only by speaking with the adolescent patient alone, and by clarifying with whom the information disclosed will be shared (Breuner & Mattson, 2016). Starting the adolescent appointment by acknowledging these concerns and responding to them initially can improve communication and information exchange between the patient and provider. As in the case of interviewing an adult, it is best to open the adolescent examination with a current news topic or story that is appropriate for introducing HPV and risk behaviors. Asking the patient what he or she has heard or knows about HPV can be a good start. As with adults, asking specific, open-ended questions and waiting an appropriate length of time for the patient to respond is critical. Although adolescent patients may not disclose high-risk behaviors during the patient interview, they can assimilate and apply the information on HPV and risk factors for acquiring the virus to their personal behaviors. Adolescent patients, when asking questions, are often direct and may use “street language” instead of technical or medical terms. (Breuner & Mattson, 2016). Research in the area of adolescent questions and concerns about HPV and cancer is lacking. Published information about HPV and adolescents most often relates to parental concerns about the HPV vaccine. It is likely that adolescents’ questions about HPV are similar to those expressed toward HIV. Table 13 provides information to include in adolescent HPV education.
likely see their dentist more often than other healthcare providers, dental health professionals have an important role in providing HPV prevention-related information to parents and adolescents (Tillman, 2019). Adolescence is an important developmental period, when many young people make decisions and initiate behaviors that can have immediate and long-term consequences, so adolescence is a good time to empower young people to take responsibility for their health (Pathak & Chou, 2019). Privacy laws are state-specific. The Health Insurance Portability and Accountability Act (HIPAA) has applications to minors in a health-care setting. Parental Access to medical records of their children is usually allowed by (HIPAA) unless: A court has ordered medical care for the minor; that parental approval has been granted for a confidential relationship between their child and a clinician and when a minor has consented for care for which parental consent under state or other applicable law is not required (Pathak & Chou, 2019). When interviewing the adolescent patient, developing trust is critical. Adolescents have concerns around what topics they can safely discuss with their dental provider. Once an adolescent feels assured of a private and confidential relationship with their provider, they are more likely to discuss sensitive topics such as sexual activity and problems with substance abuse (Pendergrass, 2020). Adolescents also want to feel that they are in control and share responsibility for their health with the provider (Pennella, et al., 2020). Candid and complete health information can be gathered Table 13: HPV-Related Adolescent Patient Information Adolescent’s Question or Statement Dental Practitioner’s Response What is HPV?
HPV stands for the “human papillomavirus.” It is a very common virus, and nearly all sexually active men and women get it at some time in their lives. It is spread by skin-to-skin contact, usually during sexual activities. This can include oral sex, anal sex, and vaginal sex. The virus can also be spread by sex toys used during sexual activities.
Who gets HPV? If a person gets HPV, what will happen? Can I get oral cancer from oral sex?
Anyone who has sex can get the virus.
Usually a person does not know when he or she has HPV. Usually there are no symptoms to let a person know he or she has the virus, but the person can still give the virus to others. Usually the body gets rid of the virus within 2 years, but some types hang around. The types that don’t go away are the ones that can cause cancer.
HPV type 16 is related to development of oral cancer. You can get HPV type 16 from unprotected oral sex. Isn’t there a shot? Yes, the HPV vaccine is a series of three shots. The vaccine was made to protect a person from the
high-risk HPV types that cause cancer. To completely protect someone from infection, the shot has to be given before the person has sex of any kind. If you have had sex you may already be infected with HPV. The shot will protect you from future infections. You can still become infected by HPV types not covered by the shot, and you can still become infected with other STIs like syphilis and gonorrhea.
After I get the shot, can I do anything I want and not worry about HPV? Why is the HPV shot called a “cancer shot”? Does the shot cure HPV? I don’t need the shot.
Some have called the HPV vaccine a “cancer shot” because it has been advertised as a shot that will protect against cancer.
No. Nothing cures HPV. There are cures for some of the health issues caused by HPV infection, though. The shot works best when it is given to someone who has not had any type of sexual activity. Giving it early makes sure that the shot will protect you from the HPV types that cause cancer. If and when you decide to become sexually active, you will be protected from the HPV virus types that can cause cancer. This includes cervical cancer in girls and penile cancer in boys. For both boys and girls, the vaccine protects against anal cancer and HPV warts that occur in the genital area.
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