There is substantial confusion about oral HPV infections in general and oral warts in particular, as well as highly variable levels of training and understanding between various medical practitioners. The advice you received all those years ago, and to some extent in my reply in your previous thread, was based primarily on clinical experience -- that is, what doctors observed in their practices -- and not primarily on systematic research. Specialists in this area (which do not include many STD experts) classify several types of oral warts based on their appearance:  common warts (verruca vulgaris), squamous papillomas, multifocal epithelial hyperplasia, and condylomata accuminata (singular condyloma accuminatum), which tend to be caused by different types of HPV, and sometimes by types uncommonly transmitted sexually. It becomes more confusing because some experts consider squamous papillomas and condyloma accuminata to be the same thing. And there are varying opinions on sexual acquisition and transmission of oral HPV infections, and this might be different for the various oral papilloma types. (If you want to delve into the weeds, this is a pretty good and fairly recent published review of the topic:  https://pubmed.ncbi.nlm.nih.gov/30693456/.)

Given the inherent uncertainties, it isn't surprising that different doctors have differing perspectives and advice. Some ENT specialists have extensive experience treating patients with serious complications, especially throat and head and neck cancers, and might have more assertive advice about exposing others either by kissing or oral sex. This may be the case with your most recent ENT. But here's another perspective, which is most common among STD specialists and reflects my own advice to patients:  For every person with a visible or diagnosed oral wart, there are probably 10-20 others who have oral HPV infections that are equally transmissible to their partners. For those persons' current or potential sex partners, avoiding contact only with the visible wart person has little if any impact on their own risk of acquiring HPV. Even persons with fairly conservative sexual lifestyles are going to be repeatedly exposed. And even with the high risk HPV types -- those more likely to cause cancers -- the large majority of infected persons do not develop cancer. (This perspective is the same for HPV infections of any anatomic site, not just oral.)

Largely for these reasons, an entirely reasonable and healthy perspective is to more or less ignore HPV as a risk for partners. Everyone gets HPV; at least 90% of all sexually active persons become infected and many or most carry HPV viral DNA for life. Therefore getting and having HPV, whether genital, anal or oral, is a normal, expected, unavoidable consequence of being human. This doesn't mean prevention should be ignored, but the three main strategies are 1) for persistent, recurrent or otherwise atypical warts, get examined periodically by an expert to detect and effectively treat those lesions that become malignant or precancerous; 2) be vaccinated against HPV which, before exposure to the 9 HPV types covered by the vaccine offers 100% protection against these types, which cause 90% of warts and HPV cancers; and 3) for women to religiously follow guidelines for periodic Pap smears which, like strategy no. 1, allows early detection almost always in time to prevent serious outcomes. In addition, evolving evidence increasingly is that even among people already infected, vaccination reduces the frequency of reactivation and the risk of progression to warts or cancer (stress on reduce, nowhere near 100% protection). And these protections are even better than it might seem, because benefits are seen in regard to many HPV types not actually included in the vaccine.

With that long preamble, my first advice to you is to keep following up with ENT about your oral papilloma, perhaps eventually to surgically remove it but at a minimum to observe for changes suspicious for cancer or pre-cancer. Second, consider immunization if not already done:  protection isn't guaranteed, but the risk of both progression and transmission of your current HPV infection(s) might be lower. Third, I disagree with your latest ENT advice and see no need to start avoiding kissing and oral sex. This last might be modified for some partners, however. If aware of your wart or especially concerned about HPV, discuss the situation with them. Even if the chance of actual harm is little or none, they should be part of a mutual decision making process simply out of human kindness.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD 

Be clear -- the actual benefit to you isn't known precisely but probably is low to moderate at best. If I were in your situation, I probably wouldn't do it. But it's something to discuss with your doctor.

That concludes this thread. Thanks for the thanks.