Table 14: Common Parental Concerns Regarding the HPV Vaccine Parent’s Concern Dental Practitioner’s Response Aren’t condoms enough to prevent HPV?
No, condoms can lower the risk of HPV infection, but they must be used correctly and with every sex act, from start to finish. Condoms can also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. However, because HPV can infect areas that are not covered by a condom, condoms do not fully protect a person from HPV.
Note . Adapted from Centers for Disease Control and Prevention. Answering Parents’ Questions about HPV Vaccination. Last updated November 1, 2021d. https://www.cdc.gov>hpv>answering-questions; Francis Jenny K.R., Rodriguez Serena A., Dorsey Olivia, et.al. Provider perspectives on communication and dismissal policies with HPV vaccine hesitant parents. Preventive Medicine Reports. 24 (2021). 101562 https://www.science direct.com>science>article>pii; Human Papillomavirus. A Parent’s Guide to Preteen and Teen HPV Vaccination. Immunize.org November 2022b. https://immunize.org>catg.d; “Exploring variation in parental worries about HPV Vaccination,” Gilkey, Melissa B., Mohan Divya, Janssen Ellen M., et,.al. 2019, Vol. 15., Nos. 7-8, 1754-1751. Human Vaccines and Immunotherapeutics; Centers for Disease Control and Prevention. Human Papillomavirus (HPV): What Everyone Should Know. November 16, 2021f. https://www.cdc.gov>vaccines>vpd>hpv>hcp>re...; Pennella Robyn A, Ayers Katherine A and Brandt Heather M. Understanding How Adolescents Think About HPV Vaccine. Vaccines 2020,8,693. https://www.ncbi.nlm.nih.gov>articles>PMC7711578
Including parents or caregivers in the discussion Parents or caregivers can be included in the discussion when either the adolescent or provider feels that his or her presence is necessary or beneficial. It should be noted that sensitive information is not likely to be disclosed in the presence of parents (Breuner & Mattson 2016). If parents or caregiver(s) are reluctant to leave the operatory, it is sometimes helpful to tell a parent the following: For me to effectively care for your child, it is important that I develop rapport with him/her; I need your child to trust me. Sometimes it is difficult for your child to talk openly with me if you are present. After I speak with your child, I will tell you if there is a problem. Conclusion Until recently, tobacco and/or alcohol use have been viewed as the main causes of oral cancer. While this association remains strong, nearly 14,800 new cases of HPV-related oropharyngeal cancer are diagnosed each year, often in adults who have never smoked and report drinking alcohol only in moderation (CDC, 2022b). Traditional alcohol- and tobacco-related oral cancers occur more frequently in older black men, while HPV-related oropharyngeal cancer occurs in younger white men who report lower lifetime exposure to alcohol and tobacco. The 225% increase in the presence of HPV in oropharyngeal cancers concerns healthcare providers, public health professionals, and the public. Growing public awareness of the association between HPV and oral cancer requires dental professionals, as part of comprehensive care, to understand the fundamentals of HPV and develop communication skills appropriate for responding to patient inquiries and concerns (Kline, et al., 2018). Because dentists see their patients more frequently than physicians, especially for patients who maintain a regular six-month dental prophylaxis (cleaning) schedule, the profession is well positioned to play a role in the education, prevention, diagnosis, and treatment of HPV- related oropharyngeal cancer (Smith & Smith, 2017). Addressing oral HPV is complicated by a number of factors, including absence of an established causal pathway, lack of a clinical infrastructure for screening, lack of explicit symptomatology, and the virus’s affinity for Glossary ● Autoinoculation : Self-infection, as when a person with a genital HPV infection touches his or her genitals and then puts a finger in his or her mouth, resulting in transmission of the virus from the genital area to the oral cavity. ● Cancers of the head and neck : A term that includes cancers that usually begin in the squamous cells lining the moist, mucosal surfaces inside the head and neck. These cancers are sometimes called squamous cell cancers . Cancers of the head and neck are also
Some dental practices have adolescent health forms that specifically address health issues of teens. In some cases, parents are asked to sign a form acknowledging the need for privacy between their child and the provider. Any life- threatening or abuse-related information must, by law, be disclosed to the parents or caregivers. Providers can use their discretion as to the disclosure of other information. In some cases, providers can help adolescents talk with their parents by acting as advocates. In cases in which the adolescent asks that information be kept from his or her parents or caregivers, the provider should encourage open communication between family members (Breuner and Mattson, 2016). the oropharyngeal area. The availability of in-office HPV screening tests has failed to improve diagnostic ability since the test can reveal only what HPV type, if any, is present. The tests cannot provide information on the location of the virus or when it was acquired. Continued testing over time is needed to detect viral clearance. However, there are no clinical guidelines to deal with viral persistence. Therefore, the diagnostic value of testing the saliva for HPV is not clear. To date, saliva testing for the presence of HPV has not been approved by the ADA. The major role of dentistry in stopping or at least slowing the HPV epidemic lies in patient education and oral examination. Performing a thorough oral cancer screening on every patient, along with providing quality patient education, including HPV transmission, infection, viral clearance, and prevention via use of consistent safe sex practices and, if applicable, the HPV vaccine is a valuable service. Patients will have concerns about their risk of HPV infection and the potential outcomes of the infection. Dental practitioners who can communicate this information in a simple and professional manner can aid in removing the silence that still surrounds this topic. Dental practitioners cannot control the spread of HPV if they cannot talk about it. All health professionals, and particularly dental professionals, must begin this conversation to prevent HPV infections. categorized by the areas of the head and neck in which they occur. These areas of the head and neck include the oral cavity, pharynx, larynx, paranasal sinuses and nasal cavity, and salivary glands (American Dental Association, 2022). ● Carcinogenic (oncogenic) : Giving rise to tumors or causing tumors to form. ● Cutaneous : Relating to the skin.
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