There is some evidence that oral HPV infection can be acquired through open-mouth kissing (deep or French kissing). Patients in the both the general (noncancer) and HPV-OPC populations may enquire whether they should avoid open-mouth kissing to prevent either acquiring or transmitting oral HPV infection. This best practice guideline is intended to assist physicians in advising patients regarding open-mouth kissing practices; that is, to kiss or not to kiss.
Open-mouth kissing is associated with oral HPV infection transmission based on limited evidence available thus far. However, considering the relative rarity of high-risk oral HPV infection, and the apparent infrequency with which infections transform to malignancy, physicians should not advise patients to avoid open-mouth kissing beyond usual safe sex practices. Regarding the special case of HPV-OPC patients, although their partners may have a slightly increased exposure to oral HPV infection, there is no evidence that this is due to transmission of tumor-associated HPV DNA rather than to a history of shared exposures. Although HPV-OPC patients and their partners should adhere to established HPV-related anogenital cancer screening guidelines, there is not enough evidence at this time to recommend that they change their kissing practice (Laryngoscope. 2019;129:4–5).