Why your dentist may ask about your sex life

Oropharyngeal cancer, caused by the human papillomavirus (HPV), is on the rise and a head and neck examination during your regular dental check-up can be vital in detecting the cancer.

Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the throat (oropharynx). Although most cases of HPV infections resolve on their own, HPV can cause six different types of cancer. Oropharyngeal cancer is one of the types of cancer that is increasing at alarming rates says oral pathology specialist Seema Ganatra.

Oropharyngeal cancer, also known as throat or tonsil cancer, is associated with oral sex.

“This type of cancer is transmitted through oral sex. One issue is that we as dental professionals cannot easily detect this cancer because it occurs in the back of the mouth and throat, and this area is difficult to examine. It goes undetected until it spreads to the neck and is caught in later stages as a lump or mass of the neck,” she says, adding other symptoms include difficulty swallowing, a lump in the throat or experience ear pain. “But head and neck cancer examinations are critical during dental check-ups.”

With sexual preferences changing, oropharyngeal cancer is occurring more in younger people explained Ganatra. “They think oral sex is safer. But if you have had six or more unprotected oral sex partners, you are at risk of this type of cancer,” she says.

This cancer affects a younger age group - 45-55 years of age - when compared to those with tobacco and alcohol-related oral cancers explains Ganatra. People are having sex at a younger age and many are engaging in oral sex. Changing sexual preferences arose in the 1980s when oral sex was thought to be safer with the emergence of HIV disease.

Patients with oropharyngeal cancer are treated by ear, nose and throat specialists. The good news is that these patients have a better outcome with surgery, radiation treatment and chemotherapy in comparison to patients with tobacco and alcohol-related oral cancer.

For Ganatra, the biggest concern is that the awareness and education around HPV oropharyngeal cancer is not where it needs to be. People are aware of HPV and cervical cancer but not of its association with oropharyngeal cancer.

“This is where we as dentists come in. The head and neck is our area,” she says. “We need to educate our patients and have tough conversations around this topic. We need to be diligent in completing head and neck examinations during dental check-ups.”

HPV related cancers can be prevented. Vaccinations are available and whereas before they were primarily targeted to women, but now both younger and older men are being encouraged to get vaccinated.

“As dentists, we have the opportunity to promote HPV vaccinations and good oral health practices,” says Ganatra. “There are a lot of myths and stigmas associated with this type of cancer but our role is to screen and educate all of our patients.”