Yes, it is possible to get HPV (human papillomavirus) in your mouth. HPV is a very common virus that can infect the skin and mucous membranes, including the mouth and throat. There are over 100 types of HPV, and around 40 of those types can infect the mouth and throat. HPV is spread through skin-to-skin contact and is highly contagious. Many people who become infected with HPV do not have any symptoms, which is why it can easily be passed from person to person without realizing it. However, some types of oral HPV can lead to serious health issues like cancer. Knowing your risk and taking preventative measures is important for reducing your chances of developing oral HPV.
How is oral HPV transmitted?
HPV is transmitted primarily through skin-to-skin sexual contact, including vaginal, anal, and oral sex. You can get oral HPV through performing oral sex on someone who has a genital HPV infection. It can also be passed through open-mouth kissing if the person has an oral HPV infection. Less commonly, you may be able to acquire oral HPV through intimate skin contact like hand to genital contact and then touching your mouth. Sharing items like drinks, cigarettes, vapes, lipstick, or lip balm with someone infected with oral HPV can also transmit the virus. A mother can even pass HPV to her baby during childbirth. Once infected, the virus can live in your mouth and throat and potentially be transmitted to others orally for many months or even years.
What are the symptoms of oral HPV?
Most of the time, oral HPV does not cause any symptoms and people have no idea they are infected. When present, symptoms of high-risk oral HPV include:
- Sores or growths in the mouth or on the lips
- White or red patches in the mouth
- Difficult or painful swallowing
- Hoarseness or changed voice
- Ear and neck pain
- Numbness of the mouth
- Bleeding in the mouth
These symptoms are more common with precancerous lesions or oral cancer caused by high-risk HPV types like HPV16. Symptoms usually take years to develop after initial infection.
Low-risk oral HPV types that cause warts or papillomas may result in symptoms like:
- Small bumps in the mouth
- Spiked or cauliflower-shaped growths
- Wart-like lesions
These symptoms can show up weeks or months following infection.
Who is at risk for oral HPV?
HPV is extremely common, and most sexually active adults get infected at some point. Around 10% of men and 3.6% of women have oral HPV at any given time. Those at highest risk include:
- People who have oral sex
- Those with multiple oral sex partners
- Individuals with a weakened immune system
- Smokers
- Men
- People between ages 18-44
HPV is most prevalent in younger sexually active groups under age 45. At least 10% of men and 7% of women have oral HPV infections in this age range. The risk goes down in older age groups. After age 55, less than 1% of adults have oral HPV.
Men are at higher risk of both genital infection and oral HPV infection compared to women. The reasons are unclear but may relate to sexual behaviors.
People who smoke and those with weakened immune systems also seem to acquire oral HPV more easily. Poor immunity makes it harder for the body to clear HPV once infected.
Can oral HPV lead to cancer?
Over 99% of oral HPV infections will naturally clear within 1-2 years as the immune system eliminates the virus. However, persistent infection with high-risk cancer-causing types like HPV16 and HPV18 can lead to precancerous lesions that may progress to oral or throat cancer.
HPV is responsible for the majority of oropharyngeal cancers, which include:
- Base of the tongue cancer
- Tonsil cancer
- Pharyngeal wall cancer
HPV DNA is found in around 70% of all oropharyngeal cancers in the United States. It is estimated that around 18,000 HPV-related cancer cases occur each year. The risk of developing oral cancer is 14 times higher in people infected with high-risk oral HPV compared to those not infected.
Oral HPV infection is now the leading cause of oropharyngeal cancers, surpassing tobacco and alcohol use thanks to widespread HPV vaccination.
Risk factors for oral HPV cancer
While most cases of oral HPV clear quickly, certain factors raise your risk of persistent infection and cancer:
- Infection with a high-risk HPV type, especially HPV16
- Smoking or chewing tobacco
- Heavy alcohol use
- Weak immune system
- Male gender
- Multiple oral sex partners
- Poor oral hygiene
- Older age
Smoking combined with oral HPV infection significantly increases oral cancer risk. Tobacco exposure makes it harder for the immune system to clear HPV.
Chronic infection with high-risk HPV types over many years gradually raises oral cancer risk, so prevalence increases with age. Most cases occur in those ages 55-64. However, oral cancer linked to HPV has increased dramatically in younger adults ages 45 and under.
How to reduce your risk of getting oral HPV
It can be very hard to prevent oral HPV since it is so easily spread through common behaviors like kissing and oral sex. A few key ways to lower your chances of infection include:
- Get vaccinated against HPV – The HPV vaccine protects against cancer-causing strains
- Limit open-mouth kissing – Reduces exposure from contact with saliva
- Use protection during oral sex – Dental dams and condoms lower skin-to-skin contact
- Limit number of oral sex partners – Reduces exposure to possible infection
- Avoid tobacco and excess alcohol – Lowers risk of oral cancer if infected
- Practice good oral hygiene – Ensures regular removal of infected cells
Getting vaccinated before becoming sexually active between ages 9-12 provides the best protection against new HPV infection. However, adults up to age 26 can still benefit from vaccination if not previously immunized. Using dental dams as a barrier during oral sex on a woman or condoms during oral sex on a man prevents contact with genital secretions that may contain HPV. Limiting your number of sexual partners and avoiding tobacco and alcohol also helps lower oral cancer risk if you acquire an oral HPV infection at some point. Practicing good oral hygiene through brushing, flossing, and mouthwash helps remove infected cells that could otherwise linger and become cancerous over time.
Can oral HPV be tested and treated?
Unfortunately, there are no standard screening options available yet to test for oral HPV infection. Since there are no symptoms in most people, infections often go undiagnosed.
There are medical tests that can detect the presence of high-risk HPV strains through a swab of the mouth, throat, or tonsils, but these are not routine screening tools you can ask your doctor to perform. These HPV tests are primarily used for people already diagnosed with certain head and neck cancers to determine the role of HPV.
For the general public concerned about oral HPV infection, there are no recommended screening or testing methods. However, if you develop symptoms like oral lesions, growths, or sores that last more than 2-3 weeks, see your doctor or dentist for evaluation. An unusual oral lesion could indicate precancerous changes that require treatment if persistent infection with high-risk HPV is confirmed through a biopsy. Catching lesions early optimizes outcomes.
There is currently no cure or treatment for the HPV virus itself – most oral HPV infections clear on their own. However, the precancerous lesions and cancers HPV causes can be treated. Treatment options depend on the location and extent of abnormal cell growth and include:
- Surgery to remove lesions or tumors
- Radiation to kill cancerous cells
- Chemotherapy drugs to destroy cancer cells
- Targeted therapy to halt cancer cell growth
- Immunotherapy to stimulate the immune system against cancer
Treatment aims to remove or destroy HPV-infected precancerous and cancerous cells before they can spread. Early intervention provides the best chance for successful treatment and cure.
Does oral HPV go away?
The good news is that more than 90% of all oral HPV infections, including those caused by high-risk cancer-causing varieties like HPV16, are cleared from the body by natural immunity within one to two years. Only in very rare cases does an oral HPV infection persist for many years and eventually progress to cancer. However, once you have been infected with oral HPV, you can become reinfected by the same partner or potentially develop a new infection from a different partner.
In a small subset of people with weakened immune systems, HPV persists indefinitely and remains in the mouth or throat for decades. This includes people on immunosuppressive drugs for organ transplants or conditions like HIV/AIDS. Prolonged infection in these groups carries an elevated risk of eventually developing oral cancer.
While there is always a very small chance of an infection becoming chronic and developing into cancer even in healthy people, most will never know they had oral HPV at all because it is naturally eliminated by the body’s defense mechanisms.
Can oral HPV recur?
Once you have been infected with oral HPV, it is possible to be reinfected by the same strain or a new high-risk strain even after initial infection clears. Having one oral HPV infection does not provide any immunity against developing a future infection. According to some estimates, the likelihood of getting recurrent oral HPV after an initial infection may be around 31-50%.
Recurrent infections seem especially likely in older age groups and if you have a history of multiple oral sexual partners. Continued exposure to HPV through unprotected oral sex seems to increase the probability of both reinfection and persistence of oral HPV. Using protection like dental dams during oral sex and limiting partners can lower reinfection risk. Treating oral HPV-related lesions and cancers may also reduce the chances of recurrence. Avoiding tobacco is also critical, as smoking makes recurrence more likely.
Even after successful treatment for an HPV-related oral cancer, follow-up care is vital since recurrence rates can be as high as 30% within 5 years. Getting regular oral cancer screenings is advised even after initial remission, especially if you have ongoing HPV risk factors. While identical strain infection can happen, most recurrences are believed to be from acquisition of a new high-risk HPV oral infection.
Conclusion
Oral HPV is very common but rarely progresses to mouth or throat cancer since most infections resolve naturally within 1-2 years. Practicing safer sex techniques like using barriers during oral sex, limiting partners, and getting vaccinated while not smoking, drinking alcohol in moderation, and maintaining good oral hygiene are your best defenses against persistent infection. While concerning, most people infected with even high-risk oral HPV strains will clear them without ever having symptoms or complications. See your doctor about persistent mouth lesions, growths or pain as they may indicate precancerous changes that need evaluation. With early intervention, most cases of HPV-related oral cancers have a good prognosis.