HPV: Have “the Talk” April is Oral Cancer Awareness Month


By DR. MARCELO ARAUJO, VICE PRESIDENT, ADA SCIENCE INSTITUTE R


ecent news stories in the Daily Mail, New York Post, Men’s Health and


Fox News suggest your dentist may start asking about your sex life. Why? Because trans- mission of two strains of Hu- man Papilloma Virus (HPV-16 and/or HPV-18) through intimate contact may lead to the development of oropha- ryngeal cancer (OPC). This type of cancer occurs at the back of the mouth/top of the throat, and the Centers for Disease Control and Prevention indicates the numbers are on the rise. According to the American Cancer Society, an estimated 50,000 cancers of the oral cavity and pharynx will be diagnosed this year in the U.S.


A study in the January 2018 JADA¹ evaluated dentists’ level of knowledge and willingness to talk with patients about HPV-associated Oropharyngeal Cancer (OPC) and finds that more dentists need to prepare to have “the talk” with their patients.


As a dentist, and as the head of the Ameri- can Dental Association’s Science Institute, I couldn’t agree more that dentists and patients should have “the talk”—but that talk should be about OPC prevention. The HPV vaccine was originally developed for preven- tion of cervical cancer, yet the oropharynx (back of the mouth/top of the throat) is actually the most common site for HPV- associated cancers. All of the available HPV vaccines protect against HPV-16 and HPV-18, which are the estimated cause of 60 percent of oropharyngeal cancer currently diagnosed.


The ADA has teamed up with the University of Texas MD Anderson Cancer Center to


18 focus | MAR/APR 2018 | ISSUE 2


MEMBER QUESTION Performing Oral Cancer Screenings at a Community Health Fair


Recently a member dentist contacted the MDA inquiring about doing oral cancer screenings at a local health fair he had been asked to partici- pate in. Instead of merely sitting at a booth, he though this service may be helpful, but was concerned if anything prohibited him from doing so or what risks were involved. So, the MDA asked its resources: The ADA, MDIS and the Missouri Dental Board. Both the ADA and MDIS confirmed it is a good measure to check with your malpractice carrier about participating in an event that is outside your typical practice.


help increase HPV vaccination rates and eliminate tobacco use to reduce cancer. The HPV vaccine can be administered to males and females and is recommended by both the CDC and the American Academy of Pediatrics. Specific vaccination recommenda- tions are provided by the CDC.² For adult patients ineligible to receive the vaccine, den- tists can raise awareness of the risk of mouth and throat cancers associated with HPV-16 and/or HPV-18 transmitted through oral sex.


Dentists want to help their patients prevent mouth and throat cancer, and are on the front lines of noting potentially malignant lesions. Dentists periodically examine patients’ mouths and feel for lumps or other abnormalities along the neck, jaw and lymph nodes, referring patients to specialists for diagnosis.³ This can lead to earlier and potentially life-saving treatment. Now more than ever, it’s important that we all realize that oral health is integral to overall health. f


REFERENCES


1. http://jada.ada.org/article/S0002-8177(17)30747-X/ fulltext?dgcid


2. https://www.cdc.gov/mmwr/volumes/65/wr/pdfs/ mm6549a5.pdf


3. https://ebd.ada.org/en/evidence/guidelines/oral-cancer


The Missouri Dental Practice Act provides for dentists to participate in this manner with some level of protection from liability:


332.323. Dental services provided free of charge, immunity from civil damages for discrimination. Notwithstanding any other provision of law to the contrary, any health care provider licensed pursuant to this chapter who provides any service for which the health care provider is licensed may provide such service free of charge. Such health care provider shall not be subject to an action for civil damages for discrimination based on the provision of such free dental services. (L. 1998 S.B. 790)


However, the Dental Board pointed out, while this law helps protect someone volunteering in that situation, a “Good Samaritan” law will typi- cally not protect if the practitioner is found to have acted incompetently, negligently, etc.


The doctor reported that the health fair went very well, but in fact, after talking to his malprac- tice insurance carrier (in this case, MedPro) he chose not to do the oral cancer screenings due to the required record keeping.


If you are interested in participating in a health fair and wish to provide information on oral cancer, the ADA Store (ebusiness.ada.org) has resources, as does Missouri DHSS, which offers a supply form with personal care products and educational materials at no cost. View PDF samples of the brochure and find an order form at www.health.mo.gov/oralhealthlit. Finally, you also can order free materials from NIDCR at catalog.nidcr.nih.gov/OrderPublications and they do have some specific to oral cancer.


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