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Mouth Diseases

Papules on hard palate

03/24/2008

Question:

For about the last 20 years (since I was 27), I`ve had a cluster of tiny papules on the roof of my mouth. They aren`t painful, and don`t seem to change at all, but they weren`t there before and have never gone away. I also have genital HPV, types 16 and 18, and HSV. Could the bumps on the roof of my mouth be HPV, and if so, do I need to worry about transmitting it to my two small children by kissing or sharing food or drinks? Also, what is the risk of cancer from oral HPV? Thanks very much!

Answer:

It would be important to know exactly where on the "roof of the mouth" these papules were located. Are they on the soft palate or hard palate? Are they adjacent to the gingivae (gums)? Have you worn any sort of dental device - retainer, mouthguard, denture, for example - that covered the area where the papules are? Also, do the papules have a smooth surface or a rough surface, like a cauliflower?

While we occasionally see HPV-induced lesions of the oral mucosa, these are not common. The risk of oral cancer from HPV appears to be much less than that associated with HPV infections of the uterine cervical mucosa. A very small subset of oral cancer patients - young adults with cancers of the oropharyngeal (tonsilar) area - seem to have a high frequency of HPV in their tumors, however this is a rather rare presentation of oral cancer. Ideally you should be seen by an oral pathologist for evaluation of the papules that you describe.

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Response by:

The Ohio State University Carl M Allen, DDS, MSD
Professor & Director of Oral & Maxillofacial Surgery and Pathology
Dental Faculty Practice
Section of Oral and Maxillofacial Pathology
College of Dentistry
The Ohio State University
Carl M Allen, DDS, MSD