Your next annual cleaning might involve a sex ed lesson or even an STD test, because dentists care about more than just cavities. Human papillomavirus (HPV) levels continue to rise, and this is accompanied by an increase in throat cancers caused by sexually transmitted diseases.
Related: An STI You Probably Don’t Even Know Is Going Common And Drug-Resistant
In 2016, an analysis of health insurance claims conducted by FAIR Health, a non-profit organization that manages health insurance billing, found that cases related to oral cancers increased by 61% between 2011 and 2015.
Traditionally, risk factors include smoking and alcohol, but over the past 15 years new strains of oral cancer have become more common, thanks to HPV. Research published by the Centers for Disease Control and Prevention in 2015 estimated that HPV caused approximately 72% of oropharyngeal cancers, with 62% attributed to HPV-16 and 18 strains.
Last year, Dr. Richard Jordan, DDS, and professor of orofacial sciences and pathology at the University of California, San Francisco, spoke to a trade publication Dermatology time as to the severity of the increase.
“By 2030, there will be more patients per 100,000 with oral cancer, due to HPV, than cervical cancer,” he said.
But many patients don’t know the risks, according to Dr. Kenneth S. Magid, DDS. An associate professor at New York University School of Dentistry, Magid runs her own private practice and said people were shocked to find out that oral cancer could be caused by HPV, which is why dentists should be more involved in education and prevention.
“Every dentist should screen patients not only for oral cancer, but also for HPV,” he said. Newsweek. “The problem is that most dentists don’t screen.” Magid uses a screening device called Velscope because he says the early stages of cancer are hard to detect just by sight.
There may be an undeniable need for more education, but do people really want to discuss STIs with their dentists, and vice versa?
A study published this month in The Journal of the American Dental Association examined whether the profession was up to the challenge through focus groups. The study authors determined dentists’ level of knowledge about the relationship between HPV and oral cancers, as well as their overall knowledge of the sexually transmitted disease and the likelihood that they would raise the topic with patients.
According to study co-author and public health expert Ellen Daley of the University of South Florida, most dentists feel compelled to discuss oral cancer with their patients.
“There was never a sense of saying, ‘No, I’m sorry I’m not doing this.'”
Unlike Magid, Daley isn’t sure dentists should test for HPV. “This issue is controversial,” she said. Newsweek. There are swabs, rinses and tools that can detect oral HPV, but Daley says many cancers are located near the base of the tongue, making them harder to find.
Plus, she points out that knowing you have oral HPV can cause a lot of unnecessary anxiety since 90% of cases go away on their own without turning into cancer.
Instead, Daley thinks dentists should focus on cancer prevention, which includes urging patients to get vaccinated against HPV. Although many of the dental professionals she spoke to are fine with having these conversations, they often don’t know how to broach the sensitive topic.
Magid agrees that discussing HPV and oral cancer with patients could be awkward.
“You have to be careful what you talk about, and in all honesty talking to a 20-year-old about safe sex probably wouldn’t be the smartest thing to do,” he said. “You open a Pandora’s box where they start to question your motives.”
Her solution is to use the optional Velscope screening as an entry point to discuss oral cancer.
“What you have is a perfect opportunity without looking like some dirty old dentist intruding on their sex life.”