Poor oral health linked to increased risk of oral HPV infection


A study published in Cancer Prevention Research1 found that people with poor oral health are at an increased risk of being infected by oral human papillomavirus (HPV)—a virus responsible for an estimated 40%-80% of oropharyngeal cancers. The worldwide incidence of HPV-positive oropharyngeal cancers is rapidly increasing.

Although poor oral hygiene and poor oral health are associated with oral and oropharyngeal cancers, this study presents the first evidence of a possible link between poor oral health and an increased risk of oral HPV infection.

Researchers from the University of Texas Health Science Center analyzed survey data collected for the National Health and Nutrition Examination Survey, which included oral health data for 3,439 people aged 30–69 years. Four measures were used to assess oral health: self-reporting of overall oral health, whether participants thought they might have gum disease, use of mouthwash to treat dental problems in the past 7 days, and number of lost teeth. The survey also included data on oral HPV infections according to 19 low-risk and 18 high-risk HPV types, including HPV-16 and -18—the primary high-risk HPV subtypes for oral and oropharyngeal cancer.

The results showed that poor oral health increases the risk of oral HPV infection, irrespective of other known risk factors for oral HPV infection, including tobacco use and having multiple oral sex partners.

Based on these findings, the study authors postulate that poor oral health increases susceptibility to HPV infection because ulcers, mucosal disruption or chronic inflammation create entry points for the virus in the oral epithelium. Further research is needed to explore the mechanisms by which oral disease may be associated with increased risk of HPV infection.

Previous studies have linked overall HPV prevalence with oral sex, number of lifetime sex partners, and current number of cigarettes smoked each day. This study suggests that people may reduce their risk of HPV infection and HPV-related oral cancers by maintaining good oral health.


  1. Bui TC, Markham CM, Ross MW, Mullen PD. Examining the Association between Oral Health and Oral HPV Infection. Cancer Prev Res. 2013;6(9):917-24.  Epub 2013 Aug 21.