Oral papilloma

In most cases, lesions caused by viruses belonging to this strain are asymptomatic and treatable. Examples are warts (affecting the skin of the hands and feet or face), condylomas and papillomas affecting the genital and oral mucous membranes.

In general, these lesions tend to disappear spontaneously. In other cases, however, they mutate into more severe forms and give rise to tumors.

The viruses that infect the genital areas are the same viruses that affect the mucous membranes of the mouth. Cervical cancer, for example, is caused by certain types of HPV.

The main sign of the presence of the virus in the mouth are condylomas, but it should be noted that not all oral warts are caused by HPV.

What is oral papilloma?

Papillomavirus (HPV) is one of the best known and most frequent viral diseases in the population. In most cases it is asymptomatic, at least at an early stage.

Most people associate HPV with genital warts, the most common symptom of the virus, or with cervical cancer, the most serious disease it can cause. However, not everyone knows that there are also other forms of papillomavirus, certainly rarer but no less problematic, such as oral papilloma.

From the etiological point of view, there is no real difference between the papillomavirus that can cause genital condylomas and the oral form. The virus is the same, the difference lies only in the location of the lesions, not so much in their nature.

Causes of papillomavirus (HPV)

In most cases, the immune system of the mouth, especially vigilant because it isconstantly subjected to the presence of bacteria and viruses coming from the outside, blocks it without causing an infection.

However, in the case of particularly high viral loads or very close contact, or even in the presence of pre-existing abrasions or cuts, the virus survives and begins to replicate in cells, resulting in the following symptoms in the mouth or pharynx:

• Persistent sore throat.
• Pain in the ears (because the pharynx is connected to the middle ear).
• Pain on swallowing.
• Development of mouth ulcers.

Replication of the virus occurs within the mucous membranes, where ulcerative lesions usually develop, causing pain and often representing an abrasion of the warts.

Oral warts are identical to genital warts, but unlike genital warts, they are subjected to the continuous and irritating friction of saliva and food.

In more severe cases, where symptoms may be due to the presence of oncogenic strains of HPV, responsible for cervical cancer, a throat neoplasm may also develop, the treatment of which is quite complex.

Although rare, it is a possible consequence of oral papillomavirus infection.

Oral papillomavirus is not as common as genital papillomavirus, mainly because the immune system of the mouth is more efficient.

And it is precisely on strengthening the immune system that the treatment and prevention of oral papilloma is based: the more competent and effective the immune system is, the less likely it is to become infected.

The immune system plays a key role in both avoiding infection and coping with it in the best possible way, preventing the worst consequences of HPV from developing in the mouth and throat.

Main symptoms

The virus enters the body orally and, if the viral load is high enough, is able to reproduce within the epithelial cells of the oral mucosa. Theoretically, the virus can develop in several places in the oral cavity, although it is most often detected in the pharynx.

Symptoms are nonspecific, which contributes to the diagnosis being made when the infection is already in an advanced stage. Sore throat, ear pain (due to the direct communication channel between the pharynx and the middle ear through the Eustachian tubes), pain on swallowing, sometimes hoarseness or, in any case, slurred speech, and possibly even ulcers in both the oral cavity and the throat may be observed.

The lesions are generally epithelial and have the characteristic of being very painful, as they create ulcers that do not heal, also due to the continuous passage of food.

Pain and hard-to-heal lesions are the most serious consequences the virus can lead to. In some rare cases, a throat neoplasm may develop.

Treatment of oral papilloma

Oral papilloma is a pedunculated and usually solitary lesion with small irregular digitiform projections, which give it its typical cauliflower-like appearance.

They are pink or white in color and range in size from a few millimeters to 1-2 centimeters; the soft palate and tongue are the most common sites.

Condylomas, on the other hand, appear as solitary or multiple excrescences, sessile or pedunculated, with a smooth or pointed surface. They occur most frequently in the posterior part of the oropharynx, at the level of the lingual dorsum, soft palate or frenulum.

In both cases, these are lesions caused by HPV infection, which is the same responsible for genital condylomas and plantar warts. Condylomas and papillomas on the tongue or palate rarely present as multiple lesions, in which case they are associated with severe immune system deficiency.

Lesions caused by papillomavirus are not dangerous in themselves, but some HPV variants can degenerate into carcinoma. For this reason, they should always be analyzed and removed by laser.

This form of minimally invasive surgery is quick and painless.It can be performed under local anesthesia and without any special precautions. Laser is now the treatment of choice for most ENT pathologies.

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Prevention

The infection is transmitted mainly through sexual intercourse, making it one of the most widespread sexually transmitted diseases.

However, transmission can also occur by simple physical contact, provided that there are active viral cells and abrasions, cuts or lacerations on the skin and/or mucous membranes.

In theory, other forms of contagion would also be possible, for example, if unwashed hands touch intimate parts and are then taken to the mouth, but in practice these are even rarer cases, because saliva has a disinfectant action, which blocks the action of the virus at its root. For lesions to develop in the mouth, there needs to be a high viral load and fairly close contact between the two mucous membranes.

As is often the case, immunocompromised individuals are the most susceptible to infection.

More rarely, HPV infection can be caused after contact with objects or surfaces already used by infected persons.

To prevent papillomavirus infections, it is necessary to maintain simple rules of hygiene:

• Firstly, when frequenting public areas such as swimming pools and changing rooms, it is good to keep feet dry and clean and to wear rubber slippers.
• In addition, to prevent the spread of warts from the hands to the mouth, it is essential to avoid biting the nails.
• Finally, it is very important to take care of personal hygiene and have regular check-ups with the dentist.