Human papillomavirus is one of the most common sexually transmitted illnesses in humans, affecting nearly 80 million adults in the United States alone. The oral form of the illness causes HPV on the lips and oral warts. Over 7% of the sexually active population suffers from it, and it's caused by sexual contact and by indulging in oral sex with an affected individual. With over a hundred different types of the virus, there exist nearly 40 different strains that have been known to cause HPV on the lips and other forms of oral warts.   

Apart from warts in the mouth, HPV can also affect the throat, either resulting in warts, or oropharyngeal cancer. High-risk strains of the virus can lead to the development of cancer in the mouth and throat. The high-risk virus strains are also known to cause cervical, vulvar, and penile cancer in individuals that have been affected in their genital areas. In case you're curious about what HPV symptoms in the mouth involve, the further sections detail the various aspects of the infection and what it entails when it affects the oral cavity. 

Oral HPV’s Causes & Its Spread

There exist a number of ways through which human papillomavirus infects individuals, here are the common routes of transmission:

• The virus often enters either via mouth-to-mouth, or mouth-to-genital contact during sex. So in case you’ve been wondering if you can develop genital warts in the mouth, it certainly is possible. Both women and men can be infected when indulging in unprotected oral and penetrative sex, causing them to become exposed to the viral particles from the infected partner.
• HPV then enters an individual's system through cuts or sores present in the genitals, mouth, or throat.
• While healthy immune systems often fend off the virus within about a year or two, the infection can become pronounced in others that do not have a resilient immune mechanism. 
• Most cases of HPV do not even develop into the symptomatic stage - a reason for the widespread presence of the infection due to lack of detection. 
• Persistent HPV infections often lead to visible symptoms such as oral warts, HPV bumps on lips, HPV under the tongue, and HPV gums. Warts similar in appearance to those found in the oral cavity can be detected in people whose throats and genitals have been affected by the viral infection. 
• Human papillomavirus can also be transmitted from mother to child during pregnancy. 
• Also, there have been cases when the infection has spread from contaminated utensils and improperly maintained medical instruments that carried particles of the virus. 

HPV Symptoms in the Mouth & Throat 

Though HPV does not cause a symptomatic infection in most cases, lesions like warts do occur in areas of the mouth and throat. Common symptoms are: 

• Warts in the mouth 
• Bumps on the lips 
• HPV bumps on the tongue and under it 
• Cauliflower-like growths of the skin on the inner cheek 
• High-risk strains of HPV such as HPV-16 and HPV-18 can also lead to the development of oropharyngeal cancer. The malignant condition develops in about 15,000 people suffering from HPV of the mouth every year. Oropharyngeal cancer has its own set of symptoms. Some of these symptoms include: 
• Lymph node enlargement in the neck 
• Persistent sore throat 
• Large lumps on the tongue, the floor of the mouth, palate, cheek, or gums 
• Bloody discharge upon coughing 
• Earache that’s often only on one side and difficulty swallowing 
• Drastic weight loss
• Change in voice and hoarseness 
• Large tumors at the back of the throat or the base of the tongue and floor of the mouth can also obstruct the airway 
• Drooling 
• Swollen tonsils that are painless
• Lumps that do not resolve for more than 3-4 weeks
• Pain when chewing 
• White or red patches in the mouth 
• It’s important to reach out to your doctor or primary healthcare provider the moment you notice any of the above symptoms to receive specific and targeted care. 

The Appearance of HPV Symptoms in the Mouth

Though HPV often does not produce symptoms, the people that do experience symptoms of the condition report classical symptoms that are unique. The appearance of HPV involves oral warts and bumps on the lips, tongue, cheeks, palate, the floor of the mouth, and the back of the throat that look like:

• Red, pink, or white fleshy growths 
• Small & hard growths 
• Raised or flat lesions 
• Smooth, cauliflower-like, or calloused growths
• Slow growing projections 
• Either single or multiple warts

These oral warts are painless and are often noticed only upon direct observation or touch. Frequent visits to the doctor or dentist might help with the early detection and management of the oral HPV infection. 

Risk Factors of HPV in the Mouth

There exist several factors that can predispose individuals to an HPV infection. These are:

• Multiple sexual partners: Having multiple sexual partners increases the risk of HPV and HPV symptoms in the mouth. The risk is further heightened when one indulges in unprotected sex with multiple partners. 
• Oral sex: Oral sex heightens the risk of contracting oral human papillomavirus infections. Symptoms such as HPV on the lips and warts in the mouth often arise from oro-genital contact or mouth-to-mouth contact. Coming in contact with skin surrounding the genitals or the oral cavity of the individual can also lead to an infection. 
• Deep Kissing: Deep, open-mouth kissing can lead to an increased predisposition to HPV infection. 
• Sex: Men on average are more likely to contract HPV than women. 
• Smoking: Smoking makes the mucosa in the oral cavity more prone to cuts and sores. This makes it easier for the HPV particles to enter when they come in contact with an infected individual.
• Alcohol: Drinking, like smoking, increases the chances of getting cuts and sores in the mouth. Alcohol has a tendency to make your mouth dry, leading to an increased incidence of oral injury. Individuals that drink and smoke are at an even higher risk of contracting HPV and its symptoms like oral warts and HPV bumps on the lips. 

Diagnosis

• HPV’s characteristic appearance often allows dentists and doctors to make a diagnosis upon examination of the oral cavity. 
• While genital HPV can be detected in women using PAP smears, oral HPV infections require specific oral HPV tests that are not commonly included in screening tests and examinations. 
• The oral HPV test involves the PCR method which is based on the principle of creating multiple copies of the viral genome from an infected cell sample to improve the chances of detection. 
• Doctors often perform biopsies on lesions that seem like cancer. Certain tumors in the mouth and throat can come back positive for HPV. 
• Biopsies involve either the excision of a small part of the tissue from the suspected tumor or the aspiration of fluid from the suspicious tissue to examine under a microscope for the detection of malignant cells. 

Treatment for Oral HPV

• Since most infected individuals barely show any symptoms of HPV, alongside the propensity of the immune system to clear HPV infections, most people will not require treatment for this condition. 
• In case you do show symptoms of oral HPV such as oral warts, HPV bumps on the tongue, lip, gums, palate, or throat, your doctor might suggest surgical removal of these growths. 
• Topical ointments to address the growth of warts also exist, however, this treatment is tough to administer in individuals that have warts in the inaccessible parts of their oral cavities. 
• Newer modes of treatment such as cryotherapy have been shown to be very effective in addressing oral warts. The doctor will freeze the growths that appear in the mouth to harden the soft tissue that makes up the wart and excise it. 
• Injections that contain antiviral proteins created by the body’s immune system - called interferons, can be used to directly target warts and reduce their growth. 

The Outlook for Cancer Caused by HPV

• High-risk HPV strains can cause oropharyngeal cancer. A small percentage of individuals affected by HPV will contract cancer caused by the virus. 
• However, HPV-associated cancers are more responsive to anti-cancer treatment when compared to non-HPV malignancies in the oral cavity. 
• Management of HPV-associated cancer often involves surgery, chemotherapy, immunotherapy, and radiotherapy. Doctors can also suggest combinations of these modes of treatment depending on the extent of cancer. 

Preventing HPV

• For conditions like HPV, prevention is often better, since there exists no definitive resolution or cure for it. 
• Practicing safe sex with protection can help prevent HPV infections in both the genital and oral regions. Use condoms and dental dams, especially when indulging in oral sex.
• Limiting the number of sexual partners can also lower the risk of contracting oral HPV.
• Test regularly for STDs in case you’re involved with multiple sexual partners. 
• Pay regular visits to the dentist. 
• You can also search your mouth for any abnormalities or growths every month. 
• Vaccination options are now available for individuals up to 45 years of age. While the vaccine involves two shots for patients aged 15 and lower, for people over 15, the vaccination involves three shots instead. While the double-shot vaccination has injections placed 6 months apart, the latter vaccination regimen places three shots over 6 months. 
• The vaccinations are safe and also prevent oropharyngeal cancers arising from oral HPV. Oral HPV incidence is over 85% lower in individuals vaccinated against the condition. 

To know more about HPV and testing for the condition, get in touch with your doctor. If you notice any of the symptoms mentioned above, get in touch with your care provider immediately and seek treatment.