HPV Vaccination in the Dental Office
Dentists are uniquely positioned to improve access and reduce the incidence of oral cancer
Although many people maintain the simplistic perspective that a dentist is someone who "fixes teeth," the profession of dentistry includes individuals from various backgrounds who contribute to oral healthcare in a variety of ways. Some focus on research, quality improvement, materials, and lab processes, whereas others are involved in academia, the military, public health, solo practice, group practice, and more. We each have our own individual stories, but one thing that we have in common is our respect for and sense of duty to the provision of quality oral healthcare.
Fixing teeth is just a small part of what we do. Through our leadership, our teams engage with patients in many meaningful ways to address their overall health. One simple way that we can do this is by providing blood pressure screening. It's a simple, routine procedure that aligns our profession with that of our colleagues in the medical field. We often consult with physicians about premedication, assessment prior to oral surgery, and sedation dentistry, and we understand everything from the basic pharmacologic interactions of medications to the more advanced implications that untreated periodontal disease may have on an uncontrolled diabetic's A1C level.
When our patients receive a diagnosis involving cancer, we hear the grief and uncertainty in their voices when we see them for preventive treatment modalities prior to their start of cancer treatment. We are "fixers." That's a big part of what we do, but we also focus on prevention. So, let's focus on not only the prevention of caries and periodontal disease but also the prevention of cancer.
As oral healthcare providers, it's time that we leverage our education, experience, and oaths to servant leadership and join our medical colleagues in providing additional preventive measures by offering vaccinations for human papillomavirus (HPV). Education and limited screenings are not enough to prevent the loss of our patients to oropharyngeal cancer.
The stereotypical causes of oropharyngeal cancer, tobacco and alcohol use, remain problematic; however, the focus has shifted to HPV causation. According to the US Centers for Disease Control and Prevention's (CDC) HPV and Cancer Statistics, every year, about 45,000 new cases of cancer are diagnosed in areas of the body where HPV infections typically occur, and HPV infection is the probable cause in 79% of them. More specifically, of the almost 20,000 yearly cases of oropharyngeal cancer, 14,000 are estimated to be caused by HPV, and of these cases, almost 12,000 involve male patients. And of the approximately 12,000 cases of cervical cancer each year, 11,000 are estimated to be attributable to HPV.
Although mothers of young daughters know that the HPV vaccine is routinely offered during women's wellness visits, as a mother of two boys, I feel obligated to share my knowledge about the prevention of this virus that causes cancers that continue to have terrible survival rates, particularly oropharyngeal cancers, which often aren't detected until later stages when patients notice strange lumps in their necks or changes in their voices.
Many analytics indicate that the biggest population of patients that we serve is children. That's where we can start the education, screening, and prevention process. Our next largest population is composed of seniors, but unfortunately, they are not candidates for HPV vaccination. This limitation makes screening important. The patient population that we see the least comprises those who experience regular obstacles in caring for themselves because of factors such as time or finances, which results in missed opportunities for us to educate, screen, and prevent. I'm hopeful that patients in this population are educated and screened by their primary care physicians; however, we are aware that many patients who come to us for dental treatment have not been to their physicians in a while. Oral health evaluation, vaccination, and communication of our findings and treatment with our medical counterparts can create an opportunity for bidirectional treatment and a gateway to overall wellness for our patients.
As oral healthcare providers, we should have the option to administer HPV vaccinations within the scope of our profession. With our extensive experience using needles, preparation for medical emergencies, and understanding of storage requirements, dentists are uniquely positioned to join pharmacists and nurses in helping improve access to vaccinations. And the HPV vaccination series aligns perfectly with our 6-month recall schedule. Let's "fix" the problem of HPV-related oropharyngeal cancer by offering and administering the HPV vaccine.
About the Author
Hana Alberti, DDS, is the vice president of ForwardDental and maintains a private practice in Franklin, Wisconsin.