An estimated 80% of people in the U.S are carriers of the human papillomavirus (HPV). HPV is the most common sexually transmitted infection (STI) in the United States. More than 100 types of HPV exist with more than 40 subtypes. One of the most common subtypes of HPV is verruca vulgaris, also known as oral warts.

What is an oral verruca vulgaris?

Oral verruca vulgaris is most commonly referred to as oral warts. Oral HPV is fairly rare, with just 7% of 14 to 69 year olds diagnosed with this subtype.

This type of HPV infection presents itself as a small white lesion that rapidly grows and then stabilizes. Unlike other skin lesions in the mouth that can be precancerous or malignant, verrucas are generally benign.

The most common places for oral warts to occur are on the throat and tongue, but they can appear anywhere in the mouth, including the inside of the lips and the soft palate. When verruca vulgaris appears on the tonsils, your doctor will test for HPV-16, a subtype that has a high risk for oropharyngeal (mouth and pharynx) cancer.

What are verruca risk factors?

Risk factors for verrucas include the following:

Other studies indicate that open mouth kissing is a risk factor, but more research is needed to confirm this.

Men are more at risk for oral verruca vulgaris as well as cancer that arises from this viral infection.

What do oral warts look like?

There is no one test for oral verrucas. Most likely your dentist or doctor will notice them during a routine examination.

Oral warts can look like small cauliflower florets on a short stalk. They may be textured and raised, or they may be smooth and flat. The most common appearance is slightly raised and bumpy, with clusters of projections or folds located on the underside of the lips or in the back of the throat. In some cases, the base of the wart is narrower with the projecting part of it wider, rounded, and textured.

Oral warts can be white or tinged with pink and grey.

How to prevent oral warts

While contracting HPV that leads to oral warts seems inevitable due to the high incidence of HPV, there are ways to protect yourself.

  • Practice safe sex: HPV is a sexually-transmitted infection (STI) that can be prevented by abstaining from sex or using condoms when you do engage in sexual activity. If you choose to participate in oral sex, use dental dams or condoms to prevent infection.
  • Limiting number of sexual partners: The higher the number of sexual partners you have, the better the chance of contracting HPV. When you do enter into a sexual relationship, talk to your partners about preventing STIs. Limiting oral sex with new partners is also a way to limit your oral exposure to HPV.
  • Get tested: If you are sexually active, get regularly tested for STIs.
  • Go to the dentist regularly: Your dentist can monitor changes in your oral health. When you visit twice yearly, they are able to notice any issues that arise before they become more serious.
  • Get to know your own mouth: You may brush your teeth twice a day, but do you really know what the inside of your mouth looks like? Take a good look, and then keep an eye out for any changes.
  • Explore vaccination options: For some, the HPV vaccination may be a good option. A series of three shots administered over six months, the HPV vaccination is available for teens and young adults up to age 26. While the HPV vaccination does prevent some cancers, including cervical cancer in women, it may not prevent all cancers. Talk to your doctor to see if this is a good choice for you and your children.

How to get rid of oral warts

As oral warts are caused by a viral infection, in most cases they will go away by themselves when the virus recedes, usually between six months and a year. If verrucas persist, removal is the primary treatment option. There are three main removal techniques.

1. Interferon alfa-2B (Intron A, Roferon-A)

This injection essentially dissolves the wart from the inside out.

2. Cryotherapy

If the verruca does not show other signs of complications, cryotherapy is a minimally invasive and painless procedure in which the wart is frozen off. There are no side effects from this procedure, although the wart may reappear if all tissue was not removed.

3. Surgical removal

This is the most traditional removal method and is used when your doctor wants to biopsy the excised tissue.

After applying a numbing agent (topical, injected, or both), your doctor will remove the tissue with a scalpel and send it out for a biopsy. It is common to experience soreness in the area, but most sites heal with a week or so without complications.

When to see your doctor

There are other signs that may accompany oral verruca vulgaris that are more serious. These include:

  • Coughing up blood
  • A lump on the neck or in the cheek
  • Persistent hoarseness
  • Sore throat
  • White or red patches on the tonsils
  • Jaw pain or swelling
  • Numbness of the tongue

If you experience any of these in conjunction with a diagnosed verruca, it is important to see your doctor immediately. These are some of the late-stage symptoms of oropharyngeal cancer, but treatment is still possible.

Your Phoenix area weekend dentist is available if have questions about any changes in your mouth. If you need answers or are looking for a regular dentist, get in touch today.

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