The New Leading Cause of Oral Cancer

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B

It’s not just brushing and flossing that you need to be talking about with your dentist — you might want to consider discussing your sex life as well.

Every year, 40,000 Americans are diagnosed with oral cancer. Deaths from oral cancer in the U.S. last year were estimated at 7,890.

Back when I was in dental school, we were trained that the high risk groups for oral cancer were those who used tobacco and alcohol. And it’s still true; smokers and drinkers get a big jump in risk for oral cancer. When we would see these groups, we would recommend an oral cancer exam in the dental office.

But now, HPV has jumped ahead of tobacco and alcohol as the main cause for oral cancer.

This is why you should consider discussing your sex life with your dentist, just as you would discuss it with your primary care physician. It could save your life.

When Should You Talk to Your Dentist About Oral Sex?

It’s a dangerous myth that oral sex is safer than intercourse when it comes to STDs. But oral sex can still spread STDs like HPV.

At a Glance: The Facts About Oral Sex, HPV and Oral Cancer

HPV is the leading cause of oropharyngeal cancer. That’s cancer at the back of the mouth and throat. Virtually all experts and studies confirm there is a connection between oral sex and oral cancer.

As much as 90% of oral cancer is caused by oral sex. Between 1970 and 2005, HPV was responsible for only 23 percent of oral cancers until 2005 when it accounted for 64 to 93 percent (depends on which study you’re looking at). This can perhaps be explained by a change in sexual habits, as said by Dr. Tina Dalianis of the Karolinska Institute in Sweden who conducts research on HPV-related oral cancer: “We believe that sexual habits have changed, and that there is an increase in sexual activity earlier on in life, with an exchange of many more sex partners in general.”

As your number of sex partners goes up, so does your risk. Having six or more oral partners increases your risk for oral cancer (tongue, throat or tonsils). 26 or more oral partners triples the risk.

Men and boys are at higher risk than women and girls. Rates of oral cancer linked to HPV have risen dramatically in American men. This is another reason that the new HPV vaccines are recommended for both boys and girls.

Just because you don’t show symptoms doesn’t mean you don’t have it. HPV has long periods of dormancy. So if you or your partner has HPV, s/he might not show symptoms for a long time.

If it’s not caught early, oral cancer can kill you.

What to Ask for at the Dentist

Next time you go to the dentist, ask if you are a likely candidate for oral cancer, and what can be done about it. This will give you peace of mind.

I recommend that you find a dentist who during your twice yearly exam palpates your neck and does and a visual oral cancer exam. While this exam can be good, I’m starting to think it could be a false sense of security in some cases. When I do these exams, what I look for is a manifestation in the back areas of the base of the tongue, back of the throat, and the tonsil areas, but even with a thorough exam like this at the dentist, you can’t always see the effects of HPV 16. An ENT (ear, nose, and throat physician) can do a much more thorough exam.

If you are sexually active, and especially if you have had more than twenty partners, make sure to seek out advice from both your dentist and your primary care physician. Consider getting a referral to see an ENT to get advice and an exam as well.

Also, make sure your children consider getting the new HPV vaccine. Even though administration of the HPV vaccine has been focused on girls, I’d recommend you consider it for your sons as well, since boys are more likely to get HPV than girls.

Ask your partner how long ago they had the vaccination. Sexually transmitted infections (STIs) are very common and nothing to be ashamed about. Open up a healthy dialogue with your partner.

There’s also a new test for oral cancer on the block that I’m beginning to think should be routine. The way it works is, you spit into a test tube, which gets sent off and checked for a marker for oral cancer. Ask your dentist about this.

So have a discussion about oral sex with your dentist. It will give you peace of mind and may even save your life.

Mark Burhenne DDS

Learn More: CRP and Oral Health: What Your Physician May Not Know