HPV In Your Mouth, What Does It Look Like?

Human papillomavirus, HPV, is the most common sexually transmitted infection in the United States. About 40 can infect the genital, throat, and mouth out of the more than 100 different types.

Some strains of HPV result in harmless oral lesions that usually look like common warts, but doctors have connected some others with oral cancers.

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What causes it and how does it spread?

Oral HPV is very common, it spreads mostly through oral sex and mouth-to-mouth contact between people. During mouth-to-genital or mouth-to-mouth contact, HPV particles travel through infected saliva or mucus through an open cut or sore in the throat or mouth of an uninfected person.

Mothers can also pass on HPV to their children. HPV may sometimes spread through oral contact with contaminated utensils or medical instruments.

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The immune system usually destroys invading HPV particles before they cause an infection. Healthy immune systems usually resolve HPV infections within 1 to 2 years. However, some HPV infections can persist.

Risk factors

The greatest risk factor for developing oral HPV is oral sex or having mouth-to-mouth contact with an infected person. Some known risk factors include:

  • deep kissing
  • not using proper protection during oral sex
  • drinking having multiple sexual partners
  • smoking and tobacco products
  • engaging in sexual activities from a young age
  • drinking alcohol
  • sharing drinks and utensils

Symptoms and what it looks like

Many people with minor cases of HPV do not have any ostensible symptoms. There are also many strains of HPV that can each cause somewhat different symptoms. When it does cause a productive infection, HPV can cause growths that are:

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  • slightly raised or flat
  • painless
  • small and hard
  • white, pink, flesh-colored, or red
  • usually slow growing
  • smooth or slightly calloused
  • single or multiple in a cauliflower- or cobblestone-like mass
  • anywhere in the mouth, but frequently on the tongue, soft palate at the back or roof of the mouth, and lips

The type of HPV called HPV 16 causes most oral cancers related to HPV.

Signs and symptoms of oral cancer include:

  • a sore or painful bump that does not go away within 3 weeks
  • difficulty swallowing or the feeling of things sticking together when trying to swallow
  • chronic cough
  • discoloration (red, white, black) of the soft tissues in the mouth
  • swollen but painless tonsils
  • chronic sore throat
  • a lump in the mouth that lasts for at least 3 weeks
  • a lump that a person feels on the outside of the neck
  • drooling
  • pain when chewing
  • numbness or tingling in the lips or tongue
  • a unilateral, or one-sided, earache that lasts for more than 3 weeks

Diagnosis

The best test for HPV is a polymerase chain reaction (PCR) test which takes a tiny fragment of DNA extracted from cells in a sample of mucus and intensifies it, causing numerous identical copies. Having so many copies of the DNA fragment allows scientists to look inside cells and detect minute quantities of abnormal or viral DNA.

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When lesions are present in the mouth, a doctor may be able to diagnose HPV by only examination.

What are the treatment options?

There is currently no treatment that can cure HPV or reduce its growth. A range of topical medications has been tried and tested on HPV growths to no effect. The only way to currently treat HPV growths is to remove it surgically. Some doctors will also use cryotherapy with liquid nitrogen to freeze and remove the growths.

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Once diagnosed, people will need to be tested for HPV every 8 to 12 months until the infection has cleared or detecting it in DNA samples is no longer possible.

Prevention

  • practice safe sex by using condoms and dental dams
  • avoid multiple sexual partners
  • avoid oral sex and deep kissing when there are open cuts or sores in the mouth
  • have regular STI screening tests if sexually active
  • talk to sexual partners about their STI status
  • avoid oral sex with a new partner
  • have regular dental checkups
  • check the mouth and tongue monthly for changes and abnormal growths
  • seek medical attention from a doctor or dentist for sores or growths in the mouth or on the tongue that last for more than 2 or 3 weeks

One of the best ways for people to reduce their risk of developing HPV is by getting vaccinated. A vaccine called Gardasil 9 offers almost 100 percent protection against the strains of HPV associated with types of cancer in the United States. Currently, doctors recommend that females aged 11 to 26 years old and males aged 11 to 21 years old have the HPV vaccination.

 

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