Oral Papillomas-DoctorSpiller.com

Papilloma3Copyright 2006 Martin S. Spiller, D.M.D. courtesy of Dr. Ed Cataldo

There are approximately 80 strains of the human papilloma virus.  Only two types,  HPV16 and 18, have been shown to be the causative agents of cervical cancer (cancer affecting the epithelial cellular layer–the surface cells–surrounding the opening of the uterus) and are spread by sexual means.  The vast majority, however, are implicated only in causing common warts, the type children seem to get on their hands and feet.  These strains of HPV cause benign (non cancerous),  “cauliflower-like” growths like the ones pictured here.

These lesions can happen virtually any place in the mouth.  The image above shows a papilloma on the marginal gingiva, while the image below shows one on the buccal (cheek) mucosa.

The virus is often transferred to the mouth when warts on the hands come into contact with the oral mucosa.  They are easily removed by either cold steel or electrocautery.  Adults are less prone to common warts than are children because their immune systems have had more time to develop an immunity to most strains of the virus.

PapillomaCopyright 2006 Martin S. Spiller, D.M.D. courtesy of Dr. Ed Cataldo

 Papilloma2Copyright 2006 Martin S. Spiller, D.M.D. courtesy of Dr. Ed Cataldo

The papilloma above was found on the soft palate nearly as far back as the pharyngeal tonsil.  This lesion shows the typical cauliflower-like appearance of the common wart.  Lesions of this sort are always benign (non cancerous), however the location, so far back, almost into the throat, suggests the possibility of oral-sexual transmission of the HPV virus, and the associated possibility of HPV 16 as the causative agent. HPV 16 is known to be associated with squamous cell carcinoma of the tonsils, the lingual tonsil area at base of the tongue, and the pharynx (throat), as well as benign papillomas like the one above.  It is important to remember, however, that there are five strains (types) of papillomavirus that cause oral papillomas.  Only one of them, HPV 16, is associated with an increased risk of oral/pharyngeal cancer.

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