancers, including cancer of the vulva, vagina, penis, and anus (CDC, 2022a) and there is a growing body of research demonstrating the increasing incidence of HPV-related cancer in the oropharynx, which includes the tonsillar area and base of the tongue (CDC, 2022a; Rehan, 2017). Until recently, tobacco and/or alcohol use have been viewed as the main causes of oral cancer. Although this association remains strong, over 11,000 new cases of HPV-related oral cancer are diagnosed each year, often in adults who have never smoked and report drinking alcohol only in moderation (American Dental Association, 2022a; Ellington, et al., 2020). The increasing incidence of HPV-related oral cancer is a significant health concern for all healthcare providers (Sanyaolu, et al., 2019). As is the case with other cancers, early detection and timely treatment of HPV-related oral cancers can reduce the number of deaths from this disease (Sanyaolu, et al., 2019). Because dentists are the most frequently visited healthcare providers in the United States, the profession is well positioned to play a role in the education, prevention, diagnosis, and treatment of HPV- related oral cancer (Villa & Wagner, 2017). Regular dental checkups that include a comprehensive head and neck examination can be beneficial in the early identification of precancerous and cancerous lesions. As the general public’s awareness of the relationship between oral cancer and HPV increases, patients will increasingly rely on dentists and dental hygienists for HPV-related information. Specifically, dental patients may have questions about their risk of infection, their risk of developing cancer, and the protective value of available HPV vaccines (American Academy of Pediatric Dentistry, 2017). The established relationship between HPV and oral cancer will require dental providers Implicit bias in healthcare Implicit bias significantly affects how healthcare professionals perceive and make treatment decisions, ultimately resulting in disparities in health outcomes. These biases, often unconscious and unintentional, can shape behavior and produce differences in medical care along various lines, including race, ethnicity, gender identity, sexual orientation, age, and socioeconomic status. Healthcare disparities stemming from implicit bias can manifest in several ways. For example, a healthcare provider might unconsciously give less attention to a patient or make assumptions about their medical needs based on race, gender, or age. The unconscious assumptions can lead to delayed or inadequate care, misdiagnoses, or inappropriate treatments, all of
HPV: AN OVERVIEW
However, papillomavirus infection is not limited to humans. Papillomavirus types also exist in mammals such asrodents, cottontail rabbits, cows, and hamsters, and birds. (Frias-De- Diego, et al., 2019). However, papillomaviruses are species- specific, meaning that the viruses found in animals cannot infect humans and vice versa (eLife Sciences Publications, ltd., 2019; Canuti, et al., 2019). Use of the word “human” in human papillomavirus denotes papillomavirus types that specifically infect humans. reportable, STIs. Although HPV infection clinical conditions associated with HPV-infection are not required to be reported to the Centers for Disease Control and Prevention (CDC), some states and jurisdictions have required that certain HPV-associated conditions are reported (CDC, 2017a).
The papillomavirus has infected men and women for thousands of years. Since the time of the ancient Greeks and Romans, warts have been documented on the hands and feet, and in the external genital area, of humans. In fact, recent advances in detecting the virus have been used to identify HPV types found in mummies from ancient Egypt, South America, and Renaissance Europe (Bondell, 2018; Huhns, et al., 2017; Jarus, 2018). Prevalence and incidence Today, HPV is present throughout the world. In the United States, HPV is the most common sexually transmitted infection (STI), responsible for most new and existing STIs (CDC, 2019a). While STIs such as syphilis, HIV, and gonorrhea, require mandatory reporting, the number of new and existing HPV cases far exceeds those of other,
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