Oral Cancer and HPV: What We Should Now Know

Presented by: Dr. David Clark

RCDSO Expiry Date: March 31, 2025

To qualify as a Core Category 1 course, the course certificate must be issued no later than this date.

RCDSO CE Points: 3, Category 1

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  • Dr. David Clark BSc.,DDS, MSc.(Oral Pathology), FAAOP, FRCD(C)

    Dr. David Clark has worked as the Head of Dental Services at Ontario Shores Centre for Mental Health Sciences in Whitby, Ontario, Canada from 1988- 2017 and is also an Associate in Clinical Dentistry, Department of Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Canada.

    His hospital-based practice has been devoted primarily to the general dental care of individuals undergoing primary care for various forms of psychiatric illness often co-existing with other medically compromising conditions.

    He participates in the teaching of the undergraduate dental curriculum relating to the topics of Oral Medicine and Oral Diagnosis at the Faculty of Dentistry, University of Toronto. He is a part-time clinical instructor (Dental Hygiene Program) at Durham College, Oshawa, Ontario and at George Brown College, Toronto, Ontario.

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Oral and oropharyngeal cancer continues to represent a significant global public health issue. While the disease may occur with no prior history, traditional risk factors have included smoking and alcohol consumption in a population made up predominantly of males in the 5th to 7th decades of life often involving high risk intraoral sites such as the floor of mouth, lower lip, and ventral/lateral surfaces of the tongue. The average 5-year survival rate has essentially remained unchanged for the past several decades ranging between 56 – 60%. This poorer prognosis is particularly high due to this disease being routinely discovered in advanced stages of development – often stage III or IV.

Increasing evidence now links the role of a particular subset of human papillomavirus (HPV) to oral cavity cancer – more specifically, to the pathogenesis of oropharyngeal carcinoma (OPC). HPV- positive OPC is defined by a younger, often male demographic, non-smoker with a higher socio-economic status and now, a greater association linked to orogenital sexual contact. High-risk sites for this disease that typically develops in the posterior third of the oral cavity include the base of tongue, soft palate, and the tonsillar tissues.

Dentistry has always been about education and prevention and the dental treatment team are now in a strategic position to play a key role in this facet of oral care. On-going efforts at early-stage detection and diagnosis of all forms of head and neck squamous cell carcinoma remain crucial to improving the current 5-year survival rate for this disease and thereby enhancing a patient’s overall quality of life.

Learning Objectives:

At the conclusion of the presentation, the participant will be able to:

  1. Apply the “ask-look-feel” protocol for our patient’s routine extra-oral/intra-oral examination embracing a heightened awareness for potentially high-risk lesions occurring within the oral cavity.
  2. Discern the prevalence and risk factors for HPV related oropharyngeal carcinoma.
  3. Discuss the various tools/steps used in arriving at either a differential or definitive diagnosis of oral/oropharyngeal carcinoma.
  4. Recognize current treatment modalities for oral/oropharyngeal carcinoma including potential complications and side-effects with an emphasis on the importance of pre-treatment dental management initiatives.
  5. Engage with patients about oral cancer and in particular HPV related oropharyngeal carcinoma – the role of the oral health treatment team in answering the questions that patients will have.