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It’s about time on HPV – Dr Michael Sultan

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  Posted by: The Probe      8th December 2018

We all know that caring for our patients’ teeth is not our sole concern. It is also our duty as professionals to make patients aware of any abnormalities that we find in their mouths during treatment, and by doing so hopefully alert them to any serious dangers such as oral cancers.

Many of us have known for a long time that one of the leading causes of oral cancer is the Human Papilloma Virus (HPV) and therefore it boggles the mind that it’s taken so long for the relevant authorities to extend the vaccine to a much larger proportion of the population. Thankfully, this has recently been rectified with measures introduced to extend the vaccination to include those of the male sex – a move that could save thousands of lives every year.

Vaccines against the virus have been standard for girls of school age since 2013 as a protective barrier against cervical cancer. Although, with the knowledge that the vaccine is capable of protecting against conditions such as genital warts and oral, anal and penile cancers, it does bring to question why it wasn’t available to male students in the first place.

There are approximately 400,000 boys in the UK aged 11-12 every year, none of whom previously had access to the vaccine. This means that millions of men in Britain are susceptible to these threats – especially when you consider that HPV is the most common sexually transmitted infection of them all.[i]

This is particularly worrying as there are as many as 7,500 new cases of oral cancer each year – 2,000 of which are fatal, making it is a far more deadly than both cervical and testicular cancer combined.

Of course, this move is a step forward, and offering the vaccination to boys will undoubtedly cut the number of cases down significantly. But we do have to wonder – what about the millions of British people who won’t be able to have the vaccine free from the NHS as they are already too old? Will there be any measures introduced to make this vaccine available for people who want it outside of the school-wide programme? Although it seems the vaccination is fast being adopted by high street pharmacies such as Boots and made available to the public, it still bears a heavy price tag (£300 – £450), which means that, ultimately, a number of people will likely choose to go without.[ii]

This raises another question – will it then fall into the remit of dentists to suggest the vaccine to patients? The risk of contracting the virus will vary greatly from person to person, especially as it is primarily a sexually transmitted disease. That means that people with more than one regular sexual partner and those with a history of multiple sexual partners are more likely to have/ become infected by the virus. This opens a whole additional can of worms where we have to wonder – should we then ask patients about their sexual history in order to give them more tailored advice? It’s a difficult and convoluted subject but one that definitely bears thinking about – especially if we are to offer the best care possible for every individual.

Of course, it’s still early days. The vaccine has only just reached approval and therefore we won’t know the effect it will have on the reduction of cases or indeed how many people will choose to pay the price tag to immunise themselves privately. Therefore, as dentists the best we can do is remain vigilant for signs of oral cancers in our patients – many of which are clearly visible.

Though oral cancers can manifest themselves in many ways, there are a few signs that we should all be wary of. The first is ulcers that don’t show signs of healing. Though these may due to other problem, these lesions can be cancerous and should definitely be monitored if found. Another indicator is teeth becoming loose for no apparent reason. There are a plethora of other symptoms such as strange lumps, loose teeth, jaw stiffness and if the patient is experiencing trouble chewing or swallowing[iii]– again these may have myriad causes, but it’s always better to be safe than sorry.

The introduction of the HPV vaccine for boys is certainly a triumph, but that doesn’t mean we can rest on our laurels. By remaining attentive in our examinations we can ensure that those who are unprotected from HPV are alerted to any potential problems, and can suggest the vaccine to those who we think it may benefit most.

For further information please call EndoCare on 020 7224 0999

Or visit www.endocare.co.uk

EndoCare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist Endodontist practices. Through the use of the latest technologies and techniques, the highly-trained team can offer exceptional standards of care – always putting the patient first. What’s more, EndoCare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.

 

 

 

[i]The Oral Health Foundation. ‘Decision to Finally Offer Boys HPV Vaccine Will Save Many Lives’ Declares Charity. Link:

[ii]The Huffington Post. Should I Get The HPV Vaccine? Boots Makes Jab Available To Men And Women. Link: https://www.huffingtonpost.co.uk/entry/should-i-get-hpv-vaccine-boots-makes-jab-available-to-men-and-women_uk_58eba473e4b0c89f9120214f[Last accessed July18].

 

[iii]Mayo Clinic. Mouth Cancer Symptoms. Link: https://www.mayoclinic.org/diseases-conditions/mouth-cancer/symptoms-causes/syc-20350997[Last accessed July18].


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