Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of Medicine, University of Turku, Finland.
J Am Dent Assoc. 2011 Aug;142(8):905-14. doi: 10.14219/jada.archive.2011.0297.
Public awareness of human papillomavirus (HPV) as the causal agent of cervical cancer and of the availability of HPV vaccines has increased. As a result, more patients are asking their dentists about oral HPV infection and its prevention by means of vaccination. Parents of pediatric dental patients also may be concerned when their children have HPV-associated oral lesions, because HPV infection still often is considered a purely sexually transmitted disease. In this review, the authors provide the latest information for dental professionals about HPV infection in the oral mucosa and in general.
The authors searched PubMed for all studies regarding HPV infection in the oral mucosa, and they reviewed relevant publications focusing exclusively on HPV infections of the oral cavity. In selecting studies for review, the authors made a clear distinction between studies regarding HPV infections in the mouth and those regarding HPV infection in the oropharynx or in other head and neck sites.
HPV can infect oral mucosa. A subgroup of oral cancer clearly is associated with HPV. Oral HPV infection is transmitted sexually but also can be transmitted from mouth to mouth and vertically from an infected mother during delivery.
Persistent HPV infection in the oral mucosa might increase the risk of developing oral cancer. Regular and meticulous clinical examination is the dentist's most important tool in detecting HPV-associated changes in the oral mucosae. HPV-associated oral cancer may affect a population younger than that typically affected by HPV-independent oral cancer. Alcohol and tobacco use increase the risk of developing oral cancer, so good practice includes encouraging patients to avoid these habits. The available HPV vaccines cover the HPV genotypes found most commonly in the oral mucosa, but their protective effect against oral cancer remains to be elucidated.
公众对人乳头瘤病毒（HPV）作为宫颈癌病因的认识以及 HPV 疫苗的可及性有所提高。因此，越来越多的患者向牙医询问口腔 HPV 感染及其通过疫苗预防的问题。当儿童出现 HPV 相关口腔病变时，儿科牙科患者的家长也可能会感到担忧，因为 HPV 感染通常仍被认为是一种纯粹的性传播疾病。在这篇综述中，作者为牙科专业人员提供了有关口腔黏膜 HPV 感染的最新信息。
作者在 PubMed 上搜索了所有关于口腔黏膜 HPV 感染的研究，并回顾了专门关注口腔 HPV 感染的相关出版物。在选择要综述的研究时，作者明确区分了关于口腔 HPV 感染的研究和关于口咽或其他头颈部部位 HPV 感染的研究。
HPV 可感染口腔黏膜。口腔癌的一个亚组显然与 HPV 相关。口腔 HPV 感染通过性行为传播，但也可以通过口对口传播和垂直传播（从受感染的母亲在分娩时传播）。
口腔黏膜中持续的 HPV 感染可能会增加发生口腔癌的风险。定期、细致的临床检查是牙医发现口腔黏膜 HPV 相关变化的最重要工具。HPV 相关口腔癌可能影响比 HPV 无关口腔癌通常影响的人群更年轻。饮酒和吸烟会增加发生口腔癌的风险，因此良好的做法包括鼓励患者避免这些习惯。现有的 HPV 疫苗涵盖了在口腔黏膜中最常见的 HPV 基因型，但它们对口腔癌的保护作用仍有待阐明。
