Dental professionals have an opportunity to strengthen partnerships with patients, to help them achieve better health and wellbeing. When you widen the focus of consultations, and bring in new, relevant topics, you will capture their interest and improve engagement. The message is that oral health promotion is about supporting a healthier, happier life – so more than “just” teeth and gums.
Screening, protection and prevention
Cervical Cancer Prevention Week occurs in June. The NHS offers smear tests to women aged between 25 and 64, to check the cervix, and the sample is then tested for high-risk strains of human papillomavirus (HPV). HPV can cause the cells to change and develop into cervical cancer, if untreated, and nearly all cervical cancers are caused by HPV.
Because HPV can infect men too, vaccinations are offered to all schoolchildren in the UK, aged between 11 and 13. The vaccine does not just protect against cervical cancer; some cancers of the mouth and throat, and of the anal/genital areas have also been linked to HPV.
What your patients need to know
There are many reasons why HPV is a relevant topic for oral health consultations. First, because the infection increases a patient’s risk of certain types of oral cancer. Rates of mouth cancer were increasing pre-Covid, particularly in the over 40s. The impact of the pandemic on oral cancer referrals has been described as a “ticking time bomb”; prognosis improves with early diagnosis, with real fears we could see more late-stage presentations.
There is also some myth around HPV – it isn’t just a female health issue and, although it is transmitted through sexual contact, including non-penetrative sex, any skin-to-skin contact can pass on the virus. It is also incredibly common; most people will have HPV at least once in their lifetime, and only a small minority of strains are linked to cancer.
A range of factors have long affected uptake of routine cervical screening, such as anxiety and embarrassment, also (mistakenly) believing it isn’t necessary if they aren’t sexually active or have a long-term partner. The pandemic may have impacted on a woman’s willingness to go to a GP surgery or clinic, then voluntarily have an intimate, awkward procedure. In terms of the HPV vaccine programme in schools, despite the restart, people may be feeling differently about vaccinations, generally.
Solutions and support
Women should be encouraged to attend routine cervical screening when it is offered, so talk about coping strategies if they are anxious, reassure them about safety and how the benefits outweigh a few minutes of discomfort. With embarrassment being a major reason for missing an appointment, they might be interested to know how in some areas of London with low attendance, home swab tests are being sent out as part of a pilot study which has been described as a potential “game changer”.
If vaccines are a thorny issue, empathy and understanding will be required. The statistics for combined screening/vaccination for HPV are positive, though – in Scotland, a “dramatic reduction in preinvasive cervical disease” has been attributed to the HPV rollout to girls. There is some evidence that poor oral health is a risk factor for oral HPV, making improved mouth hygiene a further preventive measure for HPV-related oral cancers. Daily brushing can be supported and elevated by using an adjunctive tool like a Waterpik® Water Flosser, which is accredited by the Oral Health Foundation, for a deep clean between teeth and below the gum line.
By empowering patients with a broad scope of knowledge, you enable them to understand why prevention is so important for protecting against poor outcomes and all kinds of disease. It is time to talk about HPV and fight misinformation to support improved outcomes, and a better quality of life for all.
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