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Oral wart - transmission and complications

Hello Dr.,

I have a very small wart on the roof of my mouth (it does not bother me in any way, and it is so small that I hardly ever remember its there) . An oral surgeon and my dentist both agreed that it was most likely a wart I acquired through oral sex at some point. 5 years ago I was diagnosed with genital warts in the perineum area and they were removed by freezing and before that treated with aldara. They never came back.  I decided not yet to have the oral wart removed because I do not want to undergo surgery in that location.  I have two questions:

1. I recently gave my boyfriend oral sex while he was wearing a condom. He then penetrated me with that same condom. Assuming the condom was intact ( which I believe it was), could he have transferred the wart virus inside my vagina via it getting on the condom?

2. As a result of having this oral wart ( i have had it now for over 2 years with no complication - it is miniscule), should this impact whether I can ever have children vaginally and also if I breastfeed in the future - could the virus be transmitted to the baby via breast milk?

Thank you so much.

R
1 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I'll try to help.

Oral warts are rare, especially in healthy people with normal immune systems.  (They are more common in people with things like terminal cancer, potent chemotherapy or immunosuppressive drugs, or advanced AIDS.)  A diagnosis confirmed by both a dentist and oral surgeon probably is reliable -- but even then, oral warts are infrequent enough that caution is required.  If there is any doubt, a biopsy might be necessary.  Further, it is very rare for warts to persist for 2 years -- so the duration makes me even more suspicious that this might not be a wart at all.

For now, though, I will assume the diagnosis is correct.  Unfortunately, however, there are no data on which to answer your question.  I am unaware of any research studies (or even informal reports) on the likelihood of transmission of oral warts.  There's probably a good chance it isn't a genital HPV type, i.e. not likely to be transmitted to someone's genital area.  (There are over 100 HPV types, of which probably 20 or so cause genital infection.  The rest do not, or only rarely.)  So the odds are good that you couldn't transmit this to your partner by oral sex even if you wanted to.  On the other hand, there is no way to guarantee that.  But you should also be aware that oral HPV infection (with genital types) isn't all that rare, mostly without visible warts -- and yet oral sex rarely seems to result in transmission of HPV to the genitals.  It may happen but probably is not very common.

1) I doubt the indirect transmission you suggest -- i.e. mechanical transfer of HPV from one part of the body to another, carried on a partner's penis -- ever occurs.  I can't say it's impossible. But if there is any risk at all for you getting a genital infection with this particular HPV strain, it somes mostly from auto-inoculation -- i.e. inadvertant hand contact with your own genitals or anal area after contact with your own mouth.

2) As I said, the 2 year duration makes me skeptical it's a wart.  But in any case, it will have no impact on safe pregnancy, labor, delivery, or breast feeding.  Even genital HPV infections rarely have such effects.

Bottom line:  I urge you to discuss the situation again with the oral surgeon, telling him or her what I said about the infrequency of oral warts and rarity of such prolonged warts.  If s/he recommends a biopsy to confirm the diagnosis, I recommend you do it.  In the meantime, I wouldn't worry about auto-inoculation, effects on pregnancy, or any other important health outcome.

Regards--  HHH, MD
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