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What Is Oral HPV?

Oral HPV is a human papilloma virus infection that occurs in the mouth or throat. It’s a sexually transmitted virus that typically spreads through oral sex. Though there is a risk that oral HPV could lead to oropharyngeal cancer, most people with the infection have no symptoms or serious health outcomes. It’s important to understand how oral HPV spreads so you can take steps to protect yourself when having oral sex.

Oral HPV Transmission

Human papilloma virus (HPV) is the most common sexually transmitted infection in the United States. About 80 million people are currently infected with HPV, and nearly everyone gets at least one type of HPV at some point in their lives.

HPV spreads through intimate skin-to-skin contact, including vaginal, anal, and oral sex. Most HPV infections occur in the genital area. However, it’s possible to get oral HPV as a result of having oral sex. This can occur when touching your mouth to the penis, vagina, or anus of someone who has an HPV infection.

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There’s also a chance that HPV could be transmitted through deep kissing, meaning open-mouth kissing with tongues touching. However, it’s more likely for oral HPV to be transmitted during oral sex.

Because oral HPV spreads through skin-to-skin contact and not bodily fluids, you can’t get it from sharing utensils or food.

Oral HPV Symptoms

Typically, people who get oral HPV never develop any symptoms. In fact, most people with oral HPV never realize that they are infected. While it’s a relief to know that oral HPV usually doesn’t cause any symptoms, you’re more likely to spread HPV to someone else if you don’t realize you have it.

Some people infected with oral HPV may develop warts. These warts are benign and will often go away on their own. If they don’t, a doctor may be able to remove them for you. Some of the types of mouth warts that may develop as a result of an HPV infection include:

  • Squamous papilloma: These warts are usually white and have small, fingerlike projections and a rough or cauliflower-like surface.
  • Verruca vulgaris: These warts usually grow quickly to an average size of less than 5 millimeters. They may remain in the mouth for quite some time before going away and often appear similar to squamous papilloma warts.
  • Focal epithelial hyperplasia: These are dome-shaped warts with a smooth, soft surface. They typically measure about 3 to 10 millimeters in size.
  • Condyloma acuminatum: These warts look similar to squamous papilloma warts, but they’re typically found in small clusters rather than individually.

Even if you do not experience any symptoms from an oral HPV infection, your partners could potentially develop warts if you pass the infection on to them.

Oral HPV Risk Factors

Certain factors may increase your risk for getting oral HPV, including:

  • Unprotected sex: Using protection, such as a condom or dental dam, can help to lower the risk of HPV being transmitted from one person to another.
  • Weakened immune system: If your immune system is weak, it will have a harder time suppressing the virus. This is especially true for people who are taking immunity-suppressing drugs or who are weakened by HIV or AIDS.
  • Age: Oral HPV infections are more common with older age.
  • Gender: Men are more likely to have oral HPV compared to women. According to the CDC, approximately 10% of men have oral HPV, while just 3.6% of women have the infection.

Oral HPV Treatment

There is no treatment available for HPV, including oral infections. However, HPV usually resolves itself anyway. In fact, nine out of 10 HPV infections go away on their own within two years.

How to Prevent Oral HPV

The following prevention strategies can reduce your chances of getting oral HPV:

  • Use protection: Condoms and dental dams can lower the chances of HPV being transmitted during oral sex.
  • Consider vaccination: The HPV vaccine protects against infections of high-risk HPV types known to cause cancer.

Oral HPV and Cancer

In rare cases, oral HPV may develop into oropharyngeal cancer (throat cancer). This can potentially occur with high-risk types of HPV, such as HPV-16 and HPV-18. Typically, it takes many years for an oral HPV infection to develop into oropharyngeal cancer.

HPV is believed to cause about 70% of oropharyngeal cancers in the U.S. The CDC reports that about 13,500 people develop throat cancer from oral HPV each year. While the vast majority of HPV infections in the mouth or throat do not develop into oropharyngeal cancer, the number of oropharyngeal cancers linked to HPV has risen dramatically in recent years.

It’s important to note that smoking or chewing tobacco may contribute to the development of HPV-related oropharyngeal cancer. Avoiding tobacco products and secondhand smoke may help to lower your risk of developing throat cancer from an HPV infection.

Signs of Oropharyngeal Cancer

The signs and symptoms of oropharyngeal cancer typically include:

  • Sore throat.
  • Earaches.
  • Hoarseness that won’t go away.
  • Enlarged lymph nodes.
  • Pain when swallowing.
  • Unexplained weight loss.
  • Coughing up blood.
  • A lump on the neck or in the cheek.

It’s easy for many of these to be mistaken for symptoms of another condition or illness. However, if you have any of the above symptoms for more than two weeks, you should see a doctor to have your throat examined.

Oropharyngeal Cancer Treatment

While there is no treatment for oral HPV infection, there are several treatment options for throat cancer, including:

  • Chemotherapy.
  • Radiation.
  • Surgery.

The good news is that oropharyngeal cancers which are HPV-positive are typically more responsive to treatment than those that are HPV-negative.

Although oral HPV is usually harmless, it’s important to take steps to prevent it if possible. Use this guide to help protect yourself against HPV and educate yourself about signs and symptoms to watch for.

Further Reading

About HPV, Centers for Disease Control and Prevention, April 2019

HPV transmission during oral sex a growing cause of mouth and throat cancer, Harvard Health Publishing, June 2019

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