Skip to main content

Assessing Dental Students’ HPV Health Literacy and Intention to Engage in HPV-Related Oropharyngeal Cancer Prevention


Oropharyngeal cancer has become the new face of HPV-related cancers, and this alarming growth highlights the pivotal role dentists can play in prevention. This study aims to identify current HPV-related curricula taught across US dental schools and evaluate HPV health literacy and intention to engage in HPV prevention among US dental students. The dental school curricula included responses from 40 Academic Deans (61% response rate). The 4-item survey focused on understanding HPV-related content in dental school curricula and was administered via Qualtrics. A 31-item paper survey was administered to dental students (N = 109) at a southeastern dental school assessing HPV health literacy, scope of practice, willingness to administer HPV vaccine, self-efficacy in HPV prevention, and basic demographics. Data were collected between February and May 2018. Over 40 courses were identified and included HPV-related content in multiple disciplines including oral and general pathology, immunology, oral medicine, microbiology, infectious diseases, public health, and oral health management among others. Among dental students, over half were female (61%), non-Hispanic White (61%), with a mean age of 26 and in their first (48%) or third year of dental school (52%). Results indicate some HPV knowledge gaps. Most dental students believe HPV prevention is within their scope of practice; however, 56% reported feeling somewhat/not at all confident in recommending the vaccine and performing oral cancer exams. Our data supports the timeliness and need to strengthen HPV-related content in dental school curricula to effectively train and engage future dental providers in HPV prevention.

This is a preview of subscription content, access via your institution.


  1. 1.

    Young D, Xiao CC, Murphy B, Moore M, Fakhry C, Day TA (2015) Increase in head and neck cancer in younger patients due to human papillomavirus (HPV). Oral Oncol 51(8):727–730.

    Article  PubMed  Google Scholar 

  2. 2.

    Centers for Disease Control and Prevention (2017) HPV-associated cancer statistics, 2016. Accessed 8 March 2019

  3. 3.

    Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, Jiang B, Goodman MT, Sibug-Saber M, Cozen W, Liu L, Lynch CF, Wentzensen N, Jordan RC, Altekruse S, Anderson WF, Rosenberg PS, Gillison ML (2011) Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 29(32):4294–4301.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Gillison ML, Broutian T, Pickard RK, Tong ZY, Xiao W, Kahle L, Graubard BI, Chaturvedi AK (2012) Prevalence of oral HPV infection in the United States, 2009-2010. JAMA 307(7):693–703.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Lingen MW, Abt E, Agrawal N, Chaturvedi AK, Cohen E, D'Souza G, Gurenlian J, Kalmar JR, Kerr AR, Lambert PM, Patton LL, Sollecito TP, Truelove E, Tampi MP, Urquhart O, Banfield L, Carrasco-Labra A (2017) Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity: a report of the American dental association. J Am Dent Assoc 148(10):712–727. e10.

    Article  PubMed  Google Scholar 

  6. 6.

    Wissinger E, Griebsch I, Lungershausen J, Foster T, Pashos CL (2014) The economic burden of head and neck cancer: a systematic literature review. PharmacoEconomics 32(9):865–882.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Kepka D, Rutkoski H, Pappas L, Tay DL, Winkler JR, Dixon B, Velazquez A, Pinzon LM (2019) US oral health students’ willingness to train and administer the HPV vaccine in dental practices. Prev Med Rep 15:100957.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Centers for Disease Control and Prevention (2018) Cancers associated with human papillomavirus, United States—2011–2015 USCS data brief, no. 4. Atlanta, GA: Centers for Disease Control and Prevention

  9. 9.

    Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Mbaeyi SA, Fredua B, Stokley S (2018) National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years - United States, 2017. MMWR Morb Mortal Wkly Rep 67(33):909–917.

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Healthy People (2020) Immunization and infectious diseases. Available at: Accessed 4 April 2020

  11. 11.

    Allen JD, Othus MK, Shelton RC, Li Y, Norman N, Tom L, del Carmen MG (2010) Parental decision making about the HPV vaccine. Cancer Epidemiol Biomark Prev 19(9):2187–2198.

    Article  Google Scholar 

  12. 12.

    McRee AL, Gilkey MB, Dempsey AF (2014) HPV vaccine hesitancy: findings from a statewide survey of health care providers. J Pediatr Health Care 28(6):541–549.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Moss JL, Gilkey MB, Rimer BK, Brewer NT (2016) Disparities in collaborative patient-provider communication about human papillomavirus (HPV) vaccination. Human vaccines & immunotherapeutics 12(6):1476–1483.

    Article  Google Scholar 

  14. 14.

    Healthy People (2020) Oral health. Available at: Accessed 15 November 2019

  15. 15.

    American Dental Association’ Council on Scientific Affairs (2012). Statement on human papillomavirus and squamous cell cancers of the oropharynx. Available at: Accessed 5 May 2018

  16. 16.

    American Dental Association (2018) ADA adopts policy on HPV vaccination for the prevention of oral hpv infection. Available at: Accessed 5 January 2019

  17. 17.

    Yellowitz JA, Horowitz AM, Drury TF, Goodman HS (2000) Survey of U.S. dentists' knowledge and opinions about oral pharyngeal cancer. J Am Dent Assoc 131(5):653–661.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Maybury C, Horowitz AM, Yan AF, Green KM, Wang MQ (2012) Maryland dentists’ knowledge of oral cancer prevention and early detection. Journal of the California Dental Association 40(4):341–350

    PubMed  Google Scholar 

  19. 19.

    Alonge OK, Narendran S (2003) Opinions about oral cancer prevention and early detection among dentists practicing along the Texas-Mexico border. Oral Dis 9(1):41–45.

    CAS  Article  PubMed  Google Scholar 

  20. 20.

    Patton LL, Elter JR, Southerland JH, Strauss RP (2005) Knowledge of oral cancer risk factors and diagnostic concepts among North Carolina dentists. Implications for diagnosis and referral. J Am Dent Assoc 136(5):602–682.

    Article  PubMed  Google Scholar 

  21. 21.

    Yellowitz JA, Goodman HS (1995) Assessing physicians' and dentists' oral cancer knowledge, opinions and practices. J Am Dent Assoc 126(1):53–60.

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Yellowitz J, Horowitz AM, Goodman HS, Canto MT, Farooq NS (1998) Knowledge, opinions and practices of general dentists regarding oral cancer: a pilot survey. J Am Dent Assoc 129(5):579–583.

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Horowitz AM, Drury TF, Goodman HS, Yellowitz JA (2000) Oral pharyngeal cancer prevention and early detection. Dentists’ opinions and practices. J Am Dent Assoc 131(4):453–462.

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Cruz, G. D., Ostroff, J. S., Kumar, J. V., & Gajendra, S. 2005. Preventing and detecting Oral cancer. Oral health care providers’ readiness to provide health behavior counseling and oral cancer examinations. J Am Dent Assoc, 136(5), 594–682.

  25. 25.

    Gajendra S, Cruz GD, Kumar JV (2006) Oral cancer prevention and early detection: knowledge, practices, and opinions of oral health care providers in New York state. J Cancer 21(3):157–162.

    Article  Google Scholar 

  26. 26.

    Lehew CW, Kaste LM (2007) Oral cancer prevention and early detection knowledge and practices of Illinois dentists--a brief communication. J Public Health Dent 67(2):89–93.

    Article  PubMed  Google Scholar 

  27. 27.

    Clark NP, Marks JG, Sandow PR, Seleski CE, Logan HL (2014) Comparative effectiveness of instructional methods: oral and pharyngeal cancer examination. J Dent Educ 78(4):622–629

    Article  Google Scholar 

  28. 28.

    Daley EM, Thompson EL, Vamos CA, Griner SB, Vazquez-Otero C, Best AL, Kline NS, Merrell LK (2018) HPV-related knowledge among dentists and dental hygienists. J Cancer Educ 33(4):901–906.

    Article  PubMed  Google Scholar 

  29. 29.

    Burzynski NJ, Rankin KV, Silverman S Jr, Scheetz JP, Jones DL (2002) Graduating dental students’ perceptions of oral cancer education: results of an exit survey of seven dental schools. J Cancer Educ 17(2):83–84.

    Article  PubMed  Google Scholar 

  30. 30.

    Cannick GF, Horowitz AM, Drury TF, Reed SG, Day TA (2005) Assessing oral cancer knowledge among dental students in South Carolina. J Am Dent Assoc 136(3):373–378.

    Article  PubMed  Google Scholar 

  31. 31.

    Boroumand S, Garcia AI, Selwitz RH, Goodman HS (2008) Knowledge and opinions regarding oral cancer among Maryland dental students. J Cancer Educ 23(2):85–91.

    Article  PubMed  Google Scholar 

  32. 32.

    Dillman DA (2000) Mail and internet surveys: the tailored design method, 2nd edn. John Wiley & Sons Inc., New York

    Google Scholar 

  33. 33.

    Daley E, Dodd V, DeBate R, Vamos C, Wheldon C, Kline N, Smith S, Chandler R, Dyer K, Helmy H, Driscoll A (2014) Prevention of HPV-related oral cancer: assessing dentists’ readiness. Public Health 128(3):231–238.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Rutkoski H, Fowler B, Mooney R, Pappas L, Dixon BL, Pinzon LM, Winkler J, Kepka D (2018) Pilot test of survey to assess dental and dental hygiene student human papillomavirus-related oropharyngeal cancer knowledge, perceptions, and clinical practices. J Cancer 33(4):907–914.

    Article  Google Scholar 

  35. 35.

    Gilkey MB, Malo TL, Shah PD, Hall ME, Brewer NT (2015) Quality of physician communication about human papillomavirus vaccine: findings from a national survey. Cancer Epidemiol Biomark Prev 24(11):1673–1679.

    Article  Google Scholar 

  36. 36.

    Rowan SD, Hu SL, Brotzman JS, Redding SW, Rankin KV, Vigneswaran N (2015) Knowledge assessment of the dental community in Texas on the role of human papilloma virus in oropharyngeal cancer. Texas dental journal 132(8):528–536

    PubMed  Google Scholar 

  37. 37.

    Daley EM, Vamos CA, Thompson E, Vázquez-Otero C, Griner SB, Merrell L, Kline N, Walker K, Driscoll A, Petrila J (2019) The role of dental providers in preventing HPV-related diseases: a systems perspective. J Dent Educ 83(2):161–172.

    Article  PubMed  Google Scholar 

  38. 38.

    Polverini PJ (2012) A curriculum for the new dental practitioner: preparing dentists for a prospective oral health care environment. Am J Public Health 102(2):e1–e3.

    Article  PubMed  PubMed Central  Google Scholar 

  39. 39.

    Hosking YP, Cappelli D, Donly K, Redding S (2017) HPV vaccination and the role of the pediatric dentist: survey of graduate program directors. Pediatr Dent 39(5):383–389

    PubMed  Google Scholar 

  40. 40.

    National HPV Vaccination Roundtable. Cancer prevention through HPV vaccination: an action guide for dental health care providers. Available at: Accessed 30 March 2020

  41. 41.

    American Academy of Pediatrics. HPV Champion Toolkit. Available Accessed March 30, 2019

  42. 42.

    Patton LL, Villa A, Bedran-Russo AK, Frazier K, Khajotia S, Lawson NC, Park J, Lipman RD, Urquhart O, Council on Scientific Affairs (2020) An American dental association clinical evaluators panel survey. J Am Dent Assoc 151(4):303–304. e2.

    Article  PubMed  Google Scholar 

Download references


The authors would like to thank participants for their time and insight provided during this study.

Author information



Corresponding author

Correspondence to Essie Torres.

Ethics declarations

Conflict of Interest

All study documents and protocols were approved by the University and Medical Center Institutional Review Board (UMCIRB).

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Torres, E., Richman, A., Wright, W. et al. Assessing Dental Students’ HPV Health Literacy and Intention to Engage in HPV-Related Oropharyngeal Cancer Prevention. J Canc Educ (2020).

Download citation


  • HPV-related oropharyngeal cancer
  • Health literacy
  • Cancer prevention
  • Dental education