Oncogenic role of human papillomavirus in oral and oropharyngeal cancers: Molecular insights and clinical implications for dental practice.

Background

Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has emerged as a distinct and rising subset of head and neck malignancy, yet awareness among dental care practitioners remains limited. The authors synthesized the molecular biology of HPV-driven oral and oropharyngeal carcinogenesis, the diagnostic frameworks, and the evidence base for an expanded dental care practitioner role in detection, counseling, and prevention. TYPES OF STUDIES REVIEWED A structured literature search of PubMed-indexed English-language articles through March 2026 was conducted using search terms including HPV, oropharyngeal cancer, oral squamous cell carcinoma, p16 immunohistochemistry, HPV vaccination, and dental practice. Original research, systematic reviews, clinical guidelines, and population-level surveillance data were selected, with an emphasis on studies reporting clinical, diagnostic, or prevention outcomes applicable to dental settings. The authors did not include single case reports or small case series, and they excluded conference abstracts, editorials, and articles not available in the English language.

Results

HPV type 16 drives from 70% through 90% of HPV-positive OPSCCs through E6-mediated p53 degradation and E7-mediated retinoblastoma protein inactivation. HPV-positive OPSCC carries a better prognosis than HPV-negative disease but lacks a clinically identifiable premalignant phase and typically manifests at an advanced locoregional stage. P16 immunohistochemistry has reduced specificity in the oral cavity and tobacco-predominant populations. Prophylactic HPV vaccination had an 88% reduction in vaccine-type oral HPV prevalence among vaccinated young adults.

Conclusions

AND PRACTICAL IMPLICATIONS Dental care practitioners can contribute meaningfully to earlier detection through systematic clinical examination, cervical lymph node palpation, timely specialist referral, patient counseling on HPV transmission, and vaccination advocacy.