CDA Essentials 2016 • Volume 3 • Issue 7 - page 37

37
Volume3 Issue7
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S
upporting
Y
our
P
ractice
Doyouhaveanyburningclinicalquestions related toyoureverydaypractice?Areyou facingachallenging
clinicalcaseandneedadvice?Sendyourqueries toOasisDiscussions forexpertguidance.The following
questionwassubmitted toOasisDiscussionsbyageneraldentist.Drs.NitaMazuratandSuhamAlexander
provideda response.
Question
Response
Does anyone have a polite and professional way to address the HPV issuewith patients in a dental
office setting?
OasisDiscussions
AskYourColleagues
The roleof dentists in thepreventionofhumanpapillomavirus
(HPV)-associatedoral cancers
❙➤
Provideaheadandneckexamination.
❙➤
Encouragepatients toperform regular self-examinations.
❙➤
Encourageadult patients andparentsof appropriatelyagedchildren toget theHPVvaccine.
❙➤
Refer patientswith suspicious lesionsor persistent symptoms.
Evaluate thepatient’shealthhistory—particularlyanyverbal orwritten indicationof suggestive symptoms,
suchas sore throat, dysphagia, hoarseness, ear pain, enlarged lymphnodesorweight loss—aspart of the
full clinical assessment andheadandneckexamination.
1,2
Educate and explain
Open theconversation
withadiscussionabout
risk: allmenandwomenareat riskof developing
oral cancer even in theabsenceof other risk
factors, suchas alcohol, smokingor smokeless
tobaccouse.
Explain that thedental examination
includesextraoral and intraoral soft
tissue
and that youperformaheadand
neckexamination for all newpatients
andat every recare/recall appointment.
Practitioners should keep inmind
that oropharyngeal cancers are
difficult todetectmanuallyand
visuallybecauseof their position
in theororfacial complex
andbecause the symptoms
mimicmorecommonbenign
conditions.
2
During theexamination, explain thatoral
cancer screening includesanassessment
of
the lymphnodesof theneck, intraoralmucosal
tissues, tongue, baseof the tongue, and
throat. Encouragepatients toperforma self-
examinationat least onceamonth.
Segue intoadiscussionabout the relationship
betweenHPVandoral cancers.
TheCenters for
DiseaseControl andPrevention (CDC)website
(
cdc.gov/std/hpv/stdfact-hpv.htm
) has a
good fact sheet that includes these keypoints:
HPV is themost common sexually transmitted
infectionandcanbe transmitted through
vaginal, anal, or oral sexwith someonewhohas
thevirus. Anyonewho is sexuallyactivecanget
HPV, even if youhavehad sexwithonlyone
person. It is socommon that nearlyall sexually
activemenandwomenget it at somepoint
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