You are brushing your teeth one morning and notice a firm bump on your tongue. It’s small, but persistent and doesn’t go away over time. There are many different oral lesions that it could be. One of them is an oral papilloma. Here’s what you should know.
What is an oral papilloma?
An oral papilloma is a lesion related to the human papilloma virus (HPV). HPV is the most common sexually transmitted disease. Most people are aware that genital warts result from an HPV infection but don’t know that the human papilloma virus also causes oral papillomas (warts).
Oral warts can occur anywhere in the mouth, including the:
- Tongue
- Gums
- Back of the throat
- Tonsils
An estimated 79 million people in the U.S. are diagnosed with human papilloma virus, with another 14 million diagnosed annually. Of these, about 7% of cases are oral papilloma. It is challenging to come up with a truly accurate estimate of cases, as many people are asymptomatic (as we’ll discuss in more detail later on in this post).
Oropharyngeal cancer symptoms
The most common papilloma is a benign papilloma, but in some cases they can become oropharyngeal cancer.
Symptoms of this rare but serious cancer include:
- Trouble swallowing
- Persistent earaches
- Coughing up blood
- Unexplained weight loss
- Enlarged lymph nodes
- Persistent sore throat
- Lumps on the cheeks
- Growths or lumps on the neck
- Hoarseness
Fortunately, the subtype of HPV (HPV-16) that causes oropharyngeal cancer is rare with just 1% of people with HPV having this type. Oral papillomas in the throat are the most likely to turn into oropharyngeal cancer, so if you have these symptoms it is important to get checked out by your doctor.
What are the causes of papilloma?
Oral papilloma causes are related to sexual activity, specifically oral sex. If a person is a carrier of the human papilloma virus and receives oral sex, there is a chance that they could transmit the virus to their partner.
Certain risk factors increase your chances of contracting oral papilloma.
- Gender: Men are more likely to contract oral papilloma due to HPV infection than women
- Multiple partners: The more partners you have, the higher your risk of developing oral papilloma becomes
- Smoking: The hot smoke and chemicals in cigarettes create micro tears in the mouth that can make people more vulnerable to HPV infection
- Alcohol: Consuming alcohol (especially when combined with smoking) increases the risk of HPV transmission
- Open mouth kissing: Open mouth kissing may increase the chances of HPV infection, but more research needs to be done
Older adults with oral papilloma are more likely to develop oropharyngeal cancer, as this takes years to develop.
Are oral papillomas contagious?
Being related to the highly contagious human papilloma virus, oral papillomas themselves are highly contagious.
The most challenging part of this virus and why it is so widespread is because carriers are often asymptomatic. It is possible to be a carrier of HPV and not have any symptoms for your entire life. One partner who infects another simply may not be aware that they are infected themselves.
There are steps you can take to prevent this type of sexually-transmitted infection (STI), such as:
- Practice safe sex, using condoms and dental dams 100% of the time
- Ask your partners about their history of STIs
- Get tested regularly for STIs
- Ask your dentist to check for anything abnormal in your mouth during check-ups
- Pay attention to changes in your mouth
- If you are under 26, consider getting the HPV vaccination
It can be uncomfortable to have conversations about STIs with a new partner, but it is better to be a little uncomfortable for a short period of time than to contract an infection that does not go away.
Can I get oral papilloma removal?
There is no cure for the human papilloma virus. Once you contract this infection, you are a carrier. Approximately 90% of infections resolve themselves within two years.
You may never develop symptoms that do not go away on their own, but if you do, there are treatment options. The three main options for papilloma removal are:
- Surgical removal (traditional or laser)
- Cryotherapy (freezing off the lesion)
- Injection of interferon alfa-2B (branded names include Intron A and Roferon-A)
For all three, your doctor will use a topical anesthetic to ensure your comfort. For surgery, this may also be injected so that the oral wart’s roots are completely removed. Once the area around the wart is numb, your doctor will proceed.
Oral papilloma removal surgeries
For traditional surgical removal, you may require a stitch or two to close the incision. This is typically not necessary with laser surgery, as the laser removes the papilloma and cauterizes the incision.
Cryotherapy freezes the wart itself. In some cases, the wart may gradually fall off in a few days, or your doctor will pluck it off.
Interferon injections are antiviral and fight the infection from within. Gradually the wart will shrink and fall away, but this may also be accompanied by other methods of oral papilloma removal.
Some doctors will prefer to take a “wait and see” approach, allowing the infection to resolve itself. In the case of oral papilloma on the throat or accompanied by other symptoms, your doctor will elect to not only remove the wart but to also send it out for a biopsy.
The prognosis for early-detected oropharyngeal cancer that has the HPV-16 subtype is good (better than non-HPV related oral cancer). A brief course of radiation may be recommended, as well as chemotherapy. Each person and infection is different, and your doctor will individualize treatment to you.
Your Phoenix area dental clinic can help monitor any changes in your oral health. Get in touch with AZ Dentist today to schedule a regular exam and cleaning.