CDA Essentials 2016 • Volume 3 • Issue 8

38 | Volume 3 Issue 7 S upporting Y our P ractice Need expert advice? Send us your clinical questions. oasisdiscussions@cda-adc.ca or 1-855-71-OASIS References 1. AmericanDentalAssociation. StatementonHumanPapillomavirus andSquamousCellCancersoftheOropharynx. Chicago(IL):ADA. Available:ada.org/en/about-the-ada/ada-positions-policies-and- statements/statement-on-human-papillomavirus-and-squamous- cel(accessed2015Sept25). 2. ClevelandJL,JungerML,SaraiyaM,MarkowitzLE,DunneEF, EpsteinJB.Theconnectionbetweenhumanpapillomavirusand oropharyngealsquamouscellcarcinomas intheUnitedStates: Implications fordentistry. JAmDentAssoc. 2011;142;915-924. 3. PublicHealthAgencyofCanada. Canadian ImmunizationGuide, Part4–ActiveVaccines,HumanPapillomavirusVaccine. Ottawa (ON):PHAC .Available:phac-aspc.gc.ca/publicat/cig-gci/p04-hpv- vph-eng.php(accessed2015Sept25). 4. Centers forDiseaseControlandPrevention. HumanPapillomavirus (HPV),GentitalHPV Infection–FactSheet. Atlanta(GA):CDC. Available:www.cancer.ca/en/cancer-information/cancer-101/what- is-a-risk-factor/viruses-bacteria-and-other-infectious-agents/ hpv/?region=on#HPV_and_cancer(accessed2016July25). THE AUTHORS Dr. Nita Mazurat Dr. Mazurat is an associate professor in the department of restorative dentistry and the director of infection prevention and control for the college of dentistry at the University of Manitoba. She is also the primary author of the Manitoba Dental Association infection prevention and control guidelines. Dr. SuhamAlexander Dr. Alexander is in private practice in the Ottawa area and is clinical editor of Oasis Discussions at CDA. Nita.Mazurat@umanitoba.ca Key information about HPV from the Canadian Immunization Guide 3 in their lives. Generally, HPV resolves on its own but if it does not resolve it can cause health problems, including cancer. The dental team should encourage adult patients to discuss the HPV vaccine with their physician as a preventive health measure for themselves and their children. In Canada 4 , it is estimated that HPV is associated with 80–90% of anal cancers, 40–50% of penile cancers, 40% of vaginal and vul- var cancers, 25–35% of oral cavity and oropharyngeal cancers. Most of these cancers are attributed to high-risk HPV types 16 and 18. a To read the full Oasis Discussions post, please visit: oasisdiscussions.ca /2014/10/17/hpv-2 What • HPV infections are the most common sexually transmitted infections. Most HPV infections occur without symptoms and resolve without treatment. • If not immunized, most sexually active Canadians will have an asymptomatic HPV infection at some time. • High-risk HPV types 16 and 18 and others can lead to cervical and anogenital cancers, as well as certain cancers of the head and neck. • Low-risk HPV types 6 and 11 can cause genital warts. • HPV2 and HPV4 vaccines protect against cervical cancer. HPV4 vaccine also protects against genital warts. Who • HPV2 or HPV4 vaccine is recommended for prevention of cervical cancer in girls and women 9 to 26 years of age, including those who have had previous Pap test abnormalities, cervical cancer or genital warts. • HPV4 vaccine is recommended for the prevention of vulvar, vaginal, anal cancers and their precursors and anogenital warts in girls and women, 9-26 years of age. • HPV2 or HPV4 vaccine may be administered to women 27 years of age and older at ongoing risk of exposure. • HPV4 vaccine is recommended for prevention of anogenital cancer and genital warts in boys and men 9 to 26 years of age. • HPV4 vaccine may be administered to men 27 years of age and older at ongoing risk of exposure. HPV2 vaccine is not approved for use in boys and men.